Sunanda Kane, M.D., discusses a recent study in Alimentary Pharmacology & Therapeutics about how male infertility can be impacted with therapeutic drugs used to treat inflammatory bowel disease. Specifically, Dr. Kane focuses on the effects of azathioprine, sulfasalazine, and methotrexate.
Azathioprine is used to induce remission in patients with chronic IBD. Follow-up data to a pilot study, conducted over 10 years ago, suggests that there is little risk associated with the use of azathioprine and sperm count and motility.
Sulfasalazine, which has been used for over 60 years, has been shown to cause qualitative and quantitative abnormalities of sperm. However, mesalamine products such as Lialda, Asacol or Aprizo do not carry as much risk, and it is therefore recommended that IBD patients who are on sulfasalazine be switched over to mesalamine.
There is some data to suggest that methotrexate can be toxic to sperm, but other studies report that it does not appear to affect testicular function.
The use of steroids or antibiotics over a long period can also cause a decrease in sperm concentration and motility.
Read the full study online here.
For more information about IBD, visit mayoclinic.org/IBD.
Dr. Kane is a gastroenterologist at Mayo Clinic.