Q. Do antifungal medications affect the sperm count?

Answered by
Dr. Sameer Kumar
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Oct 27, 2021

Hello doctor,

I had a sperm test, and the result showed a semen concentration of 10 million per mL and immature sperm cells. I think that the medications that I took in the past for my balanitis could be the reason for my sperm derangement.

I was diagnosed with candidiasis and balanitis with inflamed foreskin three months ago and was prescribed topical ointment and antibiotics for two weeks. It helped a little bit, but not 100%. So, we decided to do circumcision. And six weeks ago, I got circumcised with local anesthesia.

The doctor prescribed me the following;

1) Tablet Ketoconazole 200 mg twice a day for ten days.

2) Tablet Baclofen 80 mg for 45 days.

3) Tablet Clindamycin 300 mg for 15 days.

I ejaculated thrice after circumcision and had a sperm test after four days of circumcision and waiting for the results. So, my question is could my infection and medications affect my sperm results?




Welcome to

Thanks for the query.

Antifungals have also been attributed to some effect on sperm production. Considering that the life span of a sperm cell is 120 days and that you had balanitis and yeast infection three months ago, there are chances that there would have been epididymal infection. The infection would have affected the sperm growth inside the testis. However, in the presence of infection, the number and motility of the sperms will be severely affected.

In your case, as you mentioned, there have been many immature sperms, which indicates that your treatment is the reason for the derangement in sperm count. Hence it is advisable to repeat the semen analysis test once your infection is controlled.


Thank you doctor,

Good day or night doctor, thank you very much for the answer. They uploaded an online example video on the site. So I thought I can show it to you so that it can be helpful. I would appreciate the feedback. Also, when I get a report in a week, I will show it to you too.



Welcome back to

Thanks for the follow-up. Yes, you can upload the video, and also please share the semen analysis written report for reference. I am here to assist you. Regards.

Thank you doctor,

Thank you, I will have a report this Friday (I think they do not give it directly), for now, I saw only an overview on the site. My concentration was 10 million per milliliter of semen with immature sperms and I am attaching the video example. I am going to remove it after you watch it. Thank you very much for the feedback.



Welcome back to

Thanks for sharing the example video clip. It shows:

1. Severe Oligospermia.

2. Only 10 to 15 % motile sperms - Of which only 20 % were actively motile and the rest remain sluggishly motile.

3. 80 to 85% immotile or dead sperms.

4. Plenty of cellular debris present.

5. Morphological defects such as head defects and tail defects in sperms can be appreciated.

I would be happy if you could share your semen analysis video for an opinion as well. I am sure the laboratory records can be shared with the client when demanded. You may share your subsequent reports on Friday. How is the local infection remain now? Does the circumcised wound got healed well? Regards.

Thank you doctor,

The circumcision took a bit longer time to heal and I had some swelling. But now it is good. The circumcision helped with infection. All my redness and pain went away. So, what you just have seen, does not look good. Is it possible that it can get better in two months? Can it be related to the candida and antifungals? Or I had it before and just did not know? Thanks.



Welcome back to

Good to learn that you are recovering well. The video shows Oligo-astheno-teratozoospermia, which means, low count, slow sperms, and morphologically defective sperms. The presence of cellular debris can be attributed to the presence of pus cells secondary to infection. But it is difficult to attribute it to candida alone, as the cause is often bacterial. Antifungals only help in the treatment and do not cause low sperm counts directly. This is definitely treatable if the cause is infection alone, which it seems to be in your case, but as I said earlier, keeping in view of the sperm cycle of 120 days along with 90 days of treatment would give results. Regards.

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