Exogenous medication or substance-induced factors

Abstract

Half of all the primary causes of infertility are attributed to males. These causes vary by individual, and the exact etiology is difficult to determine in many infertile men. Spermatogenesis is a long and complex process controlled by gonadotropins [FSH (follicle-stimulating hormone) and LH (luteinizing hormone)], which stimulates Sertoli and Leydig cells. Some men seem to be genetically subfertile, while epigenetic causes play an important role in others. Men are exposed to environmental pollutants, toxic substances, and drugs that compromise fertility. Medications and other substances that provoke infertility may affect sperm development or the pituitary–hypothalamic axis. Unfortunately, most physicians do not inform patients about the potential for infertility associated with the drugs they prescribe. This chapter aims to highlight the adverse effect profile on fertility of frequently used drugs.