#3-15E. Silent Struggle: Male Infertility in Autoimmune Rheumatic Diseases (J Reprod Immunol, 2022)

Do you routinely screen your male patients with rheumatic diseases for infertility? Today’s episode examines a systematic review by Boussaid et al. that aggregates data from 25 studies to evaluate the often-overlooked impact of autoimmune rheumatic-related diseases (ARRDs) on male reproductive health. The researchers analyzed conditions such as SLE, rheumatoid arthritis, and Behcet’s disease, assessing clinical outcomes including semen quality, hormonal profiles, and structural abnormalities like varicocele. Crucially, the review reveals that while active inflammation and specific disease processes significantly impair sperm parameters and testosterone levels, anti-TNF agents are associated with improved semen quality, offering a favorable contrast to the established gonadotoxicity of alkylating agents like cyclophosphamide. However, when applying these findings to practice, physicians must exercise caution regarding the limited sample sizes and heterogeneous evaluation methods characteristic of the included studies. Despite these limitations, this evidence is vital for clinicians, highlighting the legitimacy of infertility screening in male ARRD patients and underscoring the need for proactive counseling that distinguishes between the risks of the disease itself and the varying impacts of pharmacotherapy.

Citation: BOUSSAID, Soumaya, et al. The effects of autoimmune rheumatic-related diseases on male reproductive health: A systematic review. Journal of Reproductive Immunology. 150, 103472, 2022. DOI: 10.1016/j.jri.2021.103472

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.