Schill W B, Przybilla B
Z Hautkr. 1985 Jul 1;60(13):1066, 1069-76, 1079-82.
Side effects of drugs on male fertility occur more often than they are expected to. In general, they are not recognized till during andrological examination on account of a barren marriage. A transient or permanent inhibition of male fertility by drugs is possible, if one of the following functions interferes: spermatogenesis, sperm maturation within the epididymis, sperm transport, sperm metabolism and motility, semen liquefaction, capacitation, acrosomal reaction, or ovum penetration. Best known is the impairment of spermatogenesis by direct inhibition of the germinal epithelium (antispermatogenic agents: cytostatics, immunosuppressive agents, psychopharmacological compounds, antibiotics) or indirectly by influencing the axis between hypothalamus, pituitary gland, and gonads (hormones: estrogens, gestagens, androgens, anabolics, antiandrogens). Sperm transport may be impaired by neuroleptic drugs, tricyclic antidepressants, antihypertensive drugs like guanethidine, and ganglionic blocking agents. Inhibition of sperm motility is possible by antibiotics, psychopharmacological agents, anthelmintics, and beta receptor blockers. In future, it will therefore be necessary to pay more attention to side effects of drugs on male fertility, particularly with regard to patients at the age of reproductiveness.
药物对男性生育能力的副作用比预期更为常见。一般来说，由于婚姻不育，这些副作用直到进行男科检查时才会被发现。如果以下任何一种功能受到干扰，药物就可能对男性生育能力产生短暂或永久性抑制：精子发生、附睾内精子成熟、精子运输、精子代谢与活力、精液液化、获能、顶体反应或卵子穿透。最广为人知的是通过直接抑制生精上皮（抗生精剂：细胞抑制剂、免疫抑制剂、精神药物、抗生素）或间接影响下丘脑、垂体和性腺之间的轴（激素：雌激素、孕激素、雄激素、同化激素、抗雄激素）来损害精子发生。抗精神病药物、三环类抗抑郁药、胍乙啶等降压药以及神经节阻断剂可能会损害精子运输。抗生素、精神药物、驱虫药和β受体阻滞剂可能会抑制精子活力。因此，未来有必要更加关注药物对男性生育能力的副作用，尤其是对于处于生育年龄的患者。
