Studies on Human Semen in Topical Corticosteroid-Treated and in Methotrexate-Treated Psoriatics

Grunnet, E; Nyfors, A; Hansén, Kristina

doi:10.1159/000251036

Cited by 69 publications

(25 citation statements)

References 5 publications

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“…The results were unrelated to the clinical type or to the duration of the disease. This agrees with the study carried by Gunther [5] and Grunnet et al [3] on psoriatic males before, during, and in some cases after treatment with methotrexate. These studies also demonstrated no uniform alteration in semen samples.…”

Section: Discussionsupporting

confidence: 93%

Methotrexate and fertility in men

El-beheiry¹,

El-Mansy²,

Kamel³

et al. 1979

Archives of Andrology

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The possible deleterious effects of folic acid antagonist methotrexate on the fertility potential have been investigated in 26 male psoriatic patients. Examination for semen, testicular histology, and spermatogenic function using radioactive phosphorus revealed that methotrexate had no unfavorable effect on male fertility. A long follow up of the patients and their offspring is needed to exclude the possible teratogenic effect of the drug.

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Section: Discussionsupporting

confidence: 93%

Methotrexate and fertility in men

El-beheiry¹,

El-Mansy²,

Kamel³

et al. 1979

Archives of Andrology

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“…However, a study by Grunnet et al. did not demonstrate reduction in semen quality of psoriasis patients treated with methotrexate compared with semen of psoriasis patients treated with topical corticosteroids, and instead found that semen analysis in the MTX group was more frequently normal . A study by De Luca et al.…”

Section: Resultsmentioning

confidence: 96%

Dermatological medication effects on male fertility

et al. 2013

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Many drugs have been reported to impair semen parameters, leading to temporary or persistent infertility. Therefore, potential fathers may be concerned about the effect of medications on fertility. We searched the MEDLINE database of articles in English combining key terms including "male infertility," "spermatogenesis," "fertility," "drug effects," and "dermatology." Administration of methotrexate and finasteride has resulted in severe oligospermia and reversible infertility. Ketoconazole has had negative effects on sperm motility and testosterone production. Few individual case reports and a limited number of studies have demonstrated negative effects of tetracyclines, erythromycin, chloroquine, glucocorticoids, spironolactone, and antihistamines on fertility. It is important to counsel male patients when appropriate about the reversible negative effect on fertility when taking methotrexate and finasteride, and the adverse effect of ketoconazole. Patients may be reassured that taking oral retinoids, cyclosporine, azathioprine, and tumor necrosis factor alpha inhibitors should not affect their fertility.

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“…To our knowledge, this is the first consistent study evaluating semen quality in psoriatic patients. In 1977, Grunnet et al [23] showed that male fertility was not impaired by methotrexate treatment although they did find a low semen quality at baseline suggesting that this might be due to psoriatic lesions in the genital tract. Moreover, an impaired testicular function, characterized by an inverse correlation between disease activity and normal sperm morphology and motility, has recently been described in 10 patients affected by spondyloarthritis, 5 of whom had psoriatic arthritis [24] .…”

Section: Discussionmentioning

confidence: 99%

Untreated Psoriasis Impairs Male Fertility: A Case-Control Study

et al. 2017

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Background: Recent evidence indicates that a systemic state of inflammation may impair fertility, but data about psoriatic males are scarce. Objectives: The aim of this study was to assess gonadal function in psoriatic males implementing our knowledge about fertility in these subjects. Methods: Male psoriatic patients, aged between 18 and 55 years, and a group of healthy subjects matched for age, BMI and geographic origin were enrolled. All subjects underwent a complete physical and andrological examination, standard semen analysis, complete microbiological analysis and ultrasound evaluation of sexual glands. Seminal levels of soluble urokinase-type plasminogen activator receptor (suPAR) and serum levels of testosterone, estradiol (E2), sex hormone-binding globulin (SHBG), luteinizing hormone and follicle-stimulating hormone were also assessed. Results: Fifty patients and 50 controls fulfilled the inclusion criteria and were enrolled in our study. Testosterone and SHBG were found to be significantly decreased in patients with psoriasis compared with the control group. Higher levels of E2 were also reported in psoriatic patients. Total sperm count, sperm motility and percent of spermatozoa with normal morphology were significantly reduced in patients compared to controls. suPAR levels were significantly increased in patients compared to controls and found to be above the reference limits. Ultrasound signs of inflammation of the accessory glands were observed in 35/50 patients with psoriasis and in none of the controls. Conclusion: Our study suggests that untreated psoriasis may impair male fertility. We also found that this might be due to an impact of systemic inflammation on the hormonal profile and on sexual accessory gland inflammation.

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Studies on Human Semen in Topical Corticosteroid-Treated and in Methotrexate-Treated Psoriatics

Cited by 69 publications

References 5 publications

Methotrexate and fertility in men

Methotrexate and fertility in men

Dermatological medication effects on male fertility

Untreated Psoriasis Impairs Male Fertility: A Case-Control Study

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