Evaluation of the Quality of Semen and Sexual Function in Men with Inflammatory Bowel Disease

Valer, Paz; Algaba, Alicia; Santos, D.F.; Fuentes, Manuel; Nieto, Elva; Gisbert, Javier P.; López, Pilar Sáez; Quintanilla, E.; García‐Alonso, Francisco Javier; Guerra, Iván; Páez, Álvaro; Bermejo, Fernando

doi:10.1097/mib.0000000000001081

Cited by 28 publications

(23 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A cohort study reported a trend towards higher rates of infertility amongst 30 patients on azathioprine, but the incidence of infertility did not reach statistical significance compared with 54 unexposed disease (IBD) controls (25). The remaining 6 studies (>45 exposures) (7,(29)(30)(31)(32)(33) drew no association between azathioprine and abnormal sperm parameters.…”

Section: Fertilitymentioning

confidence: 99%

Safety of anti-rheumatic drugs in men trying to conceive: A systematic review and analysis of published evidence

Mouyis

Flint

Giles

2019

Seminars in Arthritis and Rheumatism

View full text Add to dashboard Cite

There is limited evidence relating to the impact of disease modifying anti-rheumatic drugs (DMARDs) upon male fertility and peri-conception paternal exposure in men with rheumatic disease. Therefore, we conducted a systematic review of available evidence to update information on this subject and guide paternal counselling. A systematic search of PubMed and Embase was carried out up to September 2017, to find relevant peer-reviewed papers, using keywords for fertility/spermatogenesis/conception, men, and disease modifying or biologic drugs commonly prescribed in patients with rheumatic disease. The search yielded 724 papers, and the titles/abstracts were screened independently by 2 authors, duplicates removed and 233 potentially relevant papers selected for full text review. A total of 84 papers were included in the final analysis which covered the impact on fertility of over 611 male exposures to relevant drugs, and over 5986 pregnancies conceived during paternal exposure to (or within 3 months of stopping) these drugs. Aside from the known adverse impact of cyclophosphamide and sulfasalazine on spermatogenesis, overall there was no firm evidence of harm to fertility or pregnancy outcomes with paternal exposure to anti-TNF therapies, abatacept, rituximab, azathioprine, cyclosporine A, hydroxychloroquine, leflunomide, methotrexate or mycophenolate mofetil. There was no evidence found pertaining to the effects of male exposure to IVIG, tacrolimus, golimumab, anakinra or belimumab on fertility or pregnancy outcomes. These results provide further reassurance as to the safety of many DMARDs for men trying to conceive and will be useful when counselling men about risks of anti-rheumatic drugs to fertility and pregnancies, and following accidental conception.

show abstract

Section: Fertilitymentioning

confidence: 99%

Safety of anti-rheumatic drugs in men trying to conceive: A systematic review and analysis of published evidence

Mouyis

Flint

Giles

2019

Seminars in Arthritis and Rheumatism

View full text Add to dashboard Cite

show abstract

“…2 Missing (%): smoking for exposed groups 59/2380 = 2.5%, smoking for unexposed groups 28,235/1,011,614 = 2.8%, BMI for exposed cohort 974/2,380 = 40.9%, BMI for unexposed cohort 462,153/1,011,614 = 45.7%. 3 Crohn's disease or ulcerative colitis. 4 Inflammatory rheumatic diseases, spondylopathies, inflammatory polyarthritis/psoriasis.…”

Section: Resultsmentioning

confidence: 99%

“…2 No distinct pattern of CAs within this group. 3 Excluding Q5.59 undescended testis. 4 Excluding Q659 dislocations of the hip.…”

Section: Discussionmentioning

confidence: 99%

“…A recently published study by Valer et al . reports that men with Crohn's disease tend to have poor semen quality. Other studies have focused on the impact of specific medications on sperm abnormalities , and apart from case reports, only very few studies have focused on the clinical impact, in terms of birth outcome, of paternal medications taken around the time of conception.…”

mentioning

confidence: 99%

“…Compared to the existing literature on the associations between maternal medication use during pregnancy and birth outcome, the available data on possible adverse effects after paternal use of medication around the time of conception are very sparse [1,2]. A recently published study by Valer et al [3] reports that men with Crohn's disease tend to have poor semen quality. Other studies have focused on the impact of specific medications on sperm abnormalities [4][5][6][7], and apart from case reports, only very few studies have focused on the clinical impact, in terms of birth outcome, of paternal medications taken around the time of conception.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Birth Outcome of Children Fathered by Men Treated with Systemic Corticosteroids during the Conception Period – A Cohort Study based on Nationwide Data

