Finasteride use in the male infertility population effects on semen and hormone parameters

Finasteride may cause reduced sperm counts in some men, but sperm counts improve dramatically for most after discontinuation. Finasteride should be used with caution in men who desire fertility.

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Mary K. Samplaski, M.D., Kirk Lo, M.D., Ethan Grober, M.D., Keith Jarvi, M.D.

Volume 100, Issue 6, Pages 1542-1546, December 2013



To determine the degree of improvement in semen parameters after finasteride discontinuation.


A prospective database of men presenting for a fertility evaluation was analyzed for semen and hormone parameters before and after discontinuation of finasteride.


A male infertility specialty clinic.


Men presenting for fertility evaluation from 2008–2012 on finasteride.



Main Outcome Measure(s):

Semen and hormone parameters before and after discontinuation of finasteride.


At presentation, 27 (0.6%) of 4,400 men on finasteride. The mean duration of treatment with finasteride was 57.4 months, and mean dose was 1.04 mg/day. There was an average 11.6-fold increase in sperm counts after finasteride discontinuation. Of the men with severe oligospermia (15 M/mL after finasteride cessation. No man had a decrease in sperm count. There was no change in hormone parameters, sperm motility, or sperm morphology.


Finasteride, even at low doses, may cause reduced sperm counts in some men. In this population, counts improved dramatically for the majority of men after finasteride discontinuation. The hormone parameters, sperm motility, and sperm morphology were unchanged after cessation. Finasteride should be discontinued in subfertile men with oligospermia, and used with caution in men who desire fertility.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.