Evaluation of the Quality of Semen and Sexual Function in Men with Inflammatory Bowel Disease

Background: Data on fertility rates and medication safety in men with inflammatory bowel disease (IBD) are limited. The aim of this study was to evaluate whether there is a seminal alteration in patients with IBD and, if so, to evaluate the mechanisms that may play a role according to what has been described in the literature. Its secondary aim was to evaluate the impact on male sexual function of IBD. Methods: Multicenter, cross-sectional, case series study comparing men with IBD and control subjects. Semen analysis was performed according to the recommendations of World Health Organization. The impact on male sexual function was evaluated with the International Index of Erectile Function questionnaire. Results: On multivariate analysis, patients with Crohn's disease had lower sperm concentrations compared with those with ulcerative colitis (median [interquartile range], 34.5 [19.2–48] versus 70 [34.5–127.5], P = 0.02) and lower seminal zinc levels (mean ± SD, 1475 ± 235 &mgr;mol/L versus 2221 ± 1123 &mgr;mol/L, P = 0.04). Patients with Crohn's disease on anti–tumor necrosis factor treatment had better progressive motility (mean ± SD, 56.7 ± 17.7 versus 35.1 ± 22.1, P = 0.01) and sperm morphology (14.4 ± 7.1 versus 7.6 ± 4.9, P = 0.04) than those who were not on anti–tumor necrosis factor. Regarding sexual function, no significant differences were found across patients with IBD and control subjects. Conclusions: Men with Crohn's disease showed a trend toward poorer semen quality than those with ulcerative colitis. Treatment with anti–tumor necrosis factor drugs does not seem to be associated with poor sperm quality. In patients in clinical remission, male sexual function is not affected by IBD.

[1]  H. Fidder,et al.  Sexual Dysfunctions in Men and Women with Inflammatory Bowel Disease: The Influence of IBD-Related Clinical Factors and Depression on Sexual Function. , 2015, The journal of sexual medicine.

[2]  D. Greenwald,et al.  Review article: the safety of therapeutic drugs in male inflammatory bowel disease patients wishing to conceive , 2015, Alimentary pharmacology & therapeutics.

[3]  T. Ali,et al.  Assessment Of Sexual Function Among Inflammatory Bowel Disease Patients , 2015, The American Journal of Gastroenterology.

[4]  M. Maggi,et al.  Current smoking is associated with lower seminal vesicles and ejaculate volume, despite higher testosterone levels, in male subjects of infertile couples. , 2015, Human reproduction.

[5]  C. J. van der Woude,et al.  The second European evidenced-based consensus on reproduction and pregnancy in inflammatory bowel disease. , 2015, Journal of Crohn's & colitis.

[6]  S. Bolboacă,et al.  TNF-α inhibitors do not impair sperm quality in males with ankylosing spondylitis after short-term or long-term treatment. , 2014, Rheumatology.

[7]  S. Friedman,et al.  Review article: the psychosexual impact of inflammatory bowel disease in male patients , 2014, Alimentary pharmacology & therapeutics.

[8]  L. Punzi,et al.  Influence of tumor necrosis factor α inhibitors on testicular function and semen in spondyloarthritis patients. , 2014, Fertility and sterility.

[9]  L. Peyrin-Biroulet,et al.  Systematic review: fertility in non‐surgically treated inflammatory bowel disease , 2013, Alimentary pharmacology & therapeutics.

[10]  A. Aziz,et al.  Tumor necrosis factor-α gene polymorphism relationship to seminal variables in infertile men. , 2013, Urology.

[11]  J. Mate,et al.  Safety of Thiopurines and Anti-TNF-α Drugs During Pregnancy in Patients With Inflammatory Bowel Disease , 2013, The American Journal of Gastroenterology.

[12]  A. Puchner,et al.  Impact of TNF-blocking agents on male sperm characteristics and pregnancy outcomes in fathers exposed to TNF-blocking agents at time of conception. , 2012, Clinical and experimental rheumatology.

[13]  Luis Zegarra,et al.  Validación psicométrica del instrumento índice internacional de función eréctil en pacientes con disfunción eréctil en Perú , 2011 .

[14]  J. Gisbert,et al.  Outcomes of Pregnancies Fathered by Inflammatory Bowel Disease Patients Exposed to Thiopurines , 2010, The American Journal of Gastroenterology.

[15]  P. Villiger,et al.  Effects of TNF antagonists on sperm characteristics in patients with spondyloarthritis , 2010, Annals of the rheumatic diseases.

[16]  T. Hibi,et al.  Conception outcomes and opinions about pregnancy for men with inflammatory bowel disease. , 2010, Journal of Crohn's & colitis.

