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Common medications affecting fertility:
1.Smarr, M. M., et al. (2023) reported that :
- Non-steroidal anti-inflammatory drugs (NSAIDs):
- Examples: ibuprofen, naproxen, aspirin
- May interfere with ovulation and implantation
- Regular use associated with decreased fertility.
| NSAID Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| Salicylates | Aspirin | May interfere with implantation and fertility Potential increased risk of miscarriage if used around conception |
| Propionic Acid Derivatives | Ibuprofen, Naproxen | May delay or inhibit ovulation, Potential to interfere with embryo implantation |
| Acetic Acid Derivatives | Diclofenac, Indomethacin | May affect ovarian function and follicle development Potential to delay embryo implantation |
| Oxicams | Piroxicam, Meloxicam | May interfere with follicular development Possible impact on corpus luteum function |
| COX-2 Inhibitors | Celecoxib | May affect ovulation and implantation Potential impact on tubal function |
2.Casilla-Lennon, M. M., et al (2022) reported that :
- Certain antidepressants
- Selective serotonin reuptake inhibitors (SSRIs) may affect hormone levels.
- Potential impact on ovulation and menstrual cycle regularity.
| Selective Serotonin Reuptake Inhibitors (SSRIs) | Fluoxetine, Sertraline, Escitalopram | Sexual dysfunction,Increased risk of bleeding Potential impact on fertility |
| Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs) | Venlafaxine, Duloxetine | Similar to SSRIs ,Possible impact on menstrual cycle |
| Tricyclic Antidepressants (TCAs) | Amitriptyline, Nortriptyline | Sexual dysfunction, Potential impact on fertility |
| Monoamine Oxidase Inhibitors (MAOIs) | Phenelzine, Tranylcypromine | Sexual dysfunction |
| Atypical Antidepressants | Bupropion, Mirtazapine | Bupropion: less sexual dysfunction, |
| Serotonin Modulators | Vortioxetine, Vilazodone | Potentially less sexual dysfunction than SSRIs |
3.Wesseloo, R., et al. (2020) reported that :
- Antipsychotic medications:
- May disrupt hormonal balance and menstrual cycle.
- Potential to cause hyperprolactinemia, affecting ovulation.
| Antipsychotic Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| First-Generation (Typical) Antipsychotics | Haloperidol, Chlorpromazine | Hyperprolactinemia (can affect fertility), Sexual dysfunction |
| Second-Generation (Atypical) Antipsychotics | Risperidone, Olanzapine, Quetiapine | Hyperprolactinemia (varies by drug),Sexual dysfunction |
| Third-Generation Antipsychotics | Aripiprazole, Brexpiprazole | Lower risk of hyperprolactinemia, Less impact on fertility compared to other classes |
| Depot Antipsychotics (Long-acting injectables) | Haloperidol decanoate, Risperidone long-acting injection | Prolonged duration of action (consider in fertility planning) |
4.Lambertini, M., et al. (2022) reported that : - Chemotherapy drugs:
- Can damage ovarian follicles and lead to premature ovarian failure
- Effect may be temporary or permanent depending on type and dosage.
| Chemotherapy Drug Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| Alkylating Agents | Cyclophosphamide, Busulfan | High risk of ovarian failure, Premature menopause |
| Antimetabolites | Methotrexate, 5-Fluorouracil | Temporary ovarian suppression,Generally less gonadotoxic than alkylating agents |
| Anthracyclines | Doxorubicin, Epirubicin | Moderate risk of ovarian failure |
| Platinum-based Drugs | Cisplatin, Carboplatin | Moderate risk of ovarian failure |
| Taxanes | Paclitaxel, Docetaxel | Temporary ovarian suppression Generally less gonadotoxic than other classes |
| Topoisomerase Inhibitors | Etoposide, Irinotecan | Temporary ovarian suppression |
| Vinca Alkaloids | Vincristine, Vinblastine | Less impact on fertility compared to other classes |
5.Amabebe, E., & Anumba, D. O. C. (2020) reported that :
- Certain antibiotics:
- Some may interfere with hormone metabolism
- Potential to alter vaginal and gut microbiome, affecting fertility.
| Antibiotic Class | Examples | Potential Effects on Fertility | Notes |
|---|---|---|---|
| Tetracyclines | Doxycycline, Minocycline | May interfere with folate metabolism Can alter vaginal microbiome | Generally avoid during pregnancy due to effects on fetal bone development |
| Fluoroquinolones | Ciprofloxacin, Levofloxacin | May affect collagen synthesis Possible link to ovarian dysfunction | Use with caution during pregnancy; some studies suggest potential risks |
| Aminoglycosides | Gentamicin, Streptomycin | Potential to affect ovarian function if used long-term May impact mitochondrial function in eggs | - |
| Nitrofurantoin | - | Long-term use may interfere with ovulation in some cases | Generally considered safe for short-term use during pregnancy |
| Metronidazole | - | High doses or prolonged use might affect fertility Can alter vaginal microbiome | Commonly used for bacterial vaginosis and other infections |
6.Pennell, P. B., et al. (2022) reported that :
- May affect hormone levels and ovulation
- Some associated with increased risk of polycystic ovary syndrome (PCOS).
