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Review article: the safety of therapeutic drugs in male inflammatory bowel disease patients wishing to conceive
Author(s) -
Sands K.,
Jansen R.,
Zaslau S.,
Greenwald D.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13142
Subject(s) - medicine , inflammatory bowel disease , intensive care medicine , inflammatory bowel diseases , disease , medline , political science , law
Summary Background Many therapeutic drugs are used by patients with inflammatory bowel disease, often around the time of conception. The pregnancy outcomes of males and females exposed to these therapeutics needs to be examined and this information is necessary to counsel patients appropriately. Aim To review the literature describing male infertility and inflammatory bowel disease to educate practitioners of the impact of inflammatory bowel disease on male reproduction and the impact of therapeutics on pregnancy outcomes. Methods We performed a PubMed search using the search terms ‘male infertility,’ ‘Crohn's disease,’ ‘inflammatory bowel disease,’ ‘ulcerative colitis,’ ‘ciprofloxacin AND infertility,’ ‘metronidazole AND infertility,’ ‘sulfasalazine AND infertility,’ ‘azathioprine AND infertility,’ ‘methotrexate AND infertility,’ ‘ciclosporin AND infertility,’ ‘corticosteroids AND infertility,’ ‘infliximab AND male fertility,’ ‘infliximab AND infertility,’ ‘infliximab AND foetus,’ ‘infliximab AND paternal exposure’ and ‘infliximab AND sperm.’ References from selected papers were reviewed and used if relevant. Results Over half of male patients with IBD have some degree of infertility, compared to 8–17% of the general population. Semen parameters including total count, motility and morphology may be adversely affected by therapeutics. IBD medications in males do not increase foetal risk with the possible exception of azathioprine and mercaptopurine; however, increased foetal risk is seen in other drugs if taken by female patients. Conclusions It is recognised that male infertility is often impacted with therapeutic drugs used to treat inflammatory bowel disease; however, the effects of the paternal drug exposure at the time of conception and exposure in utero should be considered to counsel patients appropriately.