Medications that can mess with your fertility

Certain over-the-counter and prescription medications that can mess with your fertility and make it harder to get pregnant. Here’s what you need to know if you’re trying to conceive. 

By the time you and your partner decide you want to have a baby, you probably know how important it is to eat right, exercise, and be in good overall health. That’s a great start! But did you know that there are common medications that can mess with your fertility? They may harm sperm count and sperm quality, for example. Or they can disrupt menstrual cycles and ovulation.

For that reason, “it’s very important for patients to tell their providers exactly what they are taking when trying to conceive,” says Nanette Santoro, M.D. Dr. Santoro is a professor of obstetrics and gynecology at the University of Colorado School of Medicine in Aurora. 

By reviewing your medications, your doctor can make helpful suggestions. They might switch you to a new drug. Or they may suggest that you stop taking something altogether. 

For example, say you’re taking a medication that changes your hormone levels. And as a result, you don’t have regular menstrual cycles. That can make it tough to get pregnant. Sometimes you can try a different medication. Sometimes you can add a hormone-adjusting medication. In some cases, you may use fertility treatments.

Or perhaps, you’re taking a drug that lowers your sperm count. You may be able to use intrauterine insemination, says Dr. Santoro. That’s where doctors place your sperm directly into the uterus using a catheter or tube. “A concentrated amount of sperm can be inserted,” says Dr. Santoro. “In other words, we can work with the lower numbers of sperm.”   

If the medication you’re taking is critical or even lifesaving, that changes things. “If it is a prescription medication that’s necessary to have a reasonable quality of life, then it may not be possible to switch,” Dr. Santoro says. In these cases, there might be another way around the problem.

The upshot: Going over your meds with your doctor is key. Doing so can help you figure out the best ways to improve your odds of getting pregnant without putting your health at risk. Here is a list of medications that can mess with your fertility. Be sure to ask your doctor about them.

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These drugs help manage conditions like anxiety, depression, and insomnia. Some antidepressants have been linked with lower sperm concentration and motility. (Sperm motility is how well sperm can swim.) This includes some selective serotonin reuptake inhibitors (SSRIs). SSRIs are also linked with loss of pregnancy during the first trimester.  

Antipsychotics and many other psychotropic drugs change levels of brain chemicals. These chemicals include such as serotonin and dopamine. This can raise prolactin levels, Dr. Santoro says. Prolactin sets the stage for breastfeeding. If prolactin goes up at the wrong time, it can disrupt menstrual cycles, lower testosterone levels, and affect fertility. 

“Pain medications such as acetaminophen, aspirin, and NSAIDs [nonsteroidal anti-inflammatory drugs] like ibuprofen do not appear to hamper fertility if they are used as labeled,” Dr. Santoro says. But taking very high doses of NSAIDs around the time of ovulation might cause a problem. It can stop the egg from releasing.  

High doses of opioids are also a concern. (Opioids are a class of prescription drugs used to treat pain.) They can suppress production of key hormones that drive the reproductive system. In turn, that can lead to abnormal menstrual cycles or sperm counts.

These drugs treat autoimmune diseases like lupus or rheumatoid arthritis. They’re also used by people who have had organ transplants or stem cell transplants. They help keep the immune system in check and stop your body from damaging healthy cells and tissue. But some can also alter sperm production. Others can change hormone levels in a way that leads to an irregular menstrual cycle.

Research has found that certain epilepsy drugs may lower sperm count and movement rate. But because semen quality is often already lower in people with epilepsy, it’s a complicated issue. Your doctor can help you work through your options.

These are human-made versions of the hormone testosterone. They help treat hormonal issues or muscle loss from some diseases. They have also been linked with low sperm count. The good news: These effects can be reversed within 3 to 12 months of stopping steroid treatment.

Remember that it’s always important to balance your wish to have a baby with the health of you and your partner. And quitting a medication or taking less of it without your doctor’s input could have unwanted side effects. So be sure to work with your doctor to find the best solution for both your fertility and your well-being.

Many health plans offer prenatal support and postpartum recovery programs for their members. To learn how to get the most out of your health benefits, ask if you’re eligible for Wellframe.