The impact of autoimmune systemic inflammation and associated medications on male reproductive health in patients with chronic rheumatological, dermatological, and gastroenterological diseases: A systematic review

Abstract

Autoimmune disorders currently affect 5%‐8% of the global population, characterized by an aberrant chronic inflammatory response to self‐antigens. The aim of this study was to systematically review the current available evidence investigating the impact of systemic autoimmune diseases and associated immunosuppressive treatment on fertility parameters of adult men. Clinical trials, observational studies, and case reports written in English and reporting semen analysis, evaluation of seminal oxidative stress, and/or sperm DNA fragmentation in patients affected by psoriasis and psoriatic arthritis, celiac disease, inflammatory bowel diseases, systemic lupus erythematosus, ankylosing spondylitis, hidradenitis suppurativa, uveitis, dermatomyositis, and rheumatoid arthritis were collected by searching on PubMed, EMBASE, OVID, Scopus, and Cochrane Library databases, with no limit of time. The study quality and the extent of bias in design, methods, and outcome assessment were evaluated by applying the Joanna Briggs Institute Critical Appraisal tools. Evidence suggested that various autoimmune diseases or relevant medications can adversely affect male fertility parameters and that patients may benefit of counseling and sperm cryopreservation. Clinical trials further investigating any adverse effect of autoimmunity and related thereby on male infertility are warranted, to develop appropriate guidelines for males diagnosed and treated for autoimmune disorders.

The impact of COVID-19 on the male reproductive tract and fertility: A systematic review

“…Reproductive tract inflammation and infections are causes of male infertility, most prominently bacterial infections, environmental causes and autoimmunity [66]. This may also include systemic autoimmune disease and chronic asymptomatic inflammation associated with obesity, metabolic syndrome and diabetes mellitus [67,68]. It is known that viral infections may negatively affect fertility, including adenovirus, herpes simplex virus, HIV, hepatitis B and C [63,[69][70][71].…”

Paternal inflammatory arthritis is associated with a higher risk of miscarriage: results of a large multicentre study (iFAME-Fertility)

“…In this regard, it has been shown that systemic inflammation and certain andrological comorbidities frequently present in men with IA (i.e. hypogonadism or varicocele) [ 7 ] have been associated with abnormal sperm DNA and low sperm quality [ 12 , 13 ].…”

Andrologisch-reproduktionsmedizinische Aspekte bei rheumatologischen Erkrankungen des Mannes

“…Die Datenbasis zu möglichen Auswirkungen rheumatologischer Erkrankungen auf die reproduktive und sexuelle Gesundheit des Mannes ist insgesamt jedoch sehr begrenzt; für zahlreiche Therapiemodalitäten, insbesondere neuere Biologika, liegen noch keine entsprechenden Studien vor [12][13][14][15][16]. Die Beratung betroffener Patienten bzw.…”

“…Inhibitoren wie z. B. Etanercept oder Infliximab vor[12][13][14][15]. Bei Patienten mit Spondylitis ankylosans (radiografische axiale Spondylo arthritis) hatte die Behandlung mit TNF-Inhibitoren keine negativen Auswirkungen auf die Ejakulatqualität; in einigen Studien wurde eine Verbesserung der Spermien parameter unter Infliximab berichtet[14].…”