Methotrexate and fertility in men

Abstract

The possible deleterious effects of folic acid antagonist methotrexate on the fertility potential have been investigated in 26 male psoriatic patients. Examination for semen, testicular histology, and spermatogenic function using radioactive phosphorus revealed that methotrexate had no unfavorable effect on male fertility. A long follow up of the patients and their offspring is needed to exclude the possible teratogenic effect of the drug.

Methotrexate and psoriasis: 2009 National Psoriasis Foundation Consensus Conference

“…66 No increases in abnormal births have been documented with fathers on methotrexate. [67][68][69] Several possible explanations have been put forth. The oligospermia may be severe enough to inhibit fertilization.…”

“…70 Other studies revealed no changes in spermatogenesis and sperm counts. 68,71 Since one cycle of spermatogenesis requires 74 days, the conservative recommendation is to wait 3 months prior to conception to allow for the effects of methotrexate to completely pass. Based on the current evidence, it may be less likely for a man to conceive a child while exposed to low-dose methotrexate.…”

Guidelines of care for the management of psoriasis and psoriatic arthritis

“…Although some studies suggest that methotrexate treatment may result in severe, yet reversible, oligospermia despite normal hormone levels, 53 other studies reveal no changes in spermatogenesis and sperm counts. 54,55 One cycle of spermatogenesis requires 74 days thus it is appropriate for male patients to wait 3 months after discontinuing methotrexate before attempting to conceive a child to allow for the methotrexate effects to be eliminated.…”

Advanced Therapy for Inflammatory Bowel Disease: A Guide for the Primary Care Physician

“…Fertility should be restored in men who stop taking methotrexate or sulfasalazine 3 months before trying to conceive. 59,60 Health Maintenance Measures Primary care physicians and gastroenterologists need to work in tandem to cover the health maintenance needs of patients with IBD. Issues surrounding appropriate vaccinations should be addressed at the time of diagnosis.…”