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

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.