This pathology is related to male infertility, erectile dysfunction and insufficient production of testosterone.
Several inflammatory proteins involved in the immune response associated with inflammatory arthritis play an important role in the regulation of sperm production. Photo: Shutterstock.com.
Rheumatoid arthritis or one of the other types of inflammatory arthritis, which is diagnosed before or during the peak reproductive years, can affect men’s fertility, according to research published online.history of Rheumatic diseases’.
Inflammatory arthritis having fewer children, higher rates of infertility, involuntary absence of childrenand fertility problems, such as poor sperm quality, according to the results of this study.
This pathology, which includes rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis and ankylosing spondylitis, has been linked to male infertility, erectile dysfunction and erectile dysfunction. insufficient testosterone production and/or sperm (hypogonadism). but inflammatory arthritis effect The ability of men to father children remains largely unknown.
To explore this question, researchers led by rheumatologist Luis Fernando Pérez-García of the Netherlands’ Erasmus Medical Center compared fertility rates, or number of children per person, in men with inflammatory arthritis based on their age at diagnosis; 30 years or less; Between 31 and 40 years (considered the maximum reproductive age); and 41 years or more.
Participants were drawn from 8 different hospitals in the Netherlands between September 2019 and January 2021. Some 628, over 40 years of age and fully reflecting their family size, filled a Questionnaires about medical problems and fertility they had before and after being diagnosed with inflammatory arthritis.
Researchers also compared total number of pregnancies attached to each individual, the desired size of the family, Proportion of men without children And this medical evaluation results For fertility problems.
After adjusting for potentially influencing factors such as current age, educational level, history of heart disease and partner infertility, men diagnosed with any type of inflammatory arthritis before age 30 were significantly less likely than men in the other two age groups. were children.
These men had an average of 1.32 children, compared with 1.56 for those diagnosed between the ages of 31 and 40, and 1.88 for those diagnosed at age 41 or older.
Men diagnosed before or when 30 years of age also had fewer pregnancies (1.45) than those diagnosed between 31 and 40 years (1.73) or older (1.98). In the Netherlands, 1 in 5 and 1 in 4 men are childless. Among participants, 143 (just 22%) were childless, of whom nearly two-thirds (99; 69%) were voluntarily childless.
Once again, the percentage of men without children was 30 (45; 34%) compared with those diagnosed at age 31 to 40 (39;27%) and those diagnosed at or before age 30 (45;34%) I was much more. (59; 17%).
apart from this Proportion of men without children Unintentionality was significantly different between the 3 groups: respectively, 16 (12%); 15 (10%); and 13 (4%). Voluntary childlessness was also different: 29 (25%); 24 (18%); and 46 (15%).
But among those who did not voluntarily have children, the statement ‘my illness reduced my desire to have children’ was found to be higher by men diagnosed at the youngest age than by either of the other two age groups. status was given.
In addition, more men reported being dissatisfied with the final number of children they had when they were older, compared to men who were diagnosed at or before the age of 30 (17%) and 31 to 40 years (10%). were (5.5%). About a third of these men cited their diagnosis and/or related medical treatment as the main reason for having fewer children.
Compared to the older age group, significantly more of those diagnosed before or during the peak reproductive years were reported to be medically evaluated for fertility problems that resulted in poor sperm quality.
Although previously diagnosed males had a lower number of desired children and during their peak reproductive years, overall there was no significant difference between the 3 groups and was similar to the reported per capita figure for the general population of the Netherlands.
But, the researchers emphasize, “the difference between the desired number of children and the final number of children was significantly greater among men diagnosed before and during their reproductive years, indicating that low fertility rates were primarily due to low birth weight.” control is affected.” Not because of fertility and low desire to be a parent.
This is an observational study and thus cannot establish causation, although there are some plausible biological explanations for the associations, the researchers point out.
Several inflammatory proteins involved in the immune response associated with inflammatory arthritis, such as tumor necrosis factor (TNF), play important roles in regulating testicular stability and sperm production.
They suggest that drugs used to treat arthritis may also play a role. Side effects such as hypogonadism and poor sperm quality have been associated with commonly used immunosuppressive agents.
And it is estimated that among childless men who go to infertility clinics involuntarily, 1 in 4 take drugs that can affect sexual function, while 1 in 10 take drugs associated with impaired fertility .
Similarly, various psychosocial factors associated with their diagnosis may also have contributed to the low fertility rate, suggest the researchers.
“Because of problems or concerns associated with diagnosis and treatment, and based on medical advice (or lack thereof), men with inflammatory arthritis and their partners voluntarily decided to delay their plans to remain childless or become parents. ,” they tell. Psychosocial factors were particularly important for men diagnosed before peak reproductive age.”
Source consulted here.