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An older study supposed to report that ivermectin – already in the headlines – causes infertility in 85 percent of men gained traction online this month. However, there are many reasons to doubt this claim. If ivermectin interferes with male fertility, and this is a big if, the magnitude of the effects is probably much smaller than what is reported.
Ivermectin, an antiparasitic drug, has become the latest flashpoint in the culture war, which means that many people are motivated to distort the truth about it. Most of this comes from people exaggerating the benefits found against COVID-19 in small studies to claim that it removes the need for vaccination. There is absolutely no evidence for this, but that doesn’t mean that proper doses for proper treatment are particularly dangerous. However, diverting its uses for, say, COVID, is dangerous, the FDA has warned.
In the past few days, reports have circulated on social media, picked up by some news outlets, of a 2011 study indicating that 85% of Nigerian men treated for river blindness with ivermectin were at least partially sterilized.
The study describes the serious consequences for male fertility of taking ivermectin. However, the figure of 85 percent does not come from this study itself, but from an article cited in 2002 by overlapping authors. Previous work does not appear to be available online and may not exist. The 2011 document, however, is accompanied by a few major red flags.
To begin with, it was published in the Scholars Research Library. Although it claims to be peer reviewed, the Scholars Research Library carries some hallmarks of a “predatory journal,” which is a place that will publish whatever is submitted – for a fee. These journals do not require proper academic standards for publication, such as peer review, and unscrupulous researchers use predatory journals to fill their resumes with work that would not be published under proper scrutiny.
The 2011 study also lacks any recognition of its limitations, usually a bad sign for a medical article, and lacked a control group. Although described as being in 385 patients, most of them were excluded due to a low pre-existing sperm count, so the effects of ivermectin have only been studied in 37 individuals. The fact that the sperm count was so low in the men with river blindness before they were put on ivermectin indicates that the drug may not be the problem.
Snopes has attempted to contact the Nigerian universities the authors claim to be based in to see if they are actually working there, but has so far received no response.
However, the biggest warning sign is that ivermectin is not a new drug. In addition to being widely used as a dewormer for cattle in the West, it has treated so many people for tropical parasites that its discovery won a Nobel Prize. If most of the men who took it in the past four decades had become infertile, it’s a safe bet there would be more than one study revealing this fact.
This does not exclude more rare effects. If ivermectin caused very rare cases of infertility, it could take a long time for anyone to realize it. Indeed, a 2008 study on its effects on infertility in the peer-reviewed journal Environmental Toxicology and Pharmacology reports “mild effects” of ivermectin alone on rats, but greater effects when it is is combined with verapamil, used to treat high blood pressure. Other animals can be affected in the same way.
It’s not impossible that subtle effects, or more serious effects associated with other drugs, may have remained under the radar for so long, but an 85% drop in fertility for ivermectin alone is implausible.
Meanwhile, research continues on whether ivermectin has any benefit against COVID-19, with studies so far producing conflicting results, although none of what has been published justifies the hype. .
On the other hand, memes presenting ivermectin as a medicine only for animals can be fun, but in the cause of evidence-based medicine, two wrongs don’t do a good.
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