Hair loss treatments such as oral finasteride (1 mg also brand name Propecia or 5 mg brand name Proscar) is common in men seeking paternity. There has been quite a bit of research looking at the impact of finasteride on male fertility and semen parameters. Here are the take-home points:
- As a general rule of thumb, finasteride-related medications may cause a ~30% decrease in total sperm counts; however, this is generally reversible.
- Not all men are susceptible or sensitive to the effects of finasteride; however, for men who are; these can cause a decrease in sperm parameters.
- I recommend men to discontinue finasteride-related medications at least 3 months before conception
- Finasteride has other sexual side effects such as decreased libido and erectile dysfunction which may also result in decreased frequency of intercourse and subsequent fecundity
References:
Kian Asanad et al. Medications with Male Reproductive Side Effects. Encyclopedia of Reproduction, 3rd edition. 2024
