Effect of hydroxyurea on sperm count, motility and morphology in adult men with sickle cell or myeloproliferative disease

Intern Med J. 2007 Mar;37(3):190-2. doi: 10.1111/j.1445-5994.2006.01290.x.


Hydroxyurea (HU) is not infrequently used in patients with sickle cell disease and myeloproliferative disorders. Despite murine data showing adverse effects on sperm counts, motility and morphology, there is little information on the effect of HU on human spermatogenesis. A retrospective review of four adult men who had semen analysis during HU therapy and in three cases after its cessation suggests that HU generally reduces sperm counts and motility and results in abnormal morphology. Cessation of HU in one case with azoospermia resulted in recovery of spermatogenesis; in two of the three cases, however, sperm morphology and mobility remained impaired. Recommendations for fertility management in adult men receiving long-term HU therapy are proposed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Sickle Cell / drug therapy*
  • Anemia, Sickle Cell / pathology
  • Anemia, Sickle Cell / physiopathology
  • Antisickling Agents / adverse effects*
  • Antisickling Agents / therapeutic use
  • Azoospermia / chemically induced
  • Humans
  • Hydroxyurea / adverse effects*
  • Hydroxyurea / therapeutic use
  • Male
  • Myeloproliferative Disorders / drug therapy*
  • Myeloproliferative Disorders / pathology
  • Myeloproliferative Disorders / physiopathology
  • Nucleic Acid Synthesis Inhibitors / adverse effects*
  • Nucleic Acid Synthesis Inhibitors / therapeutic use
  • Oligospermia
  • Retrospective Studies
  • Sperm Count
  • Sperm Motility / drug effects
  • Spermatozoa / drug effects*
  • Spermatozoa / ultrastructure


  • Antisickling Agents
  • Nucleic Acid Synthesis Inhibitors
  • Hydroxyurea