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Case report

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  2. Case report
  3. Comment
  4. References

A 48-year-old man with retinal vasculitis and coronary artery disease was referred to the Urology clinic for investigation of secondary infertility. A genital and abdominal examination were normal but semen analysis showed azoospermia. His serum testosterone was 7.8 nmol/L (normal 10–30), the LH level 9.1 IU/L (normal 1–10) and prolactin 319 mU/L (normal 100–500). Regular medication included ranitidine, prednisolone, nifedipine, cyclosporin, aspirin and colchicine (at a dose of 500 μg twice daily), and drug-related azoospermia was thought probable. A literature search revealed colchicine, which the patient had taken for 6 years, as a possible candidate. The drug was stopped and semen analysis repeated; 2 months after withdrawal, his sperm count was 74×106 /mL, despite the testosterone level remaining low at 7.3 nmol/L.

Comment

  1. Top of page
  2. Case report
  3. Comment
  4. References

Colchicine is a well known mitotic inhibitor and has been reported to destroy germ cells in experimental animals [1]. The situation in humans is less conclusive. There have been no reports of colchicine-related azoospermia submitted to the Committee on Safety of Medicines from 1964 and several groups have failed to find evidence for an effect on spermatogenesis [2,3]. A study of 62 previously fertile men receiving colchicine for Behcet’s disease showed oligo/azoospermia in 40% [4]. This was most apparent in those taking colchicine for >5 years. We are aware of only one other report of colchicine producing reversible azoospermia [5] but believe it may be an unrecognized and potentially reversible cause of male infertility.

References

  1. Top of page
  2. Case report
  3. Comment
  4. References
  • 1
    Gomes WR. Chemical agents affecting testicular function and male fertility. In Gomes WR, Vandemark NL, eds,The Testis, Vol III. New York: Academic Press1970; 530
  • 2
    Bremner WJ, Paulsen CA. Colchicine and testicular function in man. N Engl J Med 1976; 294: 1384
  • 3
    Fukutani K, Ishida H, Shinohara M et al. Suppression of spermatogenesis in patients with Behcet’s disease treated with cyclophosphamide and colchicine. Fertil Steril 1981; 36: 7680
  • 4
    Sarica K, Suzer O, Gurler A et al. Urological evaluation of Behcet patients and the effect of colchicine on fertility. Eur Urol 1995; 27: 3942
  • 5
    Merlin HE. Azoospermia caused by colchicine—a case report. Fertil Steril 1972; 23: 180