Netherlands: Inflammatory arthritis (IA) diagnosis before or during the peak of reproductive age can impair male fertility, reveals a recent study in the BMJ journal Annals of the Rheumatic Diseases. The study showed that IA diagnosis can lower fertility rates, higher childlessness rates, and more fertility problems.
Rheumatoid arthritis (RA) and spondyloarthritis (SpA) are common causes of IA that affect men before or during the peak of their reproductive age. IA is associated with erectile dysfunction, male fertility, and hypogonadism. However, the impact of IA on male fertility is not explored much. Considering this, Luis Fernando Perez-Garcia, Rheumatology, Erasmus Medical Center, Rotterdam, The Netherlands, and colleagues aimed to evaluate the impact of IA on several male fertility outcomes; fertility rate (number of biological children per man), family planning, fertility problems, and childlessness.
For this purpose, the researchers performed a multicentre cross-sectional study (iFAME-Fertility). Men with IA aged 40 years and older who indicated that their family size was complete were invited to participate. They were made to complete a questionnaire that included questions related to demographic, medical and fertility. Patients were divided into groups according to age at the time of their diagnose s: ≤30 years (before the peak of reproductive age), between 31 and 40 years (during the peak) and ≥41 years (after the peak), to analyze the impact of IA on fertility rate.
The study included a total of 628 participants diagnosed with IA.
Based on the study, the researchers found the following:
Men diagnosed ≤30 years had a lower mean number of children (1.32) than men diagnosed between 31 and 40 years (1.60) and men diagnosed ≥41 years (1.88). This was statistically significant.
The percentages of men diagnosed ≤30 and 31–40 years who were involuntary childless (12.03% vs 10.34% vs 3.98%) and who reported having received medical evaluations for fertility problems (20.61%, 20.69% and 11.36%) were statistically significant higher than men diagnosed ≥41 years.
"This is the first study to show that IA can impair male fertility. Men diagnosed with IA before and during the peak of reproducitbe aage had a higher childlessness rate, lower fertility rate, and more fertility problems," wrote the authors. "The association could be due to multiple biological and non-biological mechanisms and there is an urgent need to improve the quality of care for men diagnosed with IA and a desire for parenthood."
Reference:
Perez-Garcia LF, Röder E, Goekoop RJ, et alImpaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)Annals of the Rheumatic Diseases 2021;80:1545-1552.