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However, other trials using AABs other than tamsulosin, such as alfuzosin, have not demonstrated deleterious effects on ejaculatory efficiency or altered semen parameters (35). While significant data exists to suggest that AABs, specifically tamsulosin, may contribute to MFI, the authors could not identify a large prospective trial evaluating fertility outcomes spacing 200mg viagra men taking AABs. A summary of the current evidence is offered in Table 1. Anti-epilepsy. Epilepsy is known to be associated with MFI. Epileptic males have been shown, in large studies, to have significantly lower fertility rates and greater risks of hyposexuality than the general population (36). Studies on anti-epileptic medications including carbamazepine, phenytoin and valproate have suggested specific drug-dependent side effects, including abnormal sperm morphology, reduced motility, lower sperm count, and reduced testicular volume. The most likely mechanism for these side effects is thought by some to be the interaction between anti-epileptic medications and sex hormones, interfering with normal HPG pathway functioning (37).

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Recent research has also evaluated the impact of phosphodiesterase inhibitors used to treat male penile impotence, such as sildenafil, on semen quality. Many studies have found, in animal and human trials, increased motility and other semen parameter improvement with sildenafil (64x02013;66). There is conflicting data regarding the effect of sildenafil on oocyte fertilization, however, with some studies documenting a negative effect and others finding no difference from placebo (67x02013;70). Discussion. Male factor infertility is a common cause of infertility. Only recently has more attention been given to the underlying causes of MFI including the association between semen parameters and certain medications.

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