Allopurinol and family planning

[Cujo]

I have a unusual question. We are planning to have a baby. Is my sperm in any way compromised by the fact that I take allopurinol? I know that pregnant women should not take this medication without consulting doctor but I wonder if it affects in some way for future fathers.

[Keith Taylor (GoutPal Admin)]

Actually, @cujo, the question isn’t very unusual. It has been discussed here a few times before, unfortunately without conclusion. You can see the discussions if you search for allopurinol infertility in the search box above.

I’ve also tried this search on a couple of science databases, but I still cannot find anything conclusive. It might be that a fertility expert has better access to relevant science. I have seen a small number of references to allopurinol in books about male infertility. Unfortunately, these are in lists of substances, with no explanation of where the data has come from.

Colchicine is also listed, but that makes sense to me, and studies have confirmed it. Colchicine helps gout pain by interfering with the inflammation process at cell level. It restricts cell growth, which is good for limiting inflammation, but not good for fertility.

It might be that allopurinol has got onto the “bad for fertility list” because self-reported side effects could be from gout sufferers who have reported all medications. That’s a ‘might be’ and a ‘could be’ in one sentence – as you can see, I’m clutching at straws.

My starting point would be to assume there was no connection. If difficulties arise, you should consult a fertility expert, who might have better information. By the way, I did find nearly 500 studies of anxiety and infertility, so maybe my best advice is to stop worrying.

If allopurinol is at fault, it is OK to stop it for a while if you are very careful. Uric acid crystals grow very slowly. If uric acid has been at 5 or below for over a year, taking a break from allopurinol should not cause gout attacks. You would need to monitor uric acid levels monthly, and restart if it rises above 6.5.

Good luck.

[Cujo]

Thank you Keith.

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