Finasteride-associated male infertility

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 x 10(6)/mL 16 we eks 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. (Fertil Steril (R) 2011; 95: 1786. e9-e11. (C) 2011 by American Society for Reproductive Medicine.)