RESUMO
OBJECTIVE: To describe a male patient with finasteride-associated infertility. DESIGN: Case report. SETTING: Tertiary-care clinic for male infertility. PATIENT(S): A patient with azoospermia who had been taking finasteride (1-mg dose) for 1 year for androgenic alopecia. He had been diagnosed with oligospermia 5 years before. INTERVENTION(S): Discontinuation of finasteride. MAIN OUTCOME MEASURE(S): Improvement of semen parameters. RESULT(S): After cessation of finasteride, the patient's semen volume increased immediately, and sperm concentration was up to more than 10 × 10(6)/mL 16 weeks after stopping finasteride. He is now trying to achieve pregnancy by intrauterine insemination. CONCLUSION(S): Cessation of finasteride improved spermatogenesis and allowed the couple to attempt less-invasive fertility therapy. In this case, the patient had impaired spermatogenesis before he started the drug. In such patients, the drug may further decrease spermatogenesis. We suggest that drug cessation could be taken into consideration for infertile male patients with impaired semen parameters who are taking finasteride at a 1-mg dose.
Assuntos
Alopecia/tratamento farmacológico , Finasterida/efeitos adversos , Finasterida/uso terapêutico , Infertilidade Masculina/induzido quimicamente , Inibidores de 5-alfa Redutase/efeitos adversos , Inibidores de 5-alfa Redutase/uso terapêutico , Adulto , Azoospermia/induzido quimicamente , Azoospermia/reabilitação , Feminino , Humanos , Infertilidade Masculina/reabilitação , Masculino , Gravidez , Espermatogênese/efeitos dos fármacos , Suspensão de TratamentoRESUMO
Certainly, varicoceles can have a substantive effect on sperm production in infertile males. In addition, varicocele repair may optimize sperm production. However, additional studies and evaluation of the role of varicocele repair in men with this condition (nonobstructive azoospermia) are warranted.
Assuntos
Azoospermia/etiologia , Azoospermia/cirurgia , Ensaios Clínicos Controlados como Assunto/métodos , Infertilidade Masculina/reabilitação , Observação , Varicocele/complicações , Varicocele/cirurgia , Azoospermia/reabilitação , Dissidências e Disputas , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/cirurgia , Masculino , Observação/métodos , Estudos Prospectivos , Medição de Risco , Resultado do TratamentoRESUMO
A consensus needs to be reached on a rational approach to infertile men with varicocele-associated nonobstructive azoospermia. Future studies are warranted to understand the mechanism behind the variable influence of varicocele on testicular function, which causes partial or complete damage of spermatogenesis in some cases and leaves it unaltered in others.
