Any sperm experts out there?! Qn re Finasteride

[A1983]

OH is taking Finasteride for male patterned baldness-it actually has worked brilliantly! It's prescribed in larger doses for enlarged prostates and also in smaller doses for hair growth in men. He's been taking it for about 9 months.

We were going to start ttc in 2 weeks but now I'm worried as I've read that the drug can affect the sperm (in quantity) but more importantly can cause birth defects. It's a temporary side effect and OH has stopped as of today-ill contact GP tomorrow, but sometimes they don't know themselves for sure.

How long are sperm in the testes for? I thought the current sperm take 3 months mature/live in the testes so does that mean we have to wait 3 months until we have unaffected sperm?! (I've read mixed things-the longest time suggested is one month, other studies say sperm are not affected in a way that causes birth defects). I know people have said if you've used a hot tub, you'd not have any good sperm for the next 3 months...which also isn't great as were due to go to one next week! I suppose if it's only the mature sperm that are affected then after a month they would be no more...

Thank you

 

[A1983]

No one have any experiences with finasteride/propecia?

 

[skyesmom]

it doesn't take 3 months for sperm to mature!! they are constantly produced and replenished after sex.
just think of how many times a man can ejaculate per day... i assure you, if it were 3 months, an average teenager would be left out of any sperm within 3-4 days.

maybe consult a couple of doctors; pharmacists as well may know more detailed information on the specific drug itself rather than the doctors. but in case of birth defects risk, maybe your OH would need to do a regular "clearout" for some weeks if you know what i mean

 

[A1983]

Yep completely know what you mean ha ha! I thought the same! But spermatogenesis-the development of a sperm from immature to mature is 64-70 days...so it's ONLY if this medication affects both immature developing sperm (as they contain dna from day 1) that I'd have to wait 3 months...but yes ill be ringing around today and will let you know! Thank you for your help

 

[skyesmom]

true true spermatogenesis lasts a while and is an ongoing process!

i have no experience with that particular drug, but i'd think it would affect it at a later stage. if it would occur at the spermatogonium stage, the birth defects would turn into a permanent consequence (as when the spermatogonium splits, one daughter cells go on into dividing further into sperms, and the other goes onto being a new spermatogonium "stock"... and if the drug would influence it at this stage already, then the "stock" spermatogoni cells would also be affected and affect all the future generations.)

in any case, regular "clearing" should help as the production of new fresh and unaffected sperm slows down if you don't (which is why they recommend to wait no longer than a week to bring sperm for the fertility analysis!)

 

[A1983]

Fantastic reply! You're a very knowledgeable lady! So in your opinion with regular 'clearing' how long do you think should be ok to wait? AF is due this weekend so 3 weeks to ttc time?!

 

[A1983]

Just spoke to a embryologist who didn't know for sure, but suggested it best to wait the 3 months just incase the sperm are affected by the medication Affected sperm can lead to 1) not getting pregnant 2) birth defects or 3) miscarriage. So after Christmas it is. I could kill OH!! I asked him if the tablets affected fertility before he started them and he said no, based on the GP not telling him. I would have at least read the leaflet of medication I was taking!!!

 

[A1983]

Ps! She's just phoned me back (she said she was interested in the topic and wanted to look at some research and would phone me if she found anything) and said she's found no research to show Finasteride causing birth defects when taken prior to conceiving-ie the immediate 3 months...or even if a man wanted to continue taking them whilst conceiving/partnet became pregnant. She added if a man already has 'spermatogenesis/sperm issues' ie morphology and amount then Finasteride can worsen this. Whilst taking it. My OH's sperm was analysed previously and was within the normal parameters. Sooooo...maybe we can start in 3 weeks!!! It's tough...

 

[skyesmom]

oh God!

that is a really tough decision there indeed. and such an insane negligence of your OH's GP. Sure, your OH should have read the leaflet BUT - if he asked his GP about the fertility issues it may cause, and the guy reassured him it didn't cause ANY, well... that's a SEVERE lack of information and negligence from a doctor tbh.

also because of that reason, i'd get at least another two opinions from another embryologist. the drug leaflets work like this: they are OBLIGED to put ANY side effect, even if it had occurred only once in the entire history of that medicine being used on the market, and they have to do this by law. for some side effects there is a lot of study available, for others not.

anyway just looked it up and the only 100% sure information about fenasteride causing birth defects refers to fenasteride use IN WOMEN (and this is what is reported on the leaflet i presume. it says pregnant women shouldn't take it, but it says nothing about men who are TTC).

meaning, if YOU take it during pregnancy, it is known to cause birth defects to male fetuses (since it inactivates an enzyme that converts testosterone into a more powerful variant of it; so the overall effect of the drug is to inhibit male hormones... which is NOT good for a developing male baby of course and it damages their external genitalia... :/ ).

then i googled finasteride and spermatogenesis to see if there is any info on birth defects that occur due to using finasteride while TTC or before and there is barely any info and the stuff that is there is contrasting stuff. Several articles say it really worsens male fertility and lowers the sperm count drastically:
https://medind.nic.in/jbd/t11/i2/jb...ww.propeciahelp.com/forum/viewtopic.php?t=245
https://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-86502008000300012

there is then this study that says the contrary:
https://onlinelibrary.wiley.com/doi/10.2164/jandrol.109.009381/pdf

If i were you, i'd get your OH tested and check his sperm count and sperm quality as well.

