Objective: To evaluate sperm parameters and sexual hormones in young males affected with spondyloarthritis (SpA) before and after 1 year of anti-tumor necrosis factor (TNF) α treatment.
Design: Prospective case-control study.
Setting: Rheumatology and human reproduction pathology units at a university hospital.
Patients: Ten SpA outpatients attending the rheumatology clinic; 20 healthy control subjects attending the unit of human reproduction pathology within an infertility prevention program.
Interventions: At baseline and after a 12-month treatment, disease activity was assessed and an andrologic evaluation made.
Main outcome measure(s): Rheumatologists assessed anamnestic, clinical, functional, and biomarker data. Andrologists evaluated semen analysis, fluorescence in situ hybridization for chromosomes X, Y, 13, 18, and 21, FSH, LH, and T plasma levels, and testicular color Doppler ultrasound.
Results: At baseline, SpA patients showed reduced sperm motility, higher plasma LH and FSH, and lower T levels compared with control subjects; a significant correlation between disease activity and sperm quality was found. After treatment, a statistically significant decrease in sperm aneuploidies and normal hormone levels were observed.
Conclusions: Although inflammation in SpA appears to be related to impaired testicular function, anti-TNF-α agents seem to be safe on testicular function and fertility.
Keywords: Anti–TNF-α drugs; gonadal function; sex hormones; sperm parameters; spondyloarthritis.
Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.