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Does methylphenidate use affect sperm parameters in patients undergoing infertility investigation? A retrospective
Hadar Shalev1, Yuval Mizrakli2, Atif Zeadna3
1Division of Brain Medicine, Department of Psychiatry, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Objectives:
Methylphenidate (MPH) is the most widely prescribed therapy for attention deficit hyperactivity disorder. Animal studies have shown a potential adverse effect of MPH exposure on male fertility. We examined the impact of MPH on human male sperm parameters.
Design:
Sperm parameters of 9769 samples from patients 18 years of age or older, collected as part of the basic evaluation of couples referred to the Infertility Clinic were analyzed retrospectively. We divided the study population into three groups according to MPH purchasing information: MPH purchased ≤ 90 days prior to sperm analysis-current users (n = 83), MPH purchased > 90 days prior to sperm analysis-past users (n = 293), and MPH-naïve patients (n = 9393).
Methods:
All sperm samples were analyzed by the same laboratory technician team for the following routine parameters: semen volume, sperm concentration, percentage of motile sperm, and percentage of normal morphology according to World Health Organization. The analysis of the samples was completed by evaluation of total sperm count, total sperm motility, and percentage of fast and slow motile cells. Sperm morphology was evaluated by a laboratory technician using methodological examination according to the strict Kruger-Tygerberg criteria.
Results:
Methylphenidate exposure did not affect sperm morphology but was associated with increased sperm concentration as well as increased total sperm count and total sperm motility among current and past users compared with MPH-naïve patients. In particular, progressive motility and total motile sperm count were significantly increased following MPH use. A multivariate analysis adjusting for age and current smoking was conducted, further supporting a positive correlation between current MPH use and increased values of total sperm count and total sperm motility.
Limitations:
Our study has several inherent weaknesses, foremost of which is its retrospective nature. Another notable weakness is that medication purchasing data may not accurately reflect MPH exposure in the study population. Patients may be purchasing MPH and not taking it as prescribed.
Conclusions:
In the present study, we could not demonstrate a negative impact of methylphenidate treatment on sperm parameters in adults with ADHD. Hence, we may assume that methylphenidate does not negatively affect male fertility.
Insights
Methylphenidate (MPH) use in adults with ADHD did not negatively impact sperm parameters. Current and past MPH users showed increased sperm concentration, total sperm count, and motility compared to MPH-naïve individuals.
Area of Science:
- Reproductive Endocrinology
- Pharmacology
- Andrology
Background:
- Methylphenidate (MPH) is a first-line treatment for Attention Deficit Hyperactivity Disorder (ADHD).
- Previous animal studies suggested potential adverse effects of MPH on male fertility.
- The impact of MPH on human male reproductive parameters requires thorough investigation.
Purpose of the Study:
- To investigate the association between Methylphenidate (MPH) use and human male sperm parameters.
- To compare sperm quality in current MPH users, past users, and MPH-naïve individuals.
Main Methods:
- Retrospective analysis of 9769 sperm samples from adult males.
- Categorization into current MPH users (≤90 days), past users (>90 days), and MPH-naïve groups.
- Standardized laboratory analysis of semen volume, sperm concentration, motility, and morphology.
Main Results:
- Methylphenidate (MPH) use was not associated with decreased sperm morphology.
- Current and past MPH users exhibited significantly increased sperm concentration, total sperm count, and total sperm motility compared to MPH-naïve patients.
- Multivariate analysis confirmed a positive correlation between MPH use and improved total sperm count and motility.
Conclusions:
- Methylphenidate (MPH) treatment does not appear to negatively affect sperm parameters in adult males with ADHD.
- The findings suggest that MPH may not adversely impact male fertility.
- Further research is warranted to confirm these findings and explore potential mechanisms.
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