Frågedatum: 1991-10-03
RELIS database 1991; id.nr. 7768, DRUGLINE
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Does methadone have effects on semen quality? A 36-year old man is on a methadone treatment program



Fråga: Does methadone have effects on semen quality? A 36-year old man is on a methadone treatment program for 2 years. A decrease in sperm motility was found at 2 consecutive semen tests during fertility investigation.

Sammanfattning: Although the studies of semen quality in patients taking methadone have included a limited number of subjects, a decrease in sperm motility seems to be associated with the administration of this drug. There are obvious problems to control possible confounding factors studying this problem. Methadone treatment could be the cause of the asthenospermia found in this patient.

Svar: There are contradictory data in the literature about sex hormone levels in subjects treated with methadone. Some studies, like the one of Cicero et al (1) have reported decreased testosterone levels, whereas other studies, like the one of Ragni et al (2) found no difference compared to healthy subjects in gonadotropin and testosterone levels. These discrepancies might be due to infrequent plasma sampling, as gonadotropin and testosterone are secreted in a pulsatile fashion (3).

Cicero et al (1) have reported a decrease in sperm motility (asthenospermia) in patients taking methadone, but this was not studied systematically. Ragni et al (4) have observed asthenospermia (defined by less than 40 percent of sperm with forward mobility) in 5 out of 7 patients taking methadone. A more recent study by the same team (2) has found asthenospermia in 45 percent of 22 patients. Teratospermia and oligospermia (sperm count of fewer than 20 million/ml) were not observed in their first study. However, these abnormalities were observed in the second one: among the 10 patients with asthenospermia, one had teratospermia, one had oligospermia and four had hypospermia (volume of less than 1.5 ml) (2). Nevertheless, the number of patients was small in these 3 studies and the patients were not compared to a group of healthy subjects.

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