Sperm Production and long term finasteride use - study....

[harold]

Dont know if this has done the rounds yet....

Arch Androl. 2007 Jul-Aug;53(4):229-33.Click here to read Links
Spermatozoa and chronic treatment with finasteride: a TEM and FISH study.
Collodel G, Scapigliati G, Moretti E.

Department of Surgery, Biology Section, Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy.

Finasteride is a specific inhibitor of the 5alpha reductase enzyme originally approved for the treatment of benign prostatic hypertrophy and also for the treatment of androgenetic alopecia (Androgenetic Alopecia) in men at a dose of 1 mg/day. We report on three cases of young men recruited at our Centre for Male Infertility who had used finasteride for five years. Semen quality was investigated by light microscopy to evaluate sperm concentration and motility. Sperm morphology was performed by transmission electron microscope (TEM) and the data were analyzed. The presence of Y microdeletions was investigated by PCR. Meiotic segregation was explored by fluorescence in situ hybridization (FISH). Patient 1 was azoospermic, patients 2 and 3 showed a normal sperm concentration and severely reduced progressive motility. TEM analysis revealed altered sperm morphology consistent with necrosis and FISH data revealed elevated diploidy and sex chromosome disomy frequencies. This examination was repeated 1 year after the men had suspended the use of finasteride, without receiving any other treatment. A recovery of spermatogenetic process was observed. Motility and morphology improved whereas the meiotic pattern did not change presenting elevated diploidy and sex chromosome disomy frequency.

 

[mulder]

That's pretty troubling. Here's a study from earlier this year:

The effect of 5alpha-reductase inhibition with dutasteride and finasteride on semen parameters and serum hormones in healthy men.
Amory JK, Wang C, Swerdloff RS, Anawalt BD, Matsumoto AM, Bremner WJ, Walker SE, Haberer LJ, Clark RV.

Department of Medicine, Veterans Affairs-Puget Sound Health Care System, University of Washington, Seattle, WA 98195, USA.

CONTEXT: Dutasteride and finasteride are 5alpha-reductase inhibitors (5ARIs) that dramatically reduce serum levels of dihydrotestosterone (DHT). OBJECTIVE: Because androgens are essential for fertility, we sought to determine the impact of 5ARI administration on serum testosterone (T), DHT, and spermatogenesis. DESIGN, SETTING, SUBJECTS, AND INTERVENTION: We conducted a randomized, double-blinded, placebo-controlled trial in 99 healthy men randomly assigned to receive dutasteride (D; 0.5 mg) (n = 33), finasteride (F; 5 mg) (n = 34), or placebo (n = 32) once daily for 1 yr. MAIN OUTCOME MEASURES: Blood and semen samples were collected at baseline and 26 and 52 wk of treatment and 24 wk after treatment and were assessed for T, DHT, and semen parameters. RESULTS: D and F significantly (P < 0.001) suppressed serum DHT, compared with placebo (D, 94%; F, 73%) and transiently increased serum T. In both treatment groups, total sperm count, compared with baseline, was significantly decreased at 26 wk (D, -28.6%; F, -34.3%) but not at 52 wk (D, -24.9%; F, -16.2%) or the 24-wk follow-up (D, -23.3%; F, -6.2%). At 52 wk, semen volume was decreased (D, -29.7%; F, -14.5%, significantly for D) as was sperm concentration (D, -13.2%; F, -7.4%, neither significant). There was a significant reduction of -6 to 12% in sperm motility during treatment with both D and F and at follow-up. Neither treatment had any effect on sperm morphology. CONCLUSIONS: This study demonstrates that the decrease in DHT induced by 5ARIs is associated with mild decreases in semen parameters that appear reversible after discontinuation.

 

[SoThatsLife]

So that means no kids for medicated baldies?

 

[CCS]

If 20% is not significant, that means there was a very wide spread in both the placebo and treated groups. The finasteride group was very reversible. All reductions were around 30%. I think that leaves enough of a window to get some sperm where they need to go. Were any of them mutated? Birth defects?

 

[Jkkezh]

Dont know if this has done the rounds yet....

Arch Androl. 2007 Jul-Aug;53(4):229-33.Click here to read Links
Spermatozoa and chronic treatment with finasteride: a TEM and FISH study.
Collodel G, Scapigliati G, Moretti E.

Department of Surgery, Biology Section, Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy.

