Association between terbinafine hydrochloride and sperm DNA fragmentation - case report

OBJECTIVE: To present the case of a man with normozoospermia and a high level of fragmented spermatozoa, which origin seems to be associated with long-term treatment with terbinafine hydrochloride. CASE DESCRIPTION: A 20-year-old male healthy patient, with no history of disease and addictions, used an antifungal (terbinafine hydrochloride) for one year to treat a toenail. During this treatment, he participated in a study to evaluate a method of sperm DNA fragmentation analysis. He had 99% fragmented sperm, primarily attributed to prolonged abstinence. The samples that were analyzed later indicated that the high fragmentation could be associated with the antifungal treatment and that with a 2-day abstinence and absence of treatment the fragmentation rate was again comparable with that of fertile men (15%). CONCLUSION: Terbinafine hydrochloride is likely to cause problems in male fertility, mainly affecting DNA sperm integrity. Further studies are needed to confirm this observation and to determine at what level of the genitourinary tract the alteration of DNA occurs.