Boy’s Future Fertility Could be Affected by Mother’s Acetaminophen Use in Pregnancy

A study from the United Kingdom, published in Science Translational Medicine, suggests that prolonged exposure to acetaminophen during pregnancy could lower a boy’s production of testosterone, possibly affecting his future fertility.

If the expectant mother takes acetaminophen for several days it could affect her unborn boy, lowering his future sperm count, Medical News Today (MNT) reports. Acetaminophen is a widely used over-the-counter pain-reliever and fever-reducer that is sold under brand names including Tylenol and in generic and house brands.

The study’s authors explain that the risks of low testosterone in developing male fetuses include such disorders as undescended testis (cryptorchidism) and hypospadias, a urethral malformation in which the urine outlet is not in the normal position at the end of the penis. In young adulthood, the boy could experience low sperm counts and testicular germ cell cancer can develop, according to MNT.

Pediatric endocrinologist Dr. Rod Mitchell, a Wellcome Trust clinical research fellow at the University of Edinburgh and one of the study authors, says the study “adds to existing evidence that prolonged use of acetaminophen in pregnancy may increase the risk of reproductive disorders in male babies.” If a pregnant woman needs acetaminophen, she should take “the lowest effective dose for the shortest possible time,” Mitchell says.

To examine the effects of acetaminophen on testosterone production, Dr. Sander van den Driesche and colleagues at the MRC Centre for Reproductive Health at the University of Edinburgh grafted fragments of human fetal testes into castrated mice. Xenograft—the surgical grafting of tissue from one species to an unlike species—allowed the researchers to avoid problems in trying to measure testosterone production in unborn human males. The authors say their model “reflects physiological development and can be used to test the effects of chemical exposures on testosterone production,” according to MNT.

To conduct the experiment, the researchers gave the grafted mice a dose of acetaminophen equivalent to a human dose of 20 mg per kg three times a day for seven days. Testosterone levels in their blood dropped by 45 percent and the weight of the seminal vesicle glands fell by 18 percent. Seminal vesicles secrete the semen fluid, and the researchers used the weight of the vesicles as a biomarker of exposure to testosterone. The results were compared to those for mice receiving a placebo that contained no acetaminophen. Exposure to acetaminophen for a single day did not affect the measures of testosterone production.

While the researchers say further research is needed to understand how acetaminophen affects testosterone production in male fetuses, they advise caution in extended use of acetaminophen in pregnancy. Dr. Martin Ward-Platt of the Royal College of Paediatrics and Child Health says fever during pregnancy can be harmful to the developing fetus and so acetaminophen is sometimes necessary, according to MNT. But Dr. Ward-Platt says pregnant women should avoid prolonged acetaminophen use and “should always consult with their health care professional before taking any prescription or over-the-counter medicine.”

 

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