The effect of statins on semen parameters in patients with hypercholesterolemia: A systematic review.

Abstract

Statins constitute the mainstay of treatment in patients with hypercholesterolemia. However, their effect on semen parameters is unknown. This study aimed to systematically review the best available evidence regarding the effect of statins on ejaculate volume and sperm concentration, motility, morphology, or vitality. A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases up to January 10, 2021. Either randomized-controlled trials or prospective cohorts, conducted in males with hypercholesterolemia, were included. Four studies, published between 1992 and 2014, were eligible. The number of participants ranged from 8 to 120 (n=161). Study duration ranged from 14 to 48weeks. The type and dose of statin used were pravastatin 20-80mg/day and simvastatin 20-40mg/day. With regard to ejaculate volume (n=3) and sperm concentration (n=4), no effect was shown with either pravastatin or simvastatin. Regarding sperm motility, either an increase (n=2; pravastatin, simvastatin), decrease (n=1; pravastatin), or no effect (n=1; pravastatin, simvastatin) was found. With respect to sperm morphology, either a decrease (n=2; pravastatin, simvastatin) or no effect (n=2; pravastatin, simvastatin) was shown. Concerning sperm vitality, a single study showed a decrease with simvastatin. Because of the high heterogeneity of the populations studied and the limited number of studies, a meta-analysis was not performed. This is the first systematic review on the effect of statins on semen parameters. As there is no evidence for such a detrimental effect, no specific approach has to be suggested regarding the preservation of reproductive function in men with hypercholesterolemia.