Effect of systemic isotretinoin on semen parameters and sperm ultrastructure in male patients treated for acne vulgaris : An electron microscope study

Background: Acne vulgaris (AV) is a common dermatological problem that affects males and females in the adolescent period and early adulthood. Isotretinoin is the treatment of choice for moderate to severe cases of AV, as it provides complete cure with minimal scarring. Males receiving isotretinoin are always concerned about its adverse effects, especially on their fertility potential. Objective: To study the effect of systemic isotretinoin on semen parameters and sperm ultrastructure of male patients treated for AV. Patients and Methods: This study was carried out on 40 male patients with resistant AV presented to the Dermatology Clinic, Suez Canal University Hospital. A total cumulative dose of 120 mg/kg of systemic isotretinoin was given to all patients over a period of 6 months. Computer-assisted semen analysis and sperm ultrastructure assay using transmission electron microscopy were done for all patients before and after the course of treatment. Results: After the course of systemic isotretinoin, a statistically significant increase in sperm concentration (million/ml), progressive sperm motility %, and morphologically normal sperms % was observed. By transmission electron microscopy, all sperm ultrastructural parameters and sperm structure dimensions were not significantly changed after isotretinoin use. Conclusion: Systemic isotretinoin in AV is a safe modality of treatment with no harmful adverse effects on semen parameters, sperm morphology, or sperm ultrastructure after 6 months of use.