[17]  M. Silverberg,et al.  A systematic prospective comparison of noninvasive disease activity indices in ulcerative colitis. , 2009, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[18]  S. Kane,et al.  Sexual and Reproductive Issues for Men With Inflammatory Bowel Disease , 2009, The American Journal of Gastroenterology.

[19]  P. Voulgari,et al.  Fertility and Reproduction in Male Patients with Ankylosing Spondylitis Treated with Infliximab , 2008, The Journal of Rheumatology.

[20]  G. Rogler,et al.  Determinants of male sexual function in inflammatory bowel disease: A survey‐based cross‐sectional analysis in 280 men , 2007, Inflammatory bowel diseases.

[21]  P. Lakatos.  Recent trends in the epidemiology of inflammatory bowel diseases: up or down? , 2006, World journal of gastroenterology.

[22]  S. Kalaydjiev,et al.  Circulating antibodies to human spermatozoa in patients with ulcerative colitis. , 2005, Fertility and sterility.

[23]  A. Agarwal,et al.  Infliximab may reverse the toxic effects induced by tumor necrosis factor alpha in human spermatozoa: an in vitro model. , 2005, Fertility and sterility.

[24]  J. Terdiman,et al.  Infliximab and Semen Quality in Men With Inflammatory Bowel Disease , 2005, Inflammatory bowel diseases.

[25]  C. Lombard,et al.  The Use of Semen Parameters to Identify the Subfertile Male in the General Population , 2005, Gynecologic and Obstetric Investigation.

[26]  J. Toppari,et al.  Tumor necrosis factor-alpha (TNF-alpha) promotes cell survival during spermatogenesis, and this effect can be blocked by infliximab, a TNF-alpha antagonist. , 2004, European journal of endocrinology.

[27]  A. El‐Tawil.  Zinc deficiency in men with Crohn's disease may contribute to poor sperm function and male infertility , 2003, Andrologia.

[28]  J. Cappelleri,et al.  The International Index of Erectile Function (IIEF): a state-of-the-science review , 2002, International Journal of Impotence Research.

[29]  C. Mittermaier,et al.  Azathioprine treatment and male fertility in inflammatory bowel disease. , 2001, Gastroenterology.

[30]  I. Osterloh,et al.  Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. , 1999, Urology.

[31]  R. Pounder,et al.  A simple clinical colitis activity index , 1998, Gut.

[32]  M. Ardawi,et al.  Effect of marginal or severe dietary zinc deficiency on testicular development and functions of the rat. , 1997, Archives of andrology.

[33]  Aaron Brzezinski,et al.  Clinical epidemiology of inflammatory bowel disease , 1994 .

[34]  P. E. Johnson,et al.  Homeostatic control of zinc metabolism in men: zinc excretion and balance in men fed diets low in zinc. , 1993, The American journal of clinical nutrition.

[35]  P. E. Johnson,et al.  Effects of dietary zinc depletion on seminal volume and zinc loss, serum testosterone concentrations, and sperm morphology in young men. , 1992, The American journal of clinical nutrition.

[36]  S. Riley,et al.  Sulphasalazine induced seminal abnormalities in ulcerative colitis: results of mesalazine substitution. , 1987, Gut.

[37]  J. Mayberry,et al.  European survey of fertility and pregnancy in women with Crohn's disease: a case control study by European collaborative group. , 1986, Gut.

[38]  R. Bronson,et al.  Sperm antibodies: their role in infertility. , 1984, Fertility and sterility.

[39]  H. Lukaski,et al.  Changes in plasma zinc content after exercise in men fed a low-zinc diet. , 1984, The American journal of physiology.

[40]  J. King,et al.  Tissue zinc levels and zinc excretion during experimental zinc depletion in young men. , 1984, The American journal of clinical nutrition.

[41]  R. F. Harvey,et al.  A SIMPLE INDEX OF CROHN'S-DISEASE ACTIVITY , 1980, The Lancet.

[42]  Ying Li,et al.  Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses. , 2011, Fertility and sterility.

[43]  Elizabeth Noonan,et al.  World Health Organization reference values for human semen characteristics. , 2010, Human reproduction update.

[44]  G. Rogler,et al.  Sexual function in persons with inflammatory bowel disease: a survey with matched controls. , 2007, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[45]  C. Probert,et al.  The effects of chronic ill health and treatment with sulphasalazine on fertility amongst men and women with inflammatory bowel disease in Leicestershire , 1997, International Journal of Colorectal Disease.

[46]  J. Mayberry,et al.  Perceived sexual dysfunction amongst patients with inflammatory bowel disease. , 1993, Digestion.

[47]  J. King,et al.  Human Zinc Requirements , 1989 .

[48]  M. Farthing,et al.  Impaired semen quality in Crohn's disease--drugs, ill health, or undernutrition? , 1983, Scandinavian journal of gastroenterology.