A, drugs on male fertility impact pathway: (1) direct action on the male gonads, affecting the testes sperm-producing spermatogenic cells and testicular Leydig cell function (2) action on the hypothalamus-pituitary-gonadal axis, affecting the normal secretion of hormones in the body, resulting in changes in gonadotropin and testosterone levels, ultimately affecting fertility (3) damage to sperm function (4) negative impact on male libido II. Drugs affecting male fertility are: (1) immunosuppressive drugs: the effect on fertility with the type of drug, dose and time of use. These drugs include cyclophosphamide, vincristine, adriamycin, scramblomycin, nitroprusside, nitrogen mustard, procarbazine hydrochloride, cisplatin and etoposide. Cyclophosphamide causes damage to male germ cells, often resulting in irreversible reduced fertility. Methotrexate has no significant effect on spermatogenesis, but may lead to reversible infertility; discontinue 3 months before planning pregnancy. The effect of leflunomide on male fertility is minimal, and due to lack of sufficient information, it is currently recommended that men taking leflunomide who also want to have children may refer to the regimen for female patients and take abciximide 8 g, 3/d for 11 d. Azathioprine, cyclosporine A or mortifamate do not appear to reduce male fertility, but cyclosporine can cause a decrease in sperm density and viability. (2) Antihypertensive drugs: Most mainly impair sexual function, such as certain diuretics can cause erectile dysfunction by reducing vascular resistance, resulting in inadequate blood supply to the penis; beta-blockers, such as Tretinoin, can affect libido and erectile function; Ativan affects fertility by affecting erectile function and libido and the potential impact on semen quality; calcium channel blockers can inhibit the normal fertilization process. (3) Sex hormone drugs: Anti-androgen drugs affect the normal physiological function of androgens in the body (decreased libido and sperm production disorders), causing fertility problems. More and more athletes abuse anabolic steroids, such as large amounts of synthetic androgens can lead to hypogonadism with low gonadotropins, and in most cases normal gonadal function can be restored after stopping the drug. (4) Other drugs: Some antibacterial agents such as neomycin, erythromycin, gentamicin, etc. may cause a decrease in semen quality. Colchicine and allopurinol for the treatment of gout also have adverse effects on male fertility. Furacilin, cimetidine, salazosulfapyridine, cocaine, nicotine and cannabis can impair spermatogenesis, but spermatogenesis and/or sperm function can return to normal after cessation of drug use. Lyuzosulfapyridine can affect late sperm maturation, and sperm quality can be restored after 2 to 3 months of discontinuation, enabling successful conception. Exposure to environmental toxins such as pesticides should also be noted.