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May 12, 2022
Ivermectin and male fertility
Over the course of the pandemic, you’ve likely heard of the medication ivermectin as a potential treatment for COVID-19. You may also have read that ivermectin causes low sperm counts. But what is ivermectin, can it really help against COVID-19, and can it truly affect your sperm count or fertility? We’ll explore each of these questions below.
Ivermectin is an effective medication for parasitic infections, but it's not an effective treatment for COVID-19.
There's no good evidence to suggest that ivermectin will affect male fertility.
COVID-19 has been shown to have months-long impacts on sperm health, along with its other known effects — and the best protection is vaccination.
What is ivermectin?
Ivermectin is an antiparasitic medication that’s used in people and animals.
For people, ivermectin tablets are used to treat conditions caused by parasites, such as onchocerciasis (river blindness) and intestinal strongyloidiasis (threadworm infection). Ivermectin can also be used topically to treat head lice, scabies, and rosacea (a skin condition that can cause facial redness, acne, and dry eyes).
In animals, on the other hand, ivermectin is used to treat certain parasites and to prevent heartworm disease.
It’s important to be aware that forms and doses of ivermectin are different for animals and people. Veterinary forms of ivermectin tend to be more concentrated and can include ingredients that may be unsafe for humans. Ivermectin is only safe when it’s used as prescribed.
Ivermectin paralyzes and kills worm larvae in the body. Since it doesn’t kill adult worms, repeated doses may be needed to treat infections.
Ivermectin for COVID-19?
During the pandemic, some people touted ivermectin as a way to prevent and/or treat COVID-19.
Prior research has examined ivermectin’s antiviral activity in vitro (in the lab), prompting the idea that the medication may also work against the coronavirus. But it’s important to remember that many things that kill viruses in a petri dish in a lab setting won’t actually work in the body.
For example, while ivermectin has shown in vitro activity against viruses including HIV and zika virus, studies haven’t found it to be effective when taken in vivo, or in the body, by people who actually have these viruses.
And ivermectin doesn’t appear to successfully treat COVID-19, either. According to the US Food & Drug Administration (FDA), there’s currently no good data to show that ivermectin is effective against the disease. While the FDA has authorized the emergency use of some treatments for COVID-19, this list does not include ivermectin. (Ivermectin is FDA-approved for the aforementioned parasitic infections, for which it is an effective treatment.)
Similarly, the World Health Organization (WHO) also advises against using ivermectin for COVID-19 outside of clinical trials.
Recent research backs up these policies. Although some studies have shown benefits from treatment with ivermectin, many of these studies used a small sample size or poor study design, making it difficult to draw meaningful conclusions.
A 2021 review of 14 studies found that the available evidence didn’t support using ivermectin for COVID-19. And an even more recent study of 3,515 patients indicated that early treatment with ivermectin did not help reduce hospital admissions from COVID-19.
Can using ivermectin affect male fertility?
In 2021, some news articles reported that ivermectin resulted in male infertility and linked ivermectin to low sperm counts. This led people to wonder about the medication’s potential impact on fertility, even in legitimate uses (like for parasitic infection).
As it turns out, there’s no good evidence to suggest ivermectin will significantly affect male fertility. Here’s the background.
Many of the new articles published in 2021 cited a small 2011 study that found reduced sperm parameters in participants who took ivermectin for 11 months. Specifically, the study identified significantly lower sperm counts and motilityand a significantly higher number of abnormal sperm cells in this group.
However, out of an original group of 385 patients who were diagnosed with onchocerciasis (a disease caused by a parasitic worm), the study included only 37 participants after excluding those with very low sperm counts. The low sperm counts prevalent in the original patient group suggest that reductions in fertility may have resulted from the parasitic disease, rather than from taking ivermectin.
It also didn’t include a control group to help indicate whether the study outcomes were caused by ivermectin or by another factor. Overall, this was a small and not very reliable study.
What does other research say?
An animal study found that rats taking ivermectin along with verapamil, a blood pressure medication, had slightly impaired sperm cell production. However, other research has separately linked verapamil to reduced sperm parameters in rats. The FDA notes that ivermectin alone given to rats, even at triple the recommended dose, did not impact their fertility
As a result, there’s not enough evidence to currently suggest a significant effect of ivermectin on male fertility. The FDA does not include warnings about infertility on the medication’s drug label.
While ivermectin is unlikely to affect male fertility, it may cause other side effects, including:
It’s important to follow your doctor’s instructions for medications. If you’re prescribed ivermectin for a legitimate use, like parasites, make sure to take all the doses you’re given. This may include taking the medication again in several months to make sure you clear the infection.
Risks of improper use of ivermectin
Despite limited evidence demonstrating ivermectin’s effectiveness against COVID-19, prescriptions for the medication have risen significantly during the pandemic. Compared to a pre-pandemic baseline of less than 4,000 prescriptions dispensed on average per week, pharmacies dispensed 39,000 ivermectin prescriptions in one week in January 2021. During a week in August 2021, prescriptions reached 88,000.
Just because you may be able to obtain ivermectin doesn’t mean you should take it. Using ivermectin without having a diagnosed parasitic infection — and in particular, taking ivermectin meant for animals — can endanger your health. In August 2021, the Centers for Disease Control and Prevention (CDC) issued a health advisory warning of increased calls to poison control centers related to ivermectin overdoses. Some people who have self-medicated with ivermectin have been hospitalized.
COVID-19 and male fertility
When taken without a prescription or without an FDA-approved use, ivermectin is likely more harmful for your overall health than for your fertility, specifically.
The medication also doesn’t appear to help cure COVID-19, a disease that actually canaffect male fertility.
Research indicates that COVID-19 can infect and damage the testicles, potentially resulting in orchitis, an inflammation of the testicle that may lead to infertility. Damage caused by COVID-19 may also lead to lower testosterone levels.
Fever during the course of the disease may harm sperm production as well. One study found that semen parameters worsened after moderate infection with COVID-19, showing the disease’s concrete effects on fertility.
A recent study of over 2800 couples found that, in couples in which the male partner got COVID, the couple was less likely to conceive for 2+ months post-recovery.
The best way to prevent COVID-19 and protect your fertility: vaccination