Inflammatory Arthritis Impairs Male Fertility Save

A new study in Annals of Rheumatic Disease shows that inflammatory arthritis (IA) may impair male fertility, especially during the peak reproductive age when lower fertility rates, higher childlessness rates and more fertility problems were seen.

Inflammatory arthritis (IA) and rheumatoid arthritis (RA) have been associated with male infertility, erectile dysfunction and hypogonadism. The current study sought to assessed the risk of infertility according to male reproductive age.

"iFAME-Fertility" was a multicentre cross-sectional survey study that included men with IA, 40 years or older, who indicated that their family size was complete. Groups based on age at the time of their diagnosis were the basis for comparisons: ≤30 years (before the peak of reproductive age), between 31 and 40 years (during the peak) and ≥41 years (after the peak).

From a total of 628 IA men, those diagnosed before ≤30 years had a lower mean number of children (1.32) compared to men diagnosed 31 and 40 years (1.60) or diagnosed ≥41 years (1.88; p=0.0004).

Being involuntarily childless was more common in men diagnosed ≤30 compared to 31–40 years (12.03% vs 10.34% vs 3.98%, p=0.001). 

Similarly, medical evaluations for fertility problems was higher in men diagnosed earlier, ≤30 and 31–40 years (20.61%, 20.69%) compared with those diagnosed after 41 yrs (11.36%, p=0.027). Those diagnosed younger also tended to have low sperm quality (6.57% vs 8.05% vs 3.51%; p=0.086).

Fertility issues were recently raised and complicated filgotinib's (JAK1 inhibitor) drug development program, which stalled and aborted their FDA approval process, even though filgotinib is approved by the EMA and available in multiple countries worldwide (not the USA). 

The topic of Male Infertility was recently covered at EULAR 21 

• Impact of RA on Male Fertility: New Data: Dr. Aurelie Najm

• It’s Not Just the Mom, It’s the Dad, Too! Dr. Jonathan Kay