Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Andrologia. 2022 Mar;54(2):e14315. doi: 10.1111/and.14315. Epub 2021 Nov 23.
This study examined the relationship between stimulant medications used for the treatment of attention deficit hyperactivity disorder and semen parameters. We performed a retrospective cohort study at a large, academic institution between 2002 and 2020. We included men with a semen analysis without prior spermatotoxic medication use, empiric medical therapy exposure or confounding medical diagnoses (varicocele, Klinefelter's syndrome, cryptorchidism, cystic fibrosis, diabetes, cancer or cancer-related treatment, and azoospermia). Men were stratified by stimulant exposure (methylphenidate or amphetamines). A multivariable linear regression was fit to assess the association between individual semen parameters, age, stimulant exposure and non-stimulant medication use. Of 8,861 men identified, 106 men had active prescriptions for stimulants within 90 days prior to semen testing. After controlling for age and exposure to non-stimulant medications, stimulant use was associated with decreased total motile sperm count (β: -18.00 mil/ejaculate and standard error: 8.44, p = 0.033) in the setting of decreased semen volume (β: -0.35 ml, and standard error: 0.16, p = 0.035), but not sperm concentration, motility and morphology. These findings suggest a role for reproductive physicians and mental health providers to consider counselling men on the potential negative impact of stimulants prescribed for attention deficit hyperactivity disorder on semen volume during fertility planning.
这项研究调查了用于治疗注意力缺陷多动障碍的兴奋剂药物与精液参数之间的关系。我们在 2002 年至 2020 年期间在一家大型学术机构进行了回顾性队列研究。我们纳入了没有先前使用生精毒性药物、经验性药物治疗或混杂性医学诊断（精索静脉曲张、克氏综合征、隐睾、囊性纤维化、糖尿病、癌症或癌症相关治疗以及无精子症）的男性的精液分析。男性按兴奋剂暴露（哌醋甲酯或安非他命）分层。进行多变量线性回归以评估个体精液参数、年龄、兴奋剂暴露和非兴奋剂药物使用之间的关联。在确定的 8861 名男性中，有 106 名男性在精液检测前 90 天内有活性的兴奋剂处方。在控制年龄和非兴奋剂药物暴露后，兴奋剂使用与精液量减少（β：-0.35ml，标准误差：0.16，p=0.035）相关的总活动精子数减少（β：-18.00 万/ml 精液和标准误差：8.44，p=0.033）相关，但与精子浓度、活力和形态无关。这些发现表明，生殖医生和心理健康提供者应考虑向正在进行生育计划的男性告知，治疗注意力缺陷多动障碍的兴奋剂处方可能对精液量产生负面影响。