Finasteride is a specific inhibitor of the 5alpha reductase enzyme originally approved for the treatment of benign prostatic hypertrophy and also for the treatment of androgenetic alopecia (Androgenetic Alopecia) in men at a dose of 1 mg/day. We report on three cases of young men recruited at our Centre for Male Infertility who had used finasteride for five years. Semen quality was investigated by light microscopy to evaluate sperm concentration and motility. Sperm morphology was performed by transmission electron microscope (TEM) and the data were analyzed. The presence of Y microdeletions was investigated by PCR. Meiotic segregation was explored by fluorescence in situ hybridization (FISH). Patient 1 was azoospermic, patients 2 and 3 showed a normal sperm concentration and severely reduced progressive motility. TEM analysis revealed altered sperm morphology consistent with necrosis and FISH data revealed elevated diploidy and sex chromosome disomy frequencies. This examination was repeated 1 year after the men had suspended the use of finasteride, without receiving any other treatment. A recovery of spermatogenetic process was observed. Motility and morphology improved whereas the meiotic pattern did not change presenting elevated diploidy and sex chromosome disomy frequency.

Can someone explain the results of this study in plain english? Especially the last sentence about meiotic blabala en elevated diploidyblabla

 

[ANDREW_J_I]

ur missing the point guys....

poor mobility AND poor morphology is not sumthing u wanna mess with.

It might not be reversible after a year on finasteride. What might happen after 5 years? What if ur sperm aint up to much regularly, then finasteride is gonna totally ruin it.

This is the reason i stopped taking finasteride, was the single main reason.

 

[CCS]

better to adopt than to not father at all. If i"m not on finasteride, I won't get to pass my genes on.

 

[StoptheMadness]

Dont know if this has done the rounds yet....

Arch Androl. 2007 Jul-Aug;53(4):229-33.Click here to read Links
Spermatozoa and chronic treatment with finasteride: a TEM and FISH study.
Collodel G, Scapigliati G, Moretti E.

Department of Surgery, Biology Section, Interdepartmental Centre for Research and Therapy of Male Infertility, University of Siena, Policlinico Le Scotte, Viale Bracci 14, 53100 Siena, Italy.

Finasteride is a specific inhibitor of the 5alpha reductase enzyme originally approved for the treatment of benign prostatic hypertrophy and also for the treatment of androgenetic alopecia (Androgenetic Alopecia) in men at a dose of 1 mg/day. We report on three cases of young men recruited at our Centre for Male Infertility who had used finasteride for five years. Semen quality was investigated by light microscopy to evaluate sperm concentration and motility. Sperm morphology was performed by transmission electron microscope (TEM) and the data were analyzed. The presence of Y microdeletions was investigated by PCR. Meiotic segregation was explored by fluorescence in situ hybridization (FISH). Patient 1 was azoospermic, patients 2 and 3 showed a normal sperm concentration and severely reduced progressive motility. TEM analysis revealed altered sperm morphology consistent with necrosis and FISH data revealed elevated diploidy and sex chromosome disomy frequencies. This examination was repeated 1 year after the men had suspended the use of finasteride, without receiving any other treatment. A recovery of spermatogenetic process was observed. Motility and morphology improved whereas the meiotic pattern did not change presenting elevated diploidy and sex chromosome disomy frequency.

It seems this study should get some more discussion here.

taking this at face value, 1 patient had no measureable sperm count (azoospermic) and the other have sperm but can't impregnate an egg (severely reduced motility). Is this study implicitly saying young men (whatever that age is??) cannot have children when on finasteride for at least 5 years? It appears so if this study was all you had.

 

[sphlanx2006]

This study is preety troubling but i would like some of the experts to translate it in plain english.

I think that if the results are so serious like they seem to be at a non-expert eye, finasteride should be banned from use for Androgenetic Alopecia.

 

[ginner]

It's definitely something to be mindful of but remember that this isn't an ideal study. From reading the abstract it looks as though it only included three people. They presented to the clinic with infertility and a history of finasteride use. There's no real way of knowing whether the finasteride was responsible for their infertility - though the fact that their sperm health improved after ceasing finasteride would suggest that it did play a role. This study does not use a control group and the researchers and patients are not blind to the variables.

