Fertility and sterility · 2013
Influence of tumor necrosis factor α inhibitors on testicular function and semen in spondyloarthritis patients.
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Ramonda Roberta, Foresta Carlo, Ortolan Augusta, Bertoldo Alessandro, Oliviero Francesca, Lorenzin Mariagrazia, Pizzol Damiano, Punzi Leonardo, Garolla Andrea
Аннотация
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.
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.