What Changes Occur in Sperm Count and Motility When Taking Dutasteride? (FAQ)

Source - eMD Medical News

Dutasteride

Dutasteride, a hair loss treatment, is an effective medication, but one of the most common questions patients ask is whether it affects pregnancy and sperm health.

Based on recent research findings and clinical experience, I have organized answers to frequently asked questions.

Q1. Does taking dutasteride reduce sperm motility?

Yes. In a recently published study, sperm motility tended to decrease as the duration of dutasteride use increased¹.

The World Health Organization (WHO) states that total sperm motility should be at least 42% for natural conception.

However, in the patient group that had taken dutasteride for more than 6 months, the average motility was confirmed to be below 42% in all cases¹.

In other words, long-term use may have a negative effect on the chance of natural conception. That said, this is only a statistical figure, so individual differences should also be taken into account.

Q2. Do semen volume or sperm count also change?

Yes. In the WHO 5th edition, the average sperm concentration in normal men is listed as 73 x 10⁶/mL, and the average semen volume as 3.0 mL.

However, according to the study, the average among patients taking dutasteride was 56.8 x 10⁶/mL, and semen volume was 2.1 mL¹.

In other words, both sperm count and semen volume showed a decreasing trend, suggesting that there may be some effect on fertility.

Q3. If semen analysis results are low, does that mean pregnancy is definitely difficult?

No. Low semen analysis results do not automatically mean pregnancy is impossible.

Some patients achieve natural conception even with below-average values. In addition, pregnancy is influenced not only by male factors but also by many other factors such as the female partner’s ovulation status, egg quality, and uterine environment, so pregnancy potential cannot be determined solely from sperm values.

From clinical experience, there are plenty of cases in which couples succeeded in natural conception even when semen values were somewhat low.

However, if you are planning a pregnancy, it is advisable to consult with a medical professional and periodically check semen analysis results.

Q4. Does sperm health recover after stopping dutasteride?

Yes. Multiple studies have confirmed that the effects of 5-alpha reductase inhibitors such as dutasteride are reversible.

After stopping the medication, cases have been reported in which sperm count, motility, and semen volume gradually returned to the normal range within several months to 1 year¹.

However, the speed of recovery may vary depending on the patient’s age, the presence of underlying conditions, and the original sperm status.

On average, the clearest recovery was seen between 6 and 12 months.

Therefore, if you are planning a pregnancy, it is necessary to stop the medication and allow time for recovery.

Q5. How is this approached in actual clinical practice?

Source - Hit News

Finasteride

In actual clinical settings, both the patient’s need for hair loss treatment and whether they are of reproductive age are considered together.

If pregnancy is being planned, other treatment options instead of dutasteride

(for example, finasteride, minoxidil, low-level laser therapy, etc.) may be considered first, and if the patient is already taking the medication, follow-up observation can be done by combining it with semen analysis.

Ultimately, the important thing is a personalized treatment strategy.

If it is a period when reproductive health must be prioritized, medication adjustment may be necessary; on the other hand, there are also cases where the effectiveness of hair loss treatment must be prioritized.

Dutasteride use, sperm count, and motility

Question | Key answer | Clinical significance

Q1. Decreased sperm motility? | Average below 42% after 6 months or more of use¹ | May reduce the chance of natural conception

Q2. Changes in semen volume/sperm count? | Average sperm concentration 56.8 x 10⁶/mL, semen volume 2.1 mL¹ | Lower than WHO standards

Q3. Pregnancy possible? | There are cases of pregnancy even with low values | Cannot be determined definitively; influenced by multiple factors

Q4. Recovery after stopping? | Recovery possible within several months to 1 year¹ | Reversible changes; individual differences exist

Q5. Clinical approach | Consider reproductive age status; alternative treatments available | Personalized treatment needed

Now it is time to hairhair, this was Kim Jin-o.

필생신모(必生新毛).

Reference

1. Kim J, Oh S, Choi H, Yoo HJ, Son KH, Byun K. Effect of dutasteride on semen parameters and implications for male fertility. Clinical and Experimental Reproductive Medicine. Published online March 21, 2025. doi:10.5653/cerm.2024.07675

[This post is written directly by a plastic surgery specialist for informational purposes in accordance with Article 56, Paragraph 1 of the Medical Service Act. Hair transplant surgery and treatment may have side effects, so please make a careful decision after consulting with a specialist.]

Written by: Kim Jin-o, New Hair Plastic Surgery (Director of Public Relations, Korean Association of Plastic Surgeons / Academic Director, Korean Society for Laser Dermatology and Hair)