 

[harold]

I think ginner knocked it on the head. Its not a controlled study - it is only three people but the fact that some/all of the parameters they were looking at recovered after finasteride discontinuation suggests a link. It also suggests that while finasteride might be fine if you are a guy with a nice normal sperm count at baseline but if you have borderline sperm production finasteride might push you over the edge. Whats more troubling as Andrew_J_I pointed out also is the highher occurence of sperm with poor morphology and/or motility - ie badly developed and/or poorly moving.
Studies like these aren't like the big ones that drugs get when they go for FDA approval. On the other hand they are useful for practitioners and researchers looking at the literature as being suggestive of stuff that might have slipped by. And from other areas they tend to reflect IMO more some of the real world side effects that people report with pharmaceuticals that are played down by the pharma funded studies.
So its not a hit the panic button thing necessarily. But its something to be aware of and possibly concerned about if these issues are important to you.
hh
Am speaking as a guy on finasteride right now who has been for most of the past 6 years for what its worth.

 

[CCS]

I don't care if I need 10 shots instead of one to get the job done. I care if there will birth defects when the job is done. Do you think finasteride causes birth defects?

 

[matt_1_]

Troubling news...

then again...here's my personal story...been on finasteride for 6 years now (got more hairs than cousins and bro)..got my GF pregnant...

 

[SoThatsLife]

Just wonder about the FDA studies? they wouldt have included this wouldnt it? And its allowed in all countries in the world except norway where you have to get a special form to get it. it really dosent possible that countries would allow drugs on the marked that would risk the chances of birth defect and killing semen.

And Mercks havnt written any of the papers that come with the drug, so they havent even secured the company for any lawsuit.

 

[michael barry]

patients 2 and 3 showed a normal sperm concentration

Isn't that pretty much all you need to know?


THREE measley men were tested. Finasteride is out of your system in days. Men have been on Proscar for almost 20 years. You dont hear about tons of them who are having fertility problems. Every time you ejaculate into your wife, you put tons of sperm in her.......................even if you had 30 percent less, it would still be plenty enough to get her pregnant----especially with the usage of conception techniques like her holding her pelvis upwards after you ejaculate to facilitate more sperm going up her fallopian tubes, etc.


I really wouldn't worry about this.



Remember gents........................some men are born with NO ALPHA FIVE TYPE TWO ENZYME at all, and they lead normal healthy lives after puberty when they were pseudo hermaphrodites until then with ambiguious genitalia. I wouldn't worry one bit unless I was having sexual side effects or gyno----which are not all that common.

 

[Bryan]

Remember gents........................some men are born with NO ALPHA FIVE TYPE TWO ENZYME at all, and they lead normal healthy lives after puberty when they were pseudo hermaphrodites until then with ambiguious genitalia. I wouldn't worry one bit unless I was having sexual side effects or gyno----which are not all that common.

Also, I'm pretty sure that some of the pseudos have fathered children.

 

[Lucky_UK]

On the plus side finasteride may work well as a contraceptive :smack:

 

[Whyatt]

especially with the usage of conception techniques like her holding her pelvis upwards after you ejaculate to facilitate more sperm going up her fallopian tubes, etc.

michael barry..

I'm trying to picture this, No luck though

Can you please clarify your point with some kind of illustration? I think the rest of the guys in here agrees. :agree:


About Proscar and it's twenty years anniversary..do we have any studies about long-term prosar users focusing on semen? I guess most lads using proscar for BPH, are pretty old and not that into getting kids anyway + age must have some kind of negative interference on those little swimming bastards..?

 

[stampede]

If dutasteride makes me infertile (which it should, if finasteride does), it's probably for the best.

I don't want to father any kids who lose their hair.

 

[StoptheMadness]

patients 2 and 3 showed a normal sperm concentration

Isn't that pretty much all you need to know?


THREE measley men were tested. Finasteride is out of your system in days. Men have been on Proscar for almost 20 years. You dont hear about tons of them who are having fertility problems. Every time you ejaculate into your wife, you put tons of sperm in her.......................even if you had 30 percent less, it would still be plenty enough to get her pregnant----especially with the usage of conception techniques like her holding her pelvis upwards after you ejaculate to facilitate more sperm going up her fallopian tubes, etc.


I really wouldn't worry about this.



Remember gents........................some men are born with NO ALPHA FIVE TYPE TWO ENZYME at all, and they lead normal healthy lives after puberty when they were pseudo hermaphrodites until then with ambiguious genitalia. I wouldn't worry one bit unless I was having sexual side effects or gyno----which are not all that common.

as always, thanks for your input