Psoriasis, methotrexate, and oligospermia

Abstract

A young man with severe psoriasis was treated intermittently with methotrexate. On two different occasions, severe oligospermia documented by serial seminal fluid analyses was present coincident with methotrexate administration. Discontinuation of methotrexate resulted in normal sperm concentration. Measurements of serum gonadotrophin and testosterone levels were normal during and after methotrexate treatment. It is concluded that methotrexate administration may result in severe oligospermia and that these inhibiting effects on spermatogenesis are reversible.

Behçet's syndrome in pregnancy

“…78 Spermatogenesis is potentially susceptible to methotrexate-induced mutagenesis resulting in chromosomal abnormalities and single gene mutations, 79 in addition to severe reversible oligospermia despite normal gonadotropins and testosterone. 80 However, a case series of 26 male patients exposed to methotrexate found no unfavourable effect on male fertility. 81 Methotrexate should be withdrawn at least three months prior to conception in both women and men.…”

Hypogonadism After Childhood Cancer Treatment

“…None of them had PH. Other authors as well, didn't observe important role of this type of ChT in pathogenesis of gonadal failure (Blatt et al 1981, Müller 2003), although they reported on transient oligospermia in adult patients following treatment with methotrexate (Sussman & Leonard 1980) and on possible role of VCR in pathogenesis of germ cell epithelium damage in childhood and adolescence (Rautonen et al 1992). In the group of patients treated with ChT containing AMD and VCR, 2 female patients had ovarian dysfunction and 2 males had LC dysfunction, suggesting that therapy with these 2 chemotherapy agents can cause mild degree of ovarian or LC damage.…”

“…Antimetabolites usually do not cause irreversible damage to testes, but can cause temporary oligospermia. (Sussman & Leonard 1980). …”

Review article: practical management of inflammatory bowel disease patients taking immunomodulators

“…As methotrexate is both teratogenic and a known abortifacient, ensuring adequate birth control is absolutely essential. In addition, methotrexate may be toxic to sperm, 88,89 and men should stop methotrexate at least for 3 months before trying to conceive.…”