Does Suboxone Affect Fertility?

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No, as of now researchers don’t believe Suboxone impacts fertility.

We do know that long-term opioid misuse can potentially impact fertility, although the reasons for this are unclear. We do know that long term drug use can cause weight loss, nutritional deficiencies, and hormonal imbalances all of which can potentially impact a woman’s ability to get pregnant.

The research on Suboxone and fertility specifically is very limited. However, it is likely that Suboxone will less impact fertility than being on full opioid agonists like oxycodone, methadone, fentanyl or heroin.

Suboxone & Fertility Research 

Researchers have published few studies on OUD therapies and fertility. None regarding Suboxone are definitive. 

In Men

In one study, researchers found that buprenorphine (Suboxone) could suppress testosterone and affect fertility in mice. [1] We do not know if this would apply to humans. It is also true that in rare occasions, Suboxone has been associated with loss of libido or erectile dysfunction in men. 

In Women 

A study in rats suggests that buprenorphine could change estrogen production. But the study is small, and was not conducted in humans [2]. Moreover, changes in estrogen levels do not necessarily impact fertility rates.  

What Should You Do?

Continued opioid misuse may impact your fertility, certainly more than Suboxone would, were you to be on MAT. Researchers say using opioids like fentanyl or heroin can lower a woman's fertility by 29%.[3]

Talk to your doctor about your treatment options. Together, you can find a solution that protects your health and your family.

Suboxone & Fertility FAQs

Does Suboxone affect your hormones?

The simplest answer is probably not. Researchers aren't sure if (or how) Suboxone affects hormones. More studies are required before we can say whether or not Suboxone could influence your ability to conceive. However, as far as we know, Suboxone is not thought to significantly affect fertility. Patients who are on Suboxone prior to conception are generally encouraged to continue their treatment both during attempts to conceive and even onward into pregnancy. Suboxone is thought to be very safe during pregnancy itself. Most women who are trying to conceive while on Suboxone do so successfully. If they do encounter difficulties, it may be due to many other factors and not the Suboxone. 

Does buprenorphine affect sperm count?

Small studies suggest that buprenorphine could impact a man's sperm count but as of now this has not been proven. [1] Most physicians would say that it is perfectly safe for men to stay on Suboxone while trying to conceive a child, and they would recommend against discontinuing for this reason, particularly if Suboxone is providing benefit in preventing relapse to OUD. 

Can you be pregnant while on Suboxone?

Yes, you can.

Historically, we thought that the Naloxone component of Suboxone might be teratogenic meaning it may harm a baby's development.[4] However, now that we have more research and data on this medication, Naloxone is NOT thought to be teratogenic and many women are safely prescribed Suboxone during their pregnancies.

If you become pregnant or are trying to become pregnant while on Suboxone, you should always speak to your doctor to support you both in your recovery from Substance use disorder as well as during your pregnancy. But in most cases, it is perfectly safe for you to continue on your Suboxone therapy during pregnancy.

Sources

  1. The Effects of Long-Term Administration of Buprenorphine on Blood Testosterone Level and Morphometrical and Histological Changes of Mouse Testis. Comparative Clinical Pathology. https://www.researchgate.net/publication/251418994_The_effects_of_long-term_administration_of_buprenorphine_on_blood_testosterone_level_and_morphometrical_and_histological_changes_of_mouse_testis. December 2011. Accessed August 2022.
  2. Prescription Opioid Use Among Populations of Reproductive Age: Effects on Fertility, Pregnancy Loss, and Pregnancy Complications. Epidemiologic Reviews. https://academic.oup.com/epirev/article/42/1/117/5916503. October 2020. Accessed August 2022.
  3. NIH Study Suggests Opioid Use Linked to Pregnancy Loss, Lower Chance of Conception. National Institutes of Health. https://www.nih.gov/news-events/news-releases/nih-study-suggests-opioid-use-linked-pregnancy-loss-lower-chance-conception. August 2020. Accessed August 2022. 
  4. Treatment for Opioid Use Disorder Before, During, and After Pregnancy. Centers for Disease Control and Prevention. https://www.cdc.gov/pregnancy/opioids/treatment.html. July 2021. Accessed August 2022.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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