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Arthritis at young age may impact male fertility, study finds

Arthritis at young age may impact male fertility, study finds
Men with inflammatory arthritis at younger ages are more likely to report fertility problems, according to a new study. File Photo by Lee Health/Vimeo.

Aug. 9 (UPI) -- Men diagnosed with rheumatoid arthritis or another inflammatory forms of the disease have higher rates of infertility and involuntary childlessness than those without these joint conditions, a study published Monday by the Annals of the Rheumatic Diseases found.

Those who have from any type of inflammatory arthritis before age 30 had significantly fewer children than men between ages 31 and 40 and men older than age 41, the researchers said.

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"The difference between the desired and final number of children was significantly larger in men diagnosed before and during the reproductive [years]," researchers from the Netherlands wrote.

This indicates "that the lower fertility rates are primarily affected by reduced fertility potential and not by a reduced desire for parenthood," they said.

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Inflammatory arthritis, which is caused by inflammation in the spine, joints and tendon-bone regions, includes diseases such as rheumatoid arthritis, psoriatic arthritis, juvenile idiopathic arthritis and ankylosing spondylitis, according to the Arthritis Foundation.

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These diseases affect more than 50 million people in the United States, the foundation estimates.

Men with these conditions may be at increased risk for infertility, erectile dysfunction and reduced testosterone and sperm production, or hypogonadism, an analysis published in June 2020 by the journal Seminars in Arthritis and Rheumatism found.

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For this study, the researchers, rheumatologists from various institutions in the Netherlands, compared the fertility rate, or the number of children each, among 628 men diagnosed with inflammatory arthritis based on their age at diagnosis.

Participants, who were older than 40 and indicated that their family size was complete, were recruited from eight different hospitals across the Netherlands between September 2019 and January 2021, the researchers said.

They answered a questionnaire on any medical and fertility issues prior to and following their inflammatory arthritis diagnosis as well as desired family size and the results of any medical assessments for fertility issues.

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Among the study participants, 143, or just over 22%, were childless, about two-thirds voluntarily so, the researchers said.

However, the percentage of childless men was significantly higher among those diagnosed with inflammatory arthritis before or at age 