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Inflammatory Arthritis in Men Linked to Higher Rates of Infertility

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Key Takeaways

  • A new study links inflammatory arthritis to potential infertility in men.
  • Inflammatory arthritis is characterized by painful joints, among other symptoms.
  • Some medicine treating the condition may also impact fertility.

For some couples, trying to conceive a child can be an extremely frustrating process. A recent study reveals that inflammatory arthritis (IA) in males could impair male fertility. Men who struggle with this condition can now find some clarity by working with their doctors to see if IA is contributing to their fertility struggles.

About the Study

The Netherlands-based study, published in the Annals of the Rheumatic Diseases, analyzed data from 628 men with IA over the age of 40. Led by Luis Fernando Perez-Garcia, MD, patients were divided into groups depending on whether they were diagnosed with IA before, during, or after peak fertility, which for men is between 31 to 40.

The results showed 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,” Dr. Perez-Garcia explains. However, he cautions that this is an observational study, and does not prove that IA necessarily causes infertility. He is already working on prospective follow-up studies to provide a more comprehensive understanding of the link between IA and infertility in men.

What Is Inflammatory Arthritis?

Generally, arthritis refers to any condition associated with pain and/or swelling in the joints. “There are over 100 different types of arthritis that we deal with,” Stuart Kaplan, MD, chief of Rheumatology at Mount Sinai South Nassau, in Oceanside, NY and a doctor with Rheumatology Consultants. “Fortunately, this can be broken down into two main groups: degenerative—also known as wear-and-tear arthritis—and inflammatory, or autoimmune, arthritis.”

Inflammatory or autoimmune arthritis describes a group of arthritic conditions which cause inflammation. This presents with symptoms such as swelling, warmth, redness, and pain in the joints, as the body fights itself. IA is an umbrella term for more specific conditions such as:

  • Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Ankylosing Spondylitis
  • Arthritis associated with inflammatory bowel disease (Crohn's disease and ulcerative colitis)

Some men may not realize they have IA, while others suffer from symptoms every day.

The Role of Inflammatory Arthritis Medication in Fertility

While the study doesn’t discuss the role medications for IA can have on male fertility, some experts think the issues go hand in hand. Dr. Kaplan says some medications used to treat IA can affect male fertility. For instance, sulfasalazine, an anti-inflammatory often prescribed to patients with IA, has been linked to a decrease in sperm count and quality. Luckily, men in this situation can discontinue the drug to reverse those effects.

Besides medication, there is evidence that inflammatory arthritis can impact fertility on its own, says Siddharth Tambar, MD, a physician and owner of Chicago Arthritis and Regenerative Medicine. He explains that chronic inflammation can affect the body in a number of ways. “IA itself is suspected of decreasing fertility in men via a number of mechanisms, including impaired quality of sperm and generally decreased stamina and libido,” he says. “It is possible normal hormone regulation is affected by chronic inflammation. In addition, painful swollen joints affect physical capability, which can also affect fertility.”

Dr. Kaplan says that while this is a landmark study, more research is needed to truly help men with IA maintain fertility.

Siddharth Tambar, MD

IA itself is suspected of decreasing fertility in men via a number of mechanisms, including impaired quality of sperm and generally decreased stamina and libido.

— Siddharth Tambar, MD

Talk to Your Doctor

Dr. Tambar says if a man has swollen, tender joints, he should seek the help of a board-certified rheumatologist to see if he has active IA. Dr. Kaplan adds that it’s imperative to talk to that specialist about your desire to have children, which will help inform the treatment plan.

It is important to be your own advocate at these appointments. Part of this self-advocacy includes asking critical questions about the latest studies on IA and fertility. “We know that patients expect their doctors to start the conversation,” Dr. Perez-Garcia says. “We are busy trying to increase the awareness of this problem amongst our colleagues and transform the way we approach male sexual and reproductive health, but we are not quite there.”

What This Means For You

If you have, or suspect that you have, IA and are trying to conceive a baby, speak to your healthcare provider about the potential connection between the two. Together, you can work out a treatment plan and improve your chances of getting pregnant while treating your condition.

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  1. Perez-Garcia LF, Röder E, Goekoop RJ, et al. Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility). Ann Rheum Dis. Published online August 9, 2021. doi:10.1136/annrheumdis-2021-220709