Does methylphenidate use affect sperm parameters in patients undergoing infertility investigation? A retrospective analysis of 9769 semen samples
- 1 August 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Archiv für Gynäkologie
- Vol. 304 (2), 539-546
- https://doi.org/10.1007/s00404-020-05938-z
Abstract
Objectives Methylphenidate (MPH) is the most widely prescribed therapy for attention deficit hyperactivity disorder. Animal studies have shown a potential adverse effect of MPH exposure on male fertility. We examined the impact of MPH on human male sperm parameters. Design Sperm parameters of 9769 samples from patients 18 years of age or older, collected as part of the basic evaluation of couples referred to the Infertility Clinic were analyzed retrospectively. We divided the study population into three groups according to MPH purchasing information: MPH purchased <= 90 days prior to sperm analysis-current users (n = 83), MPH purchased > 90 days prior to sperm analysis-past users (n = 293), and MPH-naive patients (n = 9393). Methods All sperm samples were analyzed by the same laboratory technician team for the following routine parameters: semen volume, sperm concentration, percentage of motile sperm, and percentage of normal morphology according to World Health Organization. The analysis of the samples was completed by evaluation of total sperm count, total sperm motility, and percentage of fast and slow motile cells. Sperm morphology was evaluated by a laboratory technician using methodological examination according to the strict Kruger-Tygerberg criteria. Results Methylphenidate exposure did not affect sperm morphology but was associated with increased sperm concentration as well as increased total sperm count and total sperm motility among current and past users compared with MPH-naive patients. In particular, progressive motility and total motile sperm count were significantly increased following MPH use. A multivariate analysis adjusting for age and current smoking was conducted, further supporting a positive correlation between current MPH use and increased values of total sperm count and total sperm motility. Limitations Our study has several inherent weaknesses, foremost of which is its retrospective nature. Another notable weakness is that medication purchasing data may not accurately reflect MPH exposure in the study population. Patients may be purchasing MPH and not taking it as prescribed. Conclusions In the present study, we could not demonstrate a negative impact of methylphenidate treatment on sperm parameters in adults with ADHD. Hence, we may assume that methylphenidate does not negatively affect male fertility.This publication has 33 references indexed in Scilit:
- An Assessment of New Sperm Tests for Male InfertilityUrology, 2011
- The Presence and Function of Dopamine Type 2 Receptors in Boar Sperm: A Possible Role for Dopamine in Viability, Capacitation, and Modulation of Sperm Motility1Biology of Reproduction, 2009
- The Cycle of the Seminiferous Epithelium in Humans: A Need to Revisit?Journal of Andrology, 2008
- Pharmacokinetics, dose‐range, and mutagenicity studies of methylphenidate hydrochloride in B6C3F1 miceEnvironmental and Molecular Mutagenesis, 2008
- Differential Pharmacokinetics and Pharmacodynamics of Methylphenidate EnantiomersJournal of Clinical Psychopharmacology, 2008
- Increase of oxidative stress in human sperm with lower motilityFertility and Sterility, 2008
- Juvenile toxicity assessment of d,l‐methylphenidate in ratsBirth Defects Research Part B: Developmental and Reproductive Toxicology, 2008
- Relationship between age and semen parameters in men with normal sperm concentration: analysis of 6022 semen samplesAndrologia, 2007
- Short‐Term Effects of Adolescent Methylphenidate Exposure on Brain Striatal Gene Expression and Sexual/Endocrine Parameters in Male RatsAnnals of the New York Academy of Sciences, 2006
- Atomoxetine Increases Extracellular Levels of Norepinephrine and Dopamine in Prefrontal Cortex of Rat A Potential Mechanism for Efficacy in Attention Deficit/Hyperactivity DisorderNeuropsychopharmacology, 2002