Antibiotics’ Influence on Fertility: A Narrative Review

The purpose of this review is to highlight the complex influence of antibiotics on human fertility and the need for them not to be underestimated. In creating this review article, data and information from the following international databases were used: PubMed, Scopus and Clarivate Analytics. Only full text articles were used. Antibacterial antibiotics are a group of drugs essential in fighting infections, having multiple mechanisms of action at the level of the bacterial cell; but at the same time they also act on human cells. One of the important actions of antibiotics is on fertility. There are both experimental and clinical data showing the influence of some antibiotics on fertility. There are both positive and negative influences of these drugs on fertility. Some of the most important actions with a positive impact on fertility are: therapy of pelvic infections in women, treatment of endometritis, reduction in post-abortion infections, treatment of infections of the male genital tract—infections that reduce fertility. The most important negative implications of some antibiotics are the direct effects of reducing the production of gametes, decreasing the activity or quality of the gametes, reducing the synthesis of sexual hormones and negative influences on the evolution of pregnancy, including spontaneous abortion in some cases. Other negative influences are produced by the direct action of some antibiotics on the embryo. Some antibiotics such as azithromycin and nitrofurantoin increase the risk of miscarriage. Although only a limited number of antibiotics are known to have an influence on fertility, this influence should not be underestimated in clinical practice.