Impaired fertility in men with inflammatory arthritis

[Fred]

Caroline passed this on to me and although the abstract doesn't mention psoriasis, is does mention "inflammatory arthritis" so some of you may find it interesting.

Quote:

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Objectives:
The impact of inflammatory arthritis (IA) on male fertility remains unexplored. Our objective was to evaluate the impact of IA on several male fertility outcomes; fertility rate (number of biological children per man), family planning, childlessness and fertility problems.

Methods:
We performed a multicentre cross-sectional study (iFAME-Fertility). Men with IA 40 years or older who indicated that their family size was complete were invited to participate. Participants completed a questionnaire that included demographic, medical and fertility-related questions. To analyse the impact of IA on fertility rate, patients were divided into 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).

Results:
In total 628 participants diagnosed with IA were included. Men diagnosed ≤30 years had a lower mean number of children (1.32 (SD 1.14)) than men diagnosed between 31 and 40 years (1.60 (SD 1.35)) and men diagnosed ≥41 years (1.88 (SD 1.14)).This was statistically significant (p=0.0004).The percentages of men diagnosed ≤30 and 31–40 years who were involuntary childless (12.03% vs 10.34% vs 3.98%, p=0.001) and who reported having received medical evaluations for fertility problems (20.61%, 20.69% and 11.36%, p=0.027) were statistically significant higher than men diagnosed ≥41 years.

Conclusions:
This is the first study that shows that IA can impair male fertility. Men diagnosed with IA before and during the peak of reproductive age had a lower fertility rate, higher childlessness rate and more fertility problems. Increased awareness and more research into the causes behind this association are urgently needed.

Source: bmj.com

[Caroline]

I can add to that, as the research was in Rotterdam Erasmus MC, that the researcher in his next step specifically will research the effect of methotrexate on the fertility, as this is a very often used medication for rheuma, and to my distress also for PsA.
He is looking for extra patients for that study at this moment.

A man without rheumatism has an average of 1.7 children in his life, according to figures from the CBS', says researcher. “Men who develop inflammatory arthritis before their childbearing years have an average of 1.3. That's a really big difference.
The big difference was in group 1, the men who got sick before having children became an issue. But there is also a difference in the number of children they have in the group of men who became ill between the ages of 30 and 40. They have a fertility rate of 1.56.

He does have a theory about it. "I think there are several reasons. The disease process itself can have an influence: the inflammatory reactions caused by the disease can negatively affect the seed. We also know that active illness can lead to sexual problems. It is also possible that medication has an influence on it. And I think psychosocial factors come into play, such as the fear that the disease could be passed on to the child. I have also literally heard men say: I am afraid that I will not be able to play football with my child later on.”

[Caroline]

That makes me think….

If the fertility rate of men with PsA is low, imagine 1.3, than this number of him and his partner is below the reproduction rate that is necessary to keep the family alive in the future. As two people reproduce in 1.3 people, and on and on and on, the family reproduction will come to a halt and the family will cease to exist.

IF genetic transfer of PsA would be the only way that it passes on to the future, then historically seen PsA would have disappeared as all families with this genetic problem will finally cease to exist.

That certainly is not the case… so simply speaking, I don’t know what other factors are involved, genetics is not the only cause of PsA, so this implicitly means that anyone can get it. A statement that Fred regularly states.
Derms often have the idea that a disease as Psoriasis, and therefore also PsA, is a specifically genetic problem.

[Fred]

A statement that Fred regularly states.

Yes people need reminding that psoriasis is not prejudice, it loves you all and you could be the next one to get it. If you do get it it will be your friend for life and I stand by my comments "Anyone can get it and you could be next"

[KatT]

For me it runs in the family.  I just had a few extras that no one else in my family has.

I am hoping my daughter won't suffer the same fate.