dutasteride and sperm count

[fml]

Anyone got any longer term information on duts effect on sperm count? The only thing I can find is this:

"The effects of dutasteride 0.5mg/day on semen characteristics were evaluated in healthy volunteers aged 18 to 52 (n=27 dutasteride, n=23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reduction from baseline in total sperm count ... [was] 23% ... in the dutasteride group when adjusted for changes from baseline in the placebo group ... After 24 weeks of follow-up, the mean percent change in total sperm count in the dutasteride group remained 23% lower than baseline..."


IIRC that is directly from GSK. Does anyone know of any longer term information on it? Though this decrease was not considered to be clinically significant (30% is), the above shows that sperm count had not recovered at all 24 weeks after having stopped the drug. But I know the half-life is long and its in the system for months afterwards. Just curious if there is any info on what sperm counts are doing one year, two years after cessation. Not looking to have kids any time soon, but it is not clear to me whether this effect is permanent or not. Anyone found anything?

(Also a bit surprised that 23% is not considered significant but if the thats what the medical community says then oh well.)

 

[xRedStaRx]

Anyone got any longer term information on duts effect on sperm count? The only thing I can find is this:

"The effects of dutasteride 0.5mg/day on semen characteristics were evaluated in healthy volunteers aged 18 to 52 (n=27 dutasteride, n=23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reduction from baseline in total sperm count ... [was] 23% ... in the dutasteride group when adjusted for changes from baseline in the placebo group ... After 24 weeks of follow-up, the mean percent change in total sperm count in the dutasteride group remained 23% lower than baseline..."


IIRC that is directly from GSK. Does anyone know of any longer term information on it? Though this decrease was not considered to be clinically significant (30% is), the above shows that sperm count had not recovered at all 24 weeks after having stopped the drug. But I know the half-life is long and its in the system for months afterwards. Just curious if there is any info on what sperm counts are doing one year, two years after cessation. Not looking to have kids any time soon, but it is not clear to me whether this effect is permanent or not. Anyone found anything?

(Also a bit surprised that 23% is not considered significant but if the thats what the medical community says then oh well.)

30% is definitely significant. I'd say more than 10-15% always is. But that also depends on your baseline.

This is a good study for both finasteride and dutasteride. Follow up was 6 months after cessation. Motility never goes back to baseline with a significant p-value, that was the most alarming thing I found.

http://press.endocrine.org/doi/full/10.1210/jc.2006-2203

TABLE 3. Percentage change in semen parameters from baseline during treatment
​

Parameter	Finasteride		Dutasteride
	Percent change[SUP]1[/SUP]	P value[SUP]2[/SUP]	Percent change[SUP]1[/SUP]	P value[SUP]2[/SUP]
Sperm count (millions)
wk 26	−34.3	0.004	−28.6	0.013
wk 52	−16.2	0.175	−24.9	0.051
Follow-up	−6.2	0.361	−23.3	0.050
Semen volume (ml)
wk 26	−21.1	0.010	−24.0	0.003
wk 52	−14.5	0.117	−29.7	0.003
Follow-up	−4.5	0.319	−16.8	0.021
Sperm concentration (million/ml)
wk 26	−21.5	0.032	−12.9	0.140
wk 52	−7.4	0.285	−3.2	0.399
Follow-up	−4.3	0.383	−10.4	0.205
Sperm motility
wk 26	−10.5	0.006	−10.1	0.006
wk 52	−10.5	0.012	−11.8	0.003
Follow-up	−9.7	0.006	−6.3	0.033
Sperm morphology[SUP]3[/SUP]
wk 26	−0.8	0.176	−0.6	0.251
wk 52	0.0	0.517	−0.1	0.137
Follow-up	0.2	0.585	−0.5	0.281

[SUP]1[/SUP]The estimated difference between treatment groups expressed as percentage of baseline, difference in least squares means for analysis of covariance, obtained by dividing the estimated difference by the median of baseline values from all treatment groups.

[SUP]2[/SUP]One-sided P value for decrease vs. placebo. Bolded values are significant.

[SUP]3[/SUP]As assessed using strict morphology criteria (percentage normal).

 

[fml]

Unfortunately if follow up is 6 months in that study its basically the same info as I have put in OP. Its certainly clear that things have not recovered at 6 months after cessation, but I really wonder what things are like after a year or two.

The finasteride numbers are interesting for sperm count. Big drop at 26 weeks, partially reversed by 52 weeks of still being on it, and substantially recovered but still 6% below baseline at 6 month follow up. Makes me think that things probably would start to recover after dutasteride, but that because of the much higher half life its going to take much longer. Thats why we really need to see info on 1 year or 2 year follow ups. I have a feeling there is no information out there on that though.

Very odd number for dutasteride at 52 weeks for sperm concentration. Surely an error.

They are generally huge recovery times and its a very slow process for both dutasteride and finasteride. Having said that, I read yesterday that it can generally take 3 months or more for sperm characteristics to recover after quitting tobacco, weed etc also. So maybe sperm production/quality is just that sensitive.

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Interesting text from the link you provided. Very surprised at the wording of the conclusion but I dont think I fully understand the data. Im not really fully understanding the p-value stuff despite my googling. Seems the larger the p-value the less statistically significant the percent change listed is but its a bit difficult for me get to get my head around.

"Results: D and F significantly (P < 0.001) suppressed serum DHT, compared with placebo (D, 94%; F, 73%) and transiently increased serum T. In both treatment groups, total sperm count, compared with baseline, was significantly decreased at 26 wk (D, −28.6%; F, −34.3%) but not at 52 wk (D, −24.9%; F, −16.2%) or the 24-wk follow-up (D, −23.3%; F, −6.2%). At 52 wk, semen volume was decreased (D, −29.7%; F, −14.5%, significantly for D) as was sperm concentration (D, −13.2%; F, −7.4%, neither significant). There was a significant reduction of −6 to 12% in sperm motility during treatment with both D and F and at follow-up. Neither treatment had any effect on sperm morphology.


Conclusions: This study demonstrates that the decrease in DHT induced by 5ARIs is associated with mild decreases in semen parameters that appear reversible after discontinuation."

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It seems the numbers might not be as shocking as I thought:

"The predetermined values for mean changes from baseline that could be regarded as clinically significant were chosen to be conservative and were derived from human studies of male fertility and effectiveness of hormonal contraceptives, using impairment of fertility as the standard. As a result, the significant changes in semen parameters observed for both finasteride and dutasteride may not be associated with any impact on fertility in most men."

 

[LouReed]

I'm on finasteride 1mg/daily.

Wife and I were having trouble. We did one IUI that didn't take. Then I went to a urologist specializing in male fertility.

He told me that recent research (past year or two) has definitively shown that finasteride will reduce your sperm parameters (count, motility, morphology, mobility, blahblahgraphy, etc). I believe him. He told me his official opinion was that I get off of finasteride temporarily to increase our chances. He said at 2 months, parameters should return to normal.

We decided to do IUI two more times before I got off of finasteride, and the first attempt took. She is pregnant now.

Here are a few supplements that I took that seemed to boost my sperm count significantly. They also made me feel mentally unstable and agressive (several of these boost T). Use with caution:

(presumed best-to-least)

- Ashwagandha
- D-Aspartic Acid
- L-Carnitine
- Quercetin (or CoQ10)
- BCAAs (or Whey protein)
- Maca
- Shilajit

Check examine.com for details/links to studies

Yeah I took all of these. I'd recommend the top 3 at least, as I saw a big boost in sperm count on them.