Inflammatory arthritis can hurt male fertility

Men diagnosed with inflammatory arthritis prior to and during the peak of reproductive age appear to have impaired fertility, with most being childless and having fertility problems, according to data from the iFAME-Fertility study.

The multicentre cross-sectional iFAME-Fertility included 628 men (mean age 57.17 years) with inflammatory arthritis. They completed a questionnaire that consisted of demographic, medical, and fertility-related questions.

The participants were divided into three groups, according to the age at the time of their diagnosis: ≤30 years (before the peak of reproductive age), between 31 and 40 years (during the peak), and ≥41 years (after the peak).

Compared with those diagnosed between 31 and 40 years or ≥41 years, men diagnosed ≤30 years had a significantly lower mean number of children (1.32 vs 1.60 and 1.88, respectively; p=0.0004) as well as total number of pregnancies (mean, 1.45 vs 1.73 and 1.98; p=0.002).

Likewise, significantly more men diagnosed at ≤30 and 31–40 years vs ≥41 years remained childless (12.03 percent and 10.34 percent vs 3.98 percent, respectively; p=0.001) and reported having received medical evaluations for fertility problems (20.61 percent and 20.69 percent vs 11.36 percent; p=0.027).

The observed association between inflammatory arthritis and impaired fertility in men could be explained by multiple biological and nonbiological mechanisms. Additional investigation is needed to improve the quality of care for male inflammatory arthritis patients who express a desire for parenthood.