Parkinson’s disease is most likely to occur in people over age 60, but it can sometimes develop in younger individuals, who may still be looking to grow their family. Besides gradually impairing your movement, the disease may also impact your fertility. Read on to learn more about the potential effects of Parkinson’s disease on fertility as well as your options for conceiving a child if you’re living with the condition.
Key takeaways
- Parkinson’s disease is a progressive nerve disorder that causes difficulty with movement and may affect sexual function and fertility.
- Parkinson’s patients who are interested in having a biological child have several options, including sperm retrieval from the testes along with IVF.
What is Parkinson’s disease?
Parkinson’s disease is a progressive neurological disorder that causes difficulties with movement. It’s the most common neurodegenerative disorder after Alzheimer’s disease, affecting around 1 million people in the US.
The condition causes trembling, slow movements, and difficulties with balance and walking. It may also affect sexual function and fertility.
Parkinson’s disease is associated with the loss of nerve cells, or neurons, in the part of the brain responsible for movement. The reduction in the number of these cells lowers the production of dopamine, a chemical in your brain that plays a role in coordinating your movements (among other important roles).
The disease progresses slowly alongside the decline in these neurons. It typically takes the loss of half or more of these neurons for symptoms to begin.
Symptoms of Parkinson’s disease
Symptoms of Parkinson’s begin slowly, and may be different in each person. Symptoms may start on one side of the body before eventually being seen on both sides, though one side may remain more severely impacted.
The main symptoms of Parkinson’s include:
- stiff muscles
- slow movements
- trembling in the hands, legs, or head
- loss of balance
Other symptoms may appear either before the disease or as the disease progresses, such as:
- trouble walking
- poor grip strength
- difficulty speaking
- depression
- memory problems
- loss of smell
- constipation
- erectile dysfunction
- difficulty chewing and swallowing
- insomnia
While treatments like medication and surgery may help with symptoms, there’s no cure for the disease.
Causes of Parkinson’s disease
Currently, the causes of Parkinson’s disease are not fully understood. It’s possible that genetic and environmental factors, particularly exposure to pollution and other toxins, contribute to the decline in nerve cells that is linked to the disease.
Exposure to toxins in the environment may also cause the buildup of proteins called “alpha-synucleins,” which can harm the neurons that control movement and sleep. The accumulation of these proteins can be seen in many people with Parkinson’s.
Risk factors for Parkinson’s disease
People usually develop Parkinson’s disease around age 60. In most cases, the disease does not appear to be passed down through families, instead seeming to occur at random.
However, around 5–10% of people start to develop the disease before age 50. In these cases, Parkinson’s could be an inherited condition, linked to genetic mutations. There’s a family history of the disease in around 15% of people with Parkinson’s.
Parkinson’s affects male patients at a rate 50% higher than female patients. Other risk factors for the disease include:
- exposure to environmental toxins, such as pesticides and air pollution
- head injuries
- vitamin D deficiency
On the other hand, research suggests that regular exercise may help prevent Parkinson’s disease.
Diagnosis of Parkinson’s disease
Parkinson’s can be challenging to diagnose, since there’s currently no way to test for it. People sometimes attribute their initial symptoms to normal aging, making the disease more difficult to spot.
If you’re in the early stages of the disease, your symptoms may need to be more pronounced before your doctor can diagnose the condition. Still, it’s important to correctly identify the disease so you can receive the proper treatment.
Your doctor will use a physical exam and your medical history to diagnose the disease. Another indicator of Parkinson’s disease is seeing improvements in your symptoms after using levodopa, a medication that helps replace dopamine in the brain. Brain scans can also sometimes help your doctor determine if a different condition is causing your symptoms.
Treatments for Parkinson’s disease
While Parkinson’s disease is not curable, medication and therapy can help patients manage their symptoms. Parkinson’s patients may be prescribed:
- The aforementioned medication levodopa (also known as L-dopa), sometimes along with a medication called carbidopa. Levodopa converts to dopamine in the brain, and carbidopa helps prevent levodopa from being broken down too early.
- Testosterone replacement therapy (TRT). People with Parkinson’s are more likely to be deficient in testosterone, and TRT may help improve both the physical and mental health symptoms of Parkinson’s disease.
- Physical, occupational, and speech therapy, which can help patients improve their motor skills, ability to walk, and ability to talk. These may be paired with lifestyle modifications, such as exercise and diet, to optimize health for people with Parkinson’s.
