A recent study confirms what has previously been suggested in that Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit ovulation and thereby have an effect on fertility.
We should therefore be discussing this with patients who present with infertility as use of NSAID’s is becoming increasingly common and we as practitioners may not even realise that our patients are on these as they can be easily purchased over the counter at pharmacies and supermarkets.
New research has submitted that Nonsteroidal anti-inflammatory drugs (NSAIDs) have a grim effect on fertility, inhibiting ovulation and reducing progesterone levels in young females
The process is reversible but women do need to stop taking NSAID’s if they wish to conceive.
The results were presented in Rome at the European League Against Rheumatism Congress 2015 by Dr Salman of the University of Baghdad.
39 women of childbearing age with minor back pain were evaluated.
They were allocated to either diclofenac 100 mg/day, naproxen 500 mg twice daily, etoricoxib 90 mg/day, or placebo.
Before the initiation of treatment, each woman underwent an ultrasound to assess the diameter of the dominant follicle, ovary size, and endothelial thickness.
They also measured progesterone levels. Treatment was initiated on day 10 of a woman’s cycle and after they had been on the drug for 10 continuous an ultrasound was done. The dominant follicle remained unruptured in 75% of women in the diclofenac group, 25% in the naproxen group, 33% in the etoricoxib group, and 0% in the placebo control group.
“All control patients on placebo ovulated, but ovulation was far less frequent in patients who were on NSAIDs,” Dr Salman reported.
“For those taking diclofenac, ovulation was reduced by an amazing 93%, whereas for both naproxen and etoricoxib, ovulation was reduced by about 75%,” he added. “This was really a shocking finding.”
With only 10 days of continuous NSAID use, there was an effect on the dominant follicle and progesterone levels.
The unruptured follicles developed into functional cysts in about 1/3 of patietns.
After the discontinuation of NSAIDs, all the women “did ovulate normally during the next cycle,” he reported. “This convinced us that the anovulatory effects of NSAIDs are reversible.”
Philip Conaghan, MD, from the University of Leeds in the United Kingdom stated that “The potential negative effects of NSAIDs on fertility have been reported for many years.”