To the editor,We read with great interest the recent study of Kumar et al (2008) published in this journal, concerning the role of glibenclamide or gliclazide and repaglinide in decreasing sperm quality. The authors, in this well designed and performed study, highlighted the role of intrasperm calcium concentration in regulating motility and viability of ejaculated spermatozoa. In recent years, other reports concerning the impact of some drugs, such as miconazole, clotrimazole or loperamide, on viability of human spermatozoa have been reported (Gulati et al 2006). However, the impact of drugs on sperm quality and male fertility may be underestimated. We focused our attention on the co-administration of statins (or HMG-CoA reductase inhibitors) and calcium-channel antagonists. The co-administration of atorvastatin and amlodipine has been reported as well-tolerated treatment for coexisting hypertension and dyslipidaemia (Messerli et al 2006) and without demonstrating significant adverse pharmacodynamic interactions or effects (Preston et al 2007). No studies regarding the effect of the co-administration of atorvastatin and amlodipine on male fertility have been reported. On the other hand, the absence of influence of statins on testicular reproductive function has already been demonstrated by several authors (Bernini et al 1998;Dostal et al 2001). We have recently reviewed our outpatients urological database to evaluate the impact of the co-administration of atorvastatin and amlodipine on male fertility. From a total study population of 689 patients with coexisting hypertension and dyslipidaemia attending our department for all urological diseases (with the exception of infertility), we selected all those patients who had been treated with either atorvastatin or amlodipine or atorvastatin and amlodipine co-administration, with an age lower than 55 years. We finally enrolled 287 patients; 12 patients were excluded for lack of clinical information. Thus, data from 275 were analysed. Ninety-one out of 275 had been treated with atorvastatin, 87 with amlodipine and 97 co-administered atorvastatin and amlodipine. All patients (mean age 48.5 years) had been undergoing pharmacological treatments for at least 12 months. From each patient we obtained at least two consecutive semen parameter analyses (with a mean interval time of 13.3 months). Fisher's exact test or Chi-square test ( 2 ) were used to assess statistical significance with P 0.05 accepted as significant. The two groups of patients did not show any significant difference in terms of smoking or other drug use. The two groups of patients who had undergone atorvastatin or amlodipine treatment did not have significant changes in two consecutive semen characteristics analyses. On the other hand, the group of patients who had undergone co-administration with atorvastatin and amlodipine demonstrated significant differences in semen parameters in the two consecutive semen analyses. In particular, the semen volume was significantly different (3.4 mL vs 1.1 mL) between the...