- Deep brain stimulation, a surgical option that involves implanting tiny electrodes into the brain to stimulate dopamine production.
How does Parkinson’s disease affect male fertility?
Parkinson’s impacts a range of physical capacities, possibly including fertility.
Parkinson’s often affects sexual function. One small study of 32 men with the disease found that 68.4% experienced erectile dysfunction and 39.5% had trouble reaching orgasm. This may be compounded by the fact that people with Parkinson’s are more likely to have low testosterone.
People with Parkinson’s can also experience retrograde ejaculation, a condition in which bladder muscle problems allow semen to flow back into the bladder instead of being ejaculated out of the penis. These issues can make it difficult to conceive naturally.
We don’t know much about the sperm health of people with Parkinson’s. Parkinson’s is associated with a lower level of dopamine in the brian. We know that dopamine can be found in semen, and that there are dopamine receptors in the testes and in sperm. Some preliminary animal research has suggested that dopamine may play a role in sperm production and sperm motility.
However, we need more research to illuminate whether the lower dopamine produced by the brains of Parkinson’s patients may affect fertility.
The genetics of Parkinson’s: crossover with male infertility?
Several proteins involved in Parkinson’s may also affect male fertility. Over 25 mutations in the PARK7 gene are linked to Parkinson’s disease. This same gene also appears to be involved both in sperm production and fertility.
The PARK7 gene is responsible for the protein DJ-1, which is found in the brain and other organs. Research suggests that a mutation in DJ-1 may help cause Parkinson’s disease. DJ-1 is also involved in the testes and with sperm production. Therefore, it’s plausible that changes to the protein may impact fertility.
In general, more research is needed in this area. Learn more about genetic causes for male infertility.
How Parkinson’s disease treatment may affect fertility
Some data suggests that treatment with levodopa may potentially improve symptoms of erectile dysfunction, and make it more possible for people with Parkinson’s to have sex and reach orgasm.
Could L-dopa or mucuna pruriens improve male fertility?
Research around levodopa’s possible impact on fertility is limited and inconclusive.
Some manufacturers have started marketing mucuna pruriens or “velvet bean” supplements, which contain high natural levels of l-dopa, as a male fertility supplement. However, there are very limited trials to suggest this is an effective treatment for male-factor infertility, and no trials looking specifically at how it might work for men with Parkinson’s.
TRT’s impact on fertility
Unlike other medications, the impact of testosterone replacement therapy on sperm health is fairly clear. Adding exogenous, or outside, testosterone can alter the delicate balance of fertility hormones in a person’s body. TRT can significantly decrease sperm production or even halt it altogether, temporarily.
If a person with Parkinson’s disease wants children and plans to use TRT, it’s highly recommended that they freeze their sperm.
Learn more about testosterone replacement therapy.
Parkinson’s disease and conceiving a child
There’s still a lot to learn about the effects of Parkinson’s disease on fertility. Depending on your symptoms and response to treatment, if you have Parkinson’s, you may still be able to conceive a child.
Medications like apomorphine (Apokyn) and pergolide (Permax) can be used to treat erectile dysfunction, potentially restoring your ability to conceive naturally. As mentioned above, levodopa may also improve symptoms of erectile dysfunction.
It’s also possible to obtain sperm directly from the testicles using surgical techniques, called “sperm retrieval.” This side steps issues like erectile dysfunction and retrograde ejaculation.
Sperm retrieval options include:
Cost, recovery times, and success rates may vary with each technique.
Using in vitro fertilization with ICSI (a technique in which a single sperm is injected into an egg to facilitate fertilization), retrieved sperm can be combined with an egg to create an embryo. Then, doctors can transfer the embryo to your partner’s uterus.
While these methods can help conceive a pregnancy that may otherwise not be possible, know that they’re not guaranteed to result in a child. Age plays a large role in the success of IVF. Women under age 35 have around a 47.8% chance of giving birth to a live baby after IVF, while women aged 41–42 have just a 13.5% chance.
Sperm freezing after a diagnosis of Parkinson’s disease
If you’ve been diagnosed with Parkinson’s, but you’re not yet ready to have kids, you may want to consider freezing your sperm to preserve your fertility for the future. This allows you to have a “backup” in case it’s difficult, later on, to ejaculate or conceive naturally.