Tough question. While most studies have shown that while finasteride can decrease ejaculate volume in some men, most indicate it does not change fertility. There have been small studies looking at men with low initial sperm counts that did indicate the discontinuation of finasteride led to an increased sperm count. Couples planning for children should discuss their comfort level in taking any medication including finasteride. In my practice I have some men that stop taking finasteride and others that continue throughout the pregnancy without issues. My advice is usually to continue the finasteride but keep the pills away from the mother because there is concern of birth defects in a pregnant female that absorbs the medication thru her skin. Men with the signs of male pattern baldness may be good candidates for finasteride. This prescription medication is many times a logical first step in addressing thinning, before or sometime s concurrently with hair restoration surgery. It typically works better on the crown than the front, although I have seen in practice some men in the very early stages that did have changes on the hairline with finasteride. The hair loss will likely increase with age to some degree regardless of your taking finasteride but at a much slower rate. The goal is to keep as much native hair as possible while other, possibly stronger, methods of prevention are researched. If you decide against finasteride then treatments such as Minoxidil (either over the counter or a compounded version), Laser and Stem Cell Therapy often yield positive results with my patients. If you are concerned with thinning hair, it is wise to address it early. Find a physician that specializes in hair restoration and come in to discuss options and maintain a relationship to track the progression whether you are considering surgery or not. As with most health concerns, prevention is key :) Dr. Christopher Varona, DO Ziering Medical