| Anti-epileptic Drug Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| Sodium Channel Blockers | Carbamazepine, | Teratogenic effects, Potential impact on contraceptive efficacy |
| GABA Analogues | Gabapentin, Pregabalin | Generally lower risk of teratogenicity |
| GABA Transaminase Inhibitors | Vigabatrin | Limited data on long-term fertility effects |
| Calcium Channel Modulators | Ethosuximide | Limited data on fertility effects |
| Broad Spectrum AEDs | Valproic Acid, Lamotrigine, Levetiracetam | Valproic acid: High teratogenic risk, PCOS risk Lamotrigine: potential interaction with hormonal contraceptives Levetiracetam: generally lower teratogenic risk |
| Newer Generation AEDs | Topiramate, Zonisamide | Topiramate: Potential teratogenic effects, interaction with hormonal contraceptives |
7.Korevaar, T. I., et al. (2022) reported that :
- Thyroid medications (if improperly dosed):
- Both hypothyroidism and hyperthyroidism can impact fertility
- Proper management is crucial for maintaining fertility.
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8.Ciftci, F. C., et al. (2021) reported that :
- Certain blood pressure medications:
- ACE inhibitors and ARBs may affect uterine blood flow
- Beta-blockers potentially linked to reduced fertility.
| ACE Inhibitors | Lisinopril, Enalapril | Potential fetal harm in pregnancy |
| Angiotensin Receptor Blockers (ARBs) | Losartan, Valsartan | Potential fetal harm in pregnancy |
| Beta Blockers | Metoprolol, Atenolol | Sexual dysfunction, Potential impact on fetal growth |
| Calcium Channel Blockers | Amlodipine, Nifedipine | Generally considered safe in pregnancy |
| Thiazide Diuretics | Hydrochlorothiazide, Chlorthalidone | Potential impact on male fertility |
| Loop Diuretics | Furosemide, Bumetanide | Potential impact on male fertility |
| Alpha Blockers | Doxazosin, Prazosin | Less impact on fertility compared to other classes |
9.Andreoli, L., et al. (2022) reported that :
- Immunosuppressants:
- May affect hormone levels and ovarian function
- Some associated with increased risk of pregnancy complications.
| Immunosuppressant Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| Corticosteroids | Prednisone, Dexamethasone | Potential impact on menstrual cycle |
| Calcineurin Inhibitors | Tacrolimus, Cyclosporine | Potential impact on ovarian function, May affect sperm quality in men |
| Antiproliferative Agents | Mycophenolate, Azathioprine | Potential teratogenic effects (mycophenolate), May affect ovarian reserve,Possible impact on sperm production |
| mTOR Inhibitors | Sirolimus, | Potential ovarian dysfunction, May affect menstrual regularity |
| Biologics | Rituximab, | May affect ovarian reserve,Possible impact on pregnancy outcomes |
| JAK Inhibitors | Tofacitinib, Baricitinib | Limited data on long-term fertility effects |
10.Smith, J. F., et al. (2021) reported that:
- Long-term opioid use:
- Can disrupt hormonal balance and menstrual cycle
- Potential impact on libido and sexual function.
| Opioid Class | Examples | Potential Side Effects (Long-term use) |
|---|---|---|
| Natural Opiates | Morphine, Codeine | Hormonal imbalances (decreased testosterone, LH, FSH) Menstrual irregularities ,Decreased libido ,Erectile dysfunction, |
| Semi-synthetic Opioids | Hydrocodone, Oxycodone, Hydromorphone | Hypogonadism,Sexual dysfunction,Infertility |
| Synthetic Opioids | Fentanyl, Methadone, Tramadol | Endocrine dysfunction,Reduced fertility,Sexual dysfunction, |
| Partial Opioid Agonists | Buprenorphine | Milder endocrine effects compared to full agonists, Potential for sexual dysfunction,Possible impact on fertility (less severe than full agonists) |
11. Glasier, A., & Gebbie, A. (2022) reported that:
This could potentially delay the diagnosis and treatment of conditions affecting fertility.
| Combined Oral Contraceptives (COCs) | Pills containing estrogen and progestin | Slight increased risk of breast and cervical cancer, Decreased risk of ovarian and endometrial cancer,Possible delay in return to fertility after discontinuation,Changes in libido |
| Progestin-Only Pills (POPs) | Mini-pills | Irregular menstrual bleeding Quick return to fertility after discontinuation |
| Hormonal Intrauterine Devices (IUDs) | Mirena, Kyleena, Skyla | Changes in menstrual bleeding patterns Hormonal side effects (less common than with systemic hormones) Rare risk of perforation during insertion Quick return to fertility after removal |
| Contraceptive Implants | Nexplanon | Irregular bleeding patterns Quick return to fertility after removal |
| Injectable Contraceptives | Depo-Provera | Delayed return to fertility (can take 6-12 months after last injection) Irregular bleeding |
| Contraceptive Patch | Xulane, Twirla | Similar to COCs Quick return to fertility after discontinuation |
| Vaginal Ring | NuvaRing, Annovera | Similar to COCs Vaginal discomfort or increased discharge Quick return to fertility after discontinuation |
