Impaired fertility in men diagnosed with inflammatory arthritis: Results of a large multicentre study (iFAME-Fertility)

Luis Fernando Perez-Garcia*, Esther Röder, Robbert J. Goekoop, Johanna M.W. Hazes, Marc R. Kok, Hieronymus T.W. Smeele, Ilja Tchetverikov, Annette H.M. Van Der Helm-Van Mil, Jos H. Van Der Kaap, Petra Kok, Bouwe P. Krijthe, Radboud J.E.M. Dolhain

*Corresponding author for this work

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Objectives The impact of inflammatory arthritis (IA) on male fertility remains unexplored. Our objective was to evaluate the impact of IA on several male fertility outcomes; fertility rate (number of biological children per man), family planning, childlessness and fertility problems. Methods We performed a multicentre cross-sectional study (iFAME-Fertility). Men with IA 40 years or older who indicated that their family size was complete were invited to participate. Participants completed a questionnaire that included demographic, medical and fertility-related questions. To analyse the impact of IA on fertility rate, patients were divided into groups according to the age at the time of their diagnosis: ≤30 years (before the peak of reproductive age), between 31 and 40 years (during the peak) and ≥41 years (after the peak). Results In total 628 participants diagnosed with IA were included. Men diagnosed ≤30 years had a lower mean number of children (1.32 (SD 1.14)) than men diagnosed between 31 and 40 years (1.60 (SD 1.35)) and men diagnosed ≥41 years (1.88 (SD 1.14)).This was statistically significant (p=0.0004).The percentages of men diagnosed ≤30 and 31-40 years who were involuntary childless (12.03% vs 10.34% vs 3.98%, p=0.001) and who reported having received medical evaluations for fertility problems (20.61%, 20.69% and 11.36%, p=0.027) were statistically significant higher than men diagnosed ≥41 years. Conclusions This is the first study that shows that IA can impair male fertility. Men diagnosed with IA before and during the peak of reproductive age had a lower fertility rate, higher childlessness rate and more fertility problems. Increased awareness and more research into the causes behind this association are urgently needed.

Original languageEnglish
Pages (from-to)1545-1552
Number of pages8
JournalAnnals of the Rheumatic Diseases
Issue number12
Publication statusPublished - 1 Dec 2021


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