Tadalafil and Fertility: Does It Affect Conception?

Tadalafil and Fertility: What You Need to Know

Published: 8 November 2026

Many men wonder about the relationship between tadalafil and fertility, particularly when planning to start a family. The good news is that tadalafil does not harm male fertility, and current evidence suggests it does not negatively affect sperm quality, count, or the ability to conceive [4]. In fact, by successfully treating erectile dysfunction, tadalafil can help couples trying for a baby by making intercourse possible and reducing performance anxiety.

Does Tadalafil Affect Sperm Quality or Count?

Research into tadalafil and fertility has found no evidence that this medication damages sperm or reduces sperm count [4]. Tadalafil belongs to a class of medicines called PDE5 inhibitors, which work by increasing blood flow to the penis during sexual stimulation. This mechanism of action is localised and does not interfere with the production or maturation of sperm in the testicles.

Some studies have even suggested that PDE5 inhibitors might have a neutral or potentially beneficial effect on certain sperm parameters, though more research is needed to confirm these findings. What is clear is that tadalafil is not associated with reduced fertility in men. The medication works only when you are sexually aroused and does not alter hormone levels or the reproductive process itself.

If you have concerns about your fertility or sperm quality, these should be discussed with your GP or a fertility specialist. Factors such as age, lifestyle, underlying health conditions, and other medications can all influence male fertility, and a healthcare professional can help identify any issues and recommend appropriate tests if needed.

How Tadalafil Works and Why It Doesn't Harm Fertility

Tadalafil works by inhibiting an enzyme called phosphodiesterase type 5 (PDE5), which is found in the smooth muscle of blood vessels in the penis [4]. When you are sexually stimulated, your body releases nitric oxide, which triggers a chain of events leading to increased blood flow. PDE5 normally breaks down the chemical messenger that maintains this blood flow, so by blocking PDE5, tadalafil helps sustain an erection.

This action is specific to the blood vessels and does not affect the testes, where sperm are produced, or the hormonal systems that regulate fertility. Tadalafil does not alter testosterone levels, luteinising hormone, or follicle-stimulating hormone—the key hormones involved in sperm production. The medication is also rapidly metabolised and eliminated from the body, with a half-life of about 17.5 hours, meaning it does not accumulate in reproductive tissues.

Because tadalafil's effects are confined to improving erectile function through vascular mechanisms, it does not interfere with the biological processes required for conception. Men taking tadalafil can continue to use it while trying for a baby without concern that the medication will reduce their chances of becoming a father.

Tadalafil Dosing Options

Tadalafil is available in two main dosing strategies: on-demand and daily [4]. On-demand tadalafil (typically 10mg or 20mg) is taken at least 30 minutes before sexual activity, with effects lasting up to 36 hours. This flexibility can be particularly helpful for couples trying to conceive, as it allows for spontaneity around ovulation windows without the need to time medication precisely. Daily tadalafil (2.5mg or 5mg) is taken once a day at the same time, providing continuous support for erectile function. Both approaches are compatible with trying for a baby, and the choice depends on your lifestyle and how often you have sex.

Using Tadalafil When Trying for a Baby

If you and your partner are trying to conceive, tadalafil can be a valuable tool to help overcome erectile dysfunction without compromising your fertility goals. Erectile dysfunction is common and can be caused by stress, anxiety about conception, underlying health conditions, or a combination of factors [1]. The pressure to conceive can itself worsen ED, creating a difficult cycle for couples.

Tadalafil helps break this cycle by reliably supporting erectile function, which can reduce performance anxiety and make the process of trying for a baby less stressful. The medication does not need to be stopped when attempting conception, and there is no evidence that it affects the health of a developing pregnancy or baby. However, it is important to ensure that any underlying causes of ED are identified and managed, as conditions such as diabetes and cardiovascular disease can affect both erectile function and overall health [2].

When using tadalafil while trying for a baby, always inform your prescriber about your plans. They can review your overall health, check for any conditions that might affect fertility, and ensure that tadalafil is the right choice for you. If conception does not occur after a year of regular unprotected intercourse (or six months if the woman is over 35), both partners should see their GP for fertility assessment.

Tadalafil and Fertility: What the Research Shows

Clinical studies and post-marketing surveillance of tadalafil have not identified any negative impact on male fertility or reproductive outcomes [4]. The medication has been used by millions of men worldwide since its approval, and no pattern of fertility problems or birth defects has been linked to its use. Tadalafil is not known to be mutagenic (causing genetic changes) or to affect sperm DNA integrity.

Some research has explored whether PDE5 inhibitors might even have benefits for certain fertility-related conditions. For example, studies have investigated their potential role in improving sperm motility (movement) in specific cases, though this remains an area of ongoing research and is not an approved use. What is well-established is that tadalafil does not harm fertility and can be used safely by men who are planning to father children.

