Biologic, thiopurine, methotrexate for IBD not detrimental to fertility

For male patients with inflammatory bowel disease (IBD), treatment with biologic, thiopurine, or methotrexate does not appear to promote impairments in fertility or adverse pregnancy outcomes, according to a study.

Researchers conducted a systematic review and meta-analysis that examined the use of IBD medications in relation to semen parameters (a proxy of male fertility) and adverse pregnancy outcomes (eg, early pregnancy loss, preterm birth, congenital malformations).

A total of 10 studies reporting semen parameters (268 IBD patients) and 16 studies reporting adverse pregnancy outcomes (over 25,000 IBD patients) were included in the meta-analysis. Pooled data revealed that biologic, thiopurine, or methotrexate use was not associated with decreased sperm count, motility, or abnormal morphology as compared with nonexposed patients.

The prevalence rate of adverse pregnancy outcomes with paternal biologic (5 percent), thiopurine (6 percent), or methotrexate (6 percent) exposure was comparable to nonexposed patients (5 percent). Biologic use was not associated with the risk of early pregnancy loss (odds ratio [OR], 1.26; I²=0 percent; p=0.12), preterm birth (OR, 1.10, I²=0percent; p=0.17), or congenital malformations (OR, 1.03, I²=0 percent; p=0.69).

Likewise, thiopurine use had a null effect on the risk of excess pregnancy loss (OR, 1.31; I²=19 percent; p=0.17), preterm birth (OR, 1.05; I²= 0 percent; p=0.20), or congenital malformations (OR, 1.07; I²=7 percent; p=0.34). Finally, methotrexate use showed no association with the risk of preterm birth (OR, 1.06; I²= 0 percent; p=0.62) or congenital malformations (OR, 1.03; I²=0 percent; p=0.81).