Horst P G J Ter, Edens M A, Besten-Bertholee D den, Mulder L W, Curfs M H J M
Department of Clinical Pharmacy, Isala, Zwolle, The Netherlands.
Department of Innovation and Science, Isala, Zwolle, The Netherlands.
PLoS One. 2025 Jul 18;20(7):e0326795. doi: 10.1371/journal.pone.0326795. eCollection 2025.
Medication can affect semen quality by decreasing ejaculate volume, sperm concentration, or decreased sperm motility and sperm function in general. We performed a retrospective explorative cross-sectional study on any medication use and semen quality in our fertility clinic in men older than 18 years with a recorded semen analysis. Men were categorized based on medication use, i.e., any type, and no medication use. Exclusion criteria were incomplete semen analysis, azoospermia, a semen analysis after vasectomy, and days of abstinence less than 2 or more than 7 days before semen collection. The primary outcome was the composite endpoint of low semen quality (LSQ) according to the WHO. In total 722 men with medication and 6716 men without medication were included in the study. At the ATC-7 level (individual drug ATC-code), univariate (borderline) statistically significant associations using a cut-off of p < 0.100 were found for metformin (A10BA02), metoprolol (C07AB02) and lisinopril (C09AA03), which remained significant after adjustment for age and abstinence days. Our study is limited by the fact that information regarding exposure to information, as information was self-reported by patients. Also, the outcome, semen quality, was hindered by patients own collection. Even if a drug had logically been used for some time before semen sampling (e.g., medication for chronic disease), there was no way to determine whether that medication had been started before or after the occurrence of LSQ. Finally, medication and disease cannot be separated, hence it could not be determined whether the medication or the disease itself was associated with LSQ. Therefore, this study should be interpreted as a hypothesis-generating study.
药物通常可通过降低射精量、精子浓度、精子活力及精子功能来影响精液质量。我们对我院生殖门诊18岁以上有精液分析记录的男性进行了一项回顾性探索性横断面研究，探讨药物使用与精液质量的关系。根据药物使用情况，即是否使用任何类型的药物，将男性分为用药组和未用药组。排除标准为精液分析不完整、无精子症、输精管结扎术后的精液分析，以及精液采集前禁欲天数少于2天或超过7天。主要结局是根据世界卫生组织标准定义的低精液质量（LSQ）复合终点。本研究共纳入722名用药男性和6716名未用药男性。在解剖学治疗学及化学分类系统（ATC-7）层面（单个药物ATC编码），使用p < 0.100的截断值，发现二甲双胍（A10BA02）、美托洛尔（C07AB02）和赖诺普利（C09AA03）存在单因素（临界）统计学显著关联，在调整年龄和禁欲天数后仍具有显著性。本研究存在局限性，因为暴露信息是患者自我报告的。此外，精液质量这一结局受患者自行采集的影响。即使在精液采样前某种药物已按逻辑使用了一段时间（例如，治疗慢性病的药物），也无法确定该药物是在LSQ出现之前还是之后开始使用的。最后，药物与疾病无法区分，因此无法确定是药物还是疾病本身与LSQ相关。所以，本研究应被视为一项产生假设的研究。