It is worth noting that tadalafil is classified as pregnancy category B in some international guidelines, meaning animal studies have not shown harm to the foetus, though it is not relevant for male users. The key point is that there is no biological mechanism or clinical evidence to suggest that a man taking tadalafil would have reduced fertility or that his partner or baby would be at risk.

Lifestyle Factors and Fertility

While tadalafil does not affect fertility, other lifestyle factors can have a significant impact on sperm quality and your ability to conceive [1]. Smoking, excessive alcohol, obesity, poor diet, lack of exercise, and chronic stress can all reduce sperm count and motility. If you are trying for a baby, adopting a healthy lifestyle—maintaining a healthy weight, eating a balanced diet rich in antioxidants, exercising regularly, limiting alcohol, and avoiding smoking—can improve both your erectile function and your fertility. Your GP or a fertility specialist can provide tailored advice and support.

Are There Any Risks of Tadalafil for Conception?

There are no known risks of tadalafil for conception or for the health of a baby conceived while the father is taking the medication [4]. Tadalafil is not present in semen at levels that would affect a partner or developing embryo. The medication is metabolised in the liver and excreted primarily in faeces, with only a small amount appearing in urine, and it does not accumulate in reproductive fluids.

However, it is important to use tadalafil safely and only when appropriate. The medication should not be taken if you have certain health conditions, such as severe heart disease, very low blood pressure, or if you are taking nitrates or other medicines that interact dangerously with PDE5 inhibitors [4]. These contraindications are about your immediate safety, not fertility, but they must be respected. Always complete an online consultation or see your GP to ensure tadalafil is suitable for you.

If you experience side effects from tadalafil—such as headache, indigestion, back pain, or nasal congestion—these are usually mild and do not affect fertility [4]. Serious side effects are rare but include prolonged erection (priapism), sudden vision or hearing loss, and chest pain. If any of these occur, seek urgent medical help. Your prescriber will review your medical history and current medications to minimise risks and ensure safe use.

Getting Tadalafil Safely When Planning a Family

If you are experiencing erectile dysfunction and planning to start a family, it is important to seek help early. ED can be an early warning sign of underlying health conditions such as cardiovascular disease or diabetes, which can also affect fertility and overall health [1][2]. Seeing your GP for an initial assessment is a sensible first step, as they can investigate any underlying causes, check your cardiovascular health, and discuss treatment options.

Tadalafil is available on prescription after a clinical consultation with a UK-registered prescriber. At Cured Pharmacy, you can complete a confidential online consultation, which is reviewed by a qualified prescriber who will check your medical history, current medications, and suitability for tadalafil. If approved, your medication is dispensed by our GPhC-registered pharmacy and delivered discreetly to your door. Tadalafil is available from £7.95 (or £6.36 for your first order with code Ednew).

When completing your consultation, be open about your plans to conceive and any concerns about fertility. The prescriber can provide reassurance, answer questions, and ensure that tadalafil is the right choice for you. If you have not already done so, consider discussing fertility with your GP, especially if you have been trying to conceive for several months without success. Early intervention can make a significant difference to both erectile function and fertility outcomes.

Other ED Treatments and Fertility

All licensed oral ED treatments in the UK—sildenafil, tadalafil, vardenafil, and avanafil—are PDE5 inhibitors and work in a similar way [3][4][5][6]. None of these medications are known to harm male fertility or affect conception. The choice between them depends on factors such as how quickly you need the medication to work, how long you want the effects to last, and any side effects you experience. Your prescriber can help you choose the most suitable option. If oral treatments are not effective or suitable, other options such as vacuum devices, alprostadil injections or cream, or referral to a specialist may be considered [2][7].

Scientific References

1. NHS. (n.d.). Erectile dysfunction (impotence). NHS website. https://www.nhs.uk/conditions/erection-problems-erectile-dysfunction/ [accessed 8 November 2026]
2. National Institute for Health and Care Excellence. (n.d.). Erectile dysfunction. Clinical Knowledge Summaries. https://cks.nice.org.uk/topics/erectile-dysfunction/ [accessed 8 November 2026]
3. Joint Formulary Committee. (n.d.). Sildenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/sildenafil/ [accessed 8 November 2026]
4. Joint Formulary Committee. (n.d.). Tadalafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/tadalafil/ [accessed 8 November 2026]
5. Joint Formulary Committee. (n.d.). Vardenafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/vardenafil/ [accessed 8 November 2026]
6. Joint Formulary Committee. (n.d.). Avanafil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/avanafil/ [accessed 8 November 2026]
7. Joint Formulary Committee. (n.d.). Alprostadil. British National Formulary. NICE. https://bnf.nice.org.uk/drugs/alprostadil/ [accessed 8 November 2026]

Information on this page is for educational purposes only and is not medical advice. Prescription treatments require clinical assessment by a UK-registered prescriber. Always consult a qualified healthcare professional before starting or changing any medication.