Arthritis and male fertility, what is their relationship?

This pathology is associated with male infertility, erectile dysfunction and insufficient testosterone production.

Several inflammatory proteins involved in the immune response associated with inflammatory arthritis play a key role in regulating sperm production. Photo: Shutterstock.

IN rheumatoid arthritis or any of the other species arthritis inflammatory, diagnosed before or during the years of maximal reproductive activity, may reduce the fertility of maleaccording to a study published online in the Annals of the Rheumatic Diseases.

IN arthritis According to the results of this study, inflammatory diseases are associated with fewer children, higher infertility rates, involuntary infertility and fertility problems, such as poor sperm quality.

This pathology, which includes rheumatoid arthritison arthritis psoriasis, arthritis juvenile idiopathic and ankylosing spondylitis has been associated with male infertility, erectile dysfunction and insufficient testosterone and / or semen production (hypogonadism). But the impact of arthritis inflammatory as male for the father of the children remains largely unknown.

To study this question, researchers led by Luis Fernando Perez-Garcia, a rheumatologist at the Erasmus Medical Center in the Netherlands, compared the fertility rate or the number of children per man between male diagnosed by arthritis inflammatory based on your age at diagnosis; 30 years or younger; between 31 and 40 years (considered the maximum reproductive age); and 41 years or older.

Participants were withdrawn from 8 different hospitals in the Netherlands between September 2019 and January 2021. About 628, over the age of 40 and indicating the full size of their family, completed a questionnaire on medical and fertility problems they had before and after being diagnosed arthritis inflammatory.

The researchers also compared the total number of pregnancies associated with each man, the desired family size, the proportion of male without children and the results of medical assessments for fertility problems.

After adjusting for potentially influential factors, such as current age, educational level, history of cardiovascular disease and partner infertility, male diagnosed with any kind arthritis inflammatory disease before the age of 30 there were significantly fewer children than male from the other two age groups.

These male they had an average of 1.32 children, compared with 1.56 of those diagnosed between the ages of 31 and 40 and 1.88 of those diagnosed when they were 41 or older.

Moose male diagnosed before or when they were 30 years old also had fewer pregnancies (1.45) than those diagnosed between 31 and 40 years (1.73) or more (1.98). In the Netherlands between 1 to 5 and 1 to 4 male they have no children. Among the participants, 143 (just over 22%) were childless, of which approximately two thirds (99; 69%) were voluntarily childless.

Once again the percentage of male without children is significantly higher among those diagnosed before or at the age of 30 (45; 34%) than among those diagnosed between 31 and 40 (39; 27%) and those diagnosed at the age of 40 (59; 17%) ).

In addition, the share of male involuntary childlessness differs significantly between the 3 groups: 16 (12%); 15 (10%); and 13 (4%). Voluntary childlessness is also different: 29 (25%); 24 (18%); and 46 (15%).

But among those who did not have children voluntarily, the statement “My illness has reduced my desire to have children” was rated higher than male diagnosed at a younger age than for those in any of the other two age groups.

In addition, a significantly higher number of male diagnosed before or at the age of 30 (17%) and between 31 and 40 years (10%) said they were less satisfied with their final number of children than male diagnosed when they were older (5.5%). About a third of them male They pointed out that the main reason for fewer children is their diagnosis and / or related medical treatment.

Compared to the older age group, significantly more than those diagnosed before or during the peak years of fertility reported being medically evaluated for fertility problems, leading to poor sperm quality.

Although the number of desired children was lower in male diagnosed earlier and during their peak years of fertility, there was no significant difference between the 3 groups as a whole and it was similar to the reported figure per capita for the total population of the Netherlands.

But, the researchers emphasize, “the difference between the desired number of children and the final number is significantly larger in male diagnosed before and during the reproductive years, which shows that lower fertility levels are mainly affected by reduced fertility potential and not by a reduced desire to become parents. “

This is an observational study and as such cannot determine the cause, but there are some plausible biological explanations for the discovered associations, the researchers explain.

Several inflammatory proteins involved in the immune response associated with arthritis Inflammation, such as tumor necrosis factor (TNF), plays a key role in regulating stability testicles and sperm production.

Drugs used for treatment arthritis they could also play a role, they suggest. Side effects such as hypogonadism and poor sperm quality are associated with commonly used immunosuppressive agents.

And it is estimated that among male without children who come inadvertently to infertility clinics, 1 in 4 take drugs that could affect sexual function, while 1 in 10 take drugs related to impaired fertility.

Similarly, various psychosocial factors associated with their diagnosis may also have contributed to lower fertility rates, the researchers suggest.

“Due to problems or concerns related to diagnosis and treatment and based on medical advice (or lack thereof), male con arthritis inflammatory disease and their partners have decided to voluntarily lose their children or postpone their plans to become parents, they explain. These psychosocial factors were particularly important for male diagnosed before peak reproductive age.

Source consulted here.