Time period to stop dutasteride before trying for a baby

[RTC]

Does anybody know how long you'd have to stop dutasteride before trying for a baby and being confident there would be no ill effects?

I would never forgive myself if I caused harm to the baby because I didn't stop in time

[Britanium]

@Future Hair Doc@DrTBarghouthi…? Best to consult with a actual Dr here 👍🏽

[DrTBarghouthi]

7 hours ago, Aslitarcan sucks said:

Does anybody know how long you'd have to stop dutasteride before trying for a baby and being confident there would be no ill effects?

I would never forgive myself if I caused harm to the baby because I didn't stop in time

There is no evidence suggesting the transfer of finasteride through the low concentrations in semen to be causing any effects. It is important for your partner not to handle the medication during the first trimester. The half life of dutasteride is few weeks so if you want to completely avoid any potential risk, I would stop 5-6 weeks before attempting and also during the first trimester. It is mostly unnecessary but if you want to deal with zero risk that’s probably what gives you peace of mind. 

[RTC]

29 minutes ago, DrTBarghouthi said:

There is no evidence suggesting the transfer of finasteride through the low concentrations in semen to be causing any effects. It is important for your partner not to handle the medication during the first trimester. The half life of dutasteride is few weeks so if you want to completely avoid any potential risk, I would stop 5-6 weeks before attempting and also during the first trimester. It is mostly unnecessary but if you want to deal with zero risk that’s probably what gives you peace of mind. 

Amazing response, thank you Doc

[DrTBarghouthi]

8 hours ago, Aslitarcan sucks said:

Does anybody know how long you'd have to stop dutasteride before trying for a baby and being confident there would be no ill effects?

I would never forgive myself if I caused harm to the baby because I didn't stop in time

Please remember that with ANY pregnancy, there is always a 3-5% background risk of any genetic abnormalities- may god forbid. That’s why I tend to ask patients to stop as I really would not want anyone to partly blame themselves for anything (even though that risk exists without being on any meds in the first place). 

[RTC]

@DrTBarghouthi

Sorry to bombard you but it's not often I get to discuss things with a Dr who specialises in hair! I appreciate I may also be asking things that are not 100% clear nor fully established within the literature or daily practice.

In regards to the below, mean sperm count was still lower than baseline at 24 weeks after stopping Dutasteride.

Could this suggest that once a steady state of Dutasteride is achieved in the body, the 'washout period' should be significantly longer than alluded to above (5-6 weeks)?

https://www.medicines.org.uk/emc/product/8917/smpc

Quote

 

Effects on male fertility

The effects of dutasteride 0.5 mg/day on semen characteristics were evaluated in healthy volunteers aged 18 to 52 (n=27 dutasteride, n=23 placebo) throughout 52 weeks of treatment and 24 weeks of post-treatment follow-up. At 52 weeks, the mean percent reduction from baseline in total sperm count, semen volume and sperm motility were 23%, 26% and 18%, respectively, in the dutasteride group when adjusted for changes from baseline in the placebo group. Sperm concentration and sperm morphology were unaffected. After 24 weeks of follow-up, the mean percent change in total sperm count in the dutasteride group remained 23% lower than baseline. While mean values for all parameters at all time points remained within the normal ranges and did not meet the predefined criteria for a clinically significant change (30%), two subjects in the dutasteride group had decreases in sperm count of greater than 90% from baseline at 52 weeks, with partial recovery at the 24 week follow-up. The possibility of reduced male fertility cannot be excluded.

 

 

Edited May 9, 2022 by Aslitarcan sucks

[DrTBarghouthi]

Yes that is very possible that suppression remains longer as half life of 5 weeks doesn’t mean that it completely goes out of the system. It can take much longer for any effects to go completely. However, I believe that from a safety point of view on transmission to embryos, the effects of Dutasteride on you have no relationship to the transmission to the baby. The changes in DHt levels or even semen analysis parameters doesn’t mean that the sperm itslef is gonna infiltrate the embryo with Dutasteride. 

[Future Hair Doc]

On 5/6/2022 at 1:00 AM, DrTBarghouthi said:

There is no evidence suggesting the transfer of finasteride through the low concentrations in semen to be causing any effects. It is important for your partner not to handle the medication during the first trimester. The half life of dutasteride is few weeks so if you want to completely avoid any potential risk, I would stop 5-6 weeks before attempting and also during the first trimester. It is mostly unnecessary but if you want to deal with zero risk that’s probably what gives you peace of mind. 

Couldn't have said it better myself

[RTC]

Thank you sir!

On 5/6/2022 at 5:16 PM, DrTBarghouthi said:

Yes that is very possible that suppression remains longer as half life of 5 weeks doesn’t mean that it completely goes out of the system. It can take much longer for any effects to go completely. However, I believe that from a safety point of view on transmission to embryos, the effects of Dutasteride on you have no relationship to the transmission to the baby. The changes in DHt levels or even semen analysis parameters doesn’t mean that the sperm itslef is gonna infiltrate the embryo with Dutasteride.