THEN... since the data there is a bit confusing and the medical community seems not to have any clear idea or info on this particular issue...

...i know three months seem to be AGES when TTC. BUT...

...both birth defects and miscarriage are life-long consequences you might have to deal with afterwards, in case they happen :/ and not only you and OH, but your baby as well.

So if i were you, i'd wait and avoid being a lab rat for pharma industry. your family and your future baby don't need to be a part of their statistics and trials, even if everything goes well.

your OH could also have monthly check ups to monitor the sperm count and the quality of his swimmers; like this, you guys could have a chance to see if suspending the drug makes any difference over time.

 

[Preggos]

I wouldn't worry, my husband took Finasteride (1mg tab) and I got pregnant both times and no issues whatsoever with baby. Our GP said the risk is so low.

There is a ton of research about Finasteride and its effect on sperm, please go on google and have a look.

We had the same freakout as you, however, research shows that the amount of Finasteride being taken is so small that it is virtually impossible to cause any issues to a man's sperm.

Word of caution however, you should NEVER handle your husbands medication or let it touch your skin, and don't ever accidentally take it yourself (I know you have more common sense than this, but just FYI), as its affect in woman is much strong and much more dangerous.

Furthermore, finasteride has only been shown to cause issues with male fetuses, not female.

Please use caution however and talk to your GP before you go ahead. Truly inform yourself beyond this message board.

 

[A1983]

Thank you Skyesmom and Preggos. Very helpful and informative and so nice of you to look up sites SM.

Yes we're seeing GP tomorrow and have phoned a fertility clinic and spoken to an embryoologist-so we are ensuring we are truly informed.

Is your child a boy preggos? Yes ive read every piece of research! A lot is conflicting hence my next approach was to ask if anyone had direct experience on here. I've now heard from many ppl whose babies are fine when they were conceived on finasteride, and I don't believe there is one case of a baby boy being affected by finasteride-but the risks are as you say written about a lot. I just couldn't find anything on sperm being affected in a way to cause birth defects...only one piece of research saying it can do but not explaining how or how they tested this-ie humans. OH has stopped taking the tablets now anyway. He can start once im pregnant and no I won't touch the tablets. Did it take you any longer to conceive do you think? A small proportion of men have lower sperm counts.

The other issue is we'll be in a hot tub next weekend-so conception may be off the cards for the next three months anyway which is annoying!

 

[skyesmom]

by the way, the birth defect research on taking finasteride during pregnancy was done only in rats...

...so all the information about finasteride causing birth defects only in male fetuses derives from research on rats and there is no data on it for humans.
(here again the research refers to finasteride taken directly by the expecting mother, not by the father before conception)

same with finasteride being absorbed through the skin (absorbtion is minimal, but still better avoid it completely just to be on the safe side).

finasteride has been on the market for a while now so i guess if it caused birth defects by altering the sperm, i think people would have noticed it and reported it by now.

 

[A1983]

Fabulous, think we've reached a positive conclusion! Thank you very much for your help

 

[Preggos]

by the way, the birth defect research on taking finasteride during pregnancy was done only in rats...

...so all the information about finasteride causing birth defects only in male fetuses derives from research on rats and there is no data on it for humans.
(here again the research refers to finasteride taken directly by the expecting mother, not by the father before conception)

same with finasteride being absorbed through the skin (absorbtion is minimal, but still better avoid it completely just to be on the safe side).

finasteride has been on the market for a while now so i guess if it caused birth defects by altering the sperm, i think people would have noticed it and reported it by now.

Agreed - Finasteride has been available since the early 90's...and is taken by million of men during the time in their life that they likely are fathering children (mid to late 20's to early 30's). If it was causing wide spread deformities or birth defects, then I am sure we would have heard things about this or there would have been a wide scale reporting of this.

Once thing I did read though is that you should avoid intercourse during Weeks 9 to 14, which are the weeks that the sex organs of the baby are created...if you are having a boy, might want to wait until sex organs are formed, even though the risk itself is virtually none...but if you just want to take all precautions, use a condom or just abstain for a few weeks.

BTW - we had a baby girl and we don't know the sex of my current pregnancy, I am in Week 8 and we are going to use condoms for the next 4-6 weeks just to be extra safe.

 

[Preggos]

It did not take us long to conceive AT all. My husband has been taking the pills since he was 17 years old, 1 mg per day. He was 28 when we conceived baby #1 (didn't happen 1st try, 2nd try we got pregnant) and was 30 when we conceived baby #2 (happened on first try after agreeing to try again).

The only side effect from the pill my husband has noticed is a slightly decreased sex drive...but not enough to be detriment to our sex life.

 

[skyesmom]

ahhh so great to know it worked so well for you Preggo such a relief when the babies don't make you wait for ages to have them!

and A1983, good luck with everything! i hope you get your BFP soon!

 

[A1983]

Thank you ladies!