Drugs increasing infertility risk
For women, drugs associated with impaired ovulation include non-steroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase inhibitors. Cytotoxic drugs in chemotherapy may cause an irreversible ovarian failure.5
Spironolactone is associated with (reversible) infertility and disturbed menstruation, while neuroleptics/antipsychotics can cause amenorrhoea and may increase prolactin levels making it harder to get pregnant. Antipsychotics which are less likely to raise prolactin levels include olanzapine, quetiapine and aripiprazole.5,16
Anovulation has also been reported with thyroid replacement therapy, asthma medications, tranquillisers and antidepressants.5
For men, sulfasalazine can reduce sperm volume and increase infertility risk, but this may be reversed by switching to mesalazine. Androgens and anabolic steroids suppress gonadotropins, with a decrease in testes volume and the suppression of sperm production. Cytotoxic drugs in chemotherapy can permanently stop sperm production.
Cannabis and cocaine, and other recreational drugs can impair ovulation and tubal functioning, and reduce male fertility.5,17
Occupational exposure to pesticides and solvents are linked to infertility in men and women, as are metals such as lead, cadmium or manganese, eg through smelting and welding, nitrous oxide or formaldehyde.5