The Association Between Methylphenidate Therapy and Improved Male Fertility Parameters

Background: Methylphenidate (MPH, Ritalin) is a widely-prescribed medication of attention -deficit/hyperactivity disorder (ADHD). During the last decade the prevalence of ADHD and of MPH use has been rising, mostly in young adults. There is an ongoing debate concerning the effect of MPH on male fertility; data coming from non-human studies.

Aim: To evaluate the prevalence of fertility problems in male patients treated with MPH.

Materials & Methods: A retrospective case-control study. Between 2009-2015, data of 7,118 consecutive semen analyses were collected as part of the basic fertility evaluation of 4,201 couples. Semen analyses were conducted according to WHO criteria. MPH samples were defined as those obtained from subjects purchasing MPH within 90 days prior to semen analysis, and the rest of the samples serving as controls. Multivariate analysis was performed using General Estimation Equation (GEE) models.

Results: 38 of the semen analyses (of 29 subjects) were conducted within 90 days of MPH purchase. Mean age was similar between the two groups (31.8±6.3 vs. 32.8 ±8.4 years, p=0.443). The revalence of oligozoospermia was significantly lower in the MPH group (10.5% vs. 29.3%, p=0.011), as well as the rate of asthenozoospermia (15.8% vs. 37.2%, p=0.007). In multivariate analysis adjusting for age, MPH therapy was found to be a protective factor for both oligozoospermia (O.R.=0.37 C.I 95% 0.15-0.89) and asthenozoospermia (O.R.=0.33 C.I 95% 0.15-0.76).

Conclusion: Consumption of MPH was found to be associated with improved sperm count and motility. Results need to be corroborated by increasing the group of sperm analyses under MPH.