Larsen

Friedman

Magnussen

et al. 2017

Basic Clin Pharma Tox

View full text Add to dashboard Cite

Information on the safety of paternal use of medications prior to the time of conception is limited, and there is little available evidence regarding possible adverse effects of paternal use of systemic corticosteroids (SCS). In this cohort study, based on nationwide data, we examined the association between paternal use of SCS prior to conception and adverse birth outcome. The study includes data from all singletons born in Denmark from 1 January 1997 through 2013 (N = 1,013,994). Children fathered by men who redeemed a prescription of SCS within 3 months before conception (N = 2380) constituted the exposed groups. The outcome was congenital abnormalities (CAs), pre-term birth and small-for-gestational age (SGA). We adjusted for co-variates in multi-level logistic regression analyses. The adjusted odds ratios for pre-term birth and SGA were 0.81 (95% CI: 0.55-1.21) and 1.06 (95% CI: 0.68-1.64), respectively. The adjusted odds ratios for CAs were 1.08 (95% CI: 0.87-1.40) in children fathered by men who redeemed one prescription within 3 months before conception and 1.33 (95% CI: 0.99-1.79) in children fathered by men who redeemed two or more prescriptions. This study is the largest to date examining the effect of paternal use of SCS prior to conception on birth outcome. We found no significantly increased risk of pre-term birth or SGA. In children of fathers who redeemed at least two prescriptions of SCS within 3 months before conception, we found an increased risk of CAs, though not statistically significant. The types of CAs did not show a distinct pattern.

show abstract

Immunosuppressants and Male Reproduction

Drobnis

Nangia

2017

Advances in Experimental Medicine and Biology

View full text Add to dashboard Cite

Prolonged use of immunosuppressant medications is occasionally seen in infertile men with chronic inflammatory conditions; autoimmune disorders; or an organ or hematopoietic stem cell transplant. Chronic inflammation impacts negatively on male reproductive endpoints, so immunosuppressant therapy can produce improvements. Corticosteroids have been used to treat antisperm antibodies and even as an empirical treatment for male infertility in general. Trials of these methods have provided mixed results on semen quality and fertility, with improvement, no change and negative effects reported by different investigators. In a substantial number of observational studies, patients on long-term therapy with prednisone for chronic inflammatory disease, testosterone levels were lower compared to untreated controls, though randomized controlled trials have not been conducted. Similarly decreases in testosterone have been reported in men receiving corticosteroids to minimize transplant rejection; however, most were treated with multiple immunosuppressive medications that may have contributed to this effect. A large number of trials of healthy men treated with corticosteroids have shown some disruption in reproductive hormone levels, but other studies reported no effect. Studies in monkeys, rats (at human equivalent dose), cattle, sheep, and horses have shown endocrine disruption, including low testosterone with dexamethasone treatment. Of the cytostatic immunosuppressives, which have high potential for cellular damage, cyclophosphamide has received the most attention, sometimes lowering sperm counts significantly. Methotrexate may decrease sperm numbers in humans and has significant negative impacts in rodents. Other chemotherapeutic drugs used as immunosuppressants are likely to impact negatively on male fertility endpoints, but few data have been collected. The TNF-α Inhibitors have also received little experimental attention. There is some evidence that the immunophilin modulators: cyclosporine, sirolimus, and everolimus cause endocrine disruption and semen quality impairment. As we review in this chapter, results in experimental species are concerning, and well-designed studies are lacking for the effects of these medications on reproductive endpoints in men.

show abstract

Evaluation of the Quality of Semen and Sexual Function in Men with Inflammatory Bowel Disease

Abstract: Men with Crohn's disease showed a trend toward poorer semen quality than those with ulcerative colitis. Treatment with anti-tumor necrosis factor drugs does not seem to be associated with poor sperm quality. In patients in clinical remission, male sexual function is not affected by IBD.

Cited by 28 publications

References 45 publications

Safety of anti-rheumatic drugs in men trying to conceive: A systematic review and analysis of published evidence

Safety of anti-rheumatic drugs in men trying to conceive: A systematic review and analysis of published evidence

Birth Outcome of Children Fathered by Men Treated with Systemic Corticosteroids during the Conception Period – A Cohort Study based on Nationwide Data

Immunosuppressants and Male Reproduction

Contact Info

Product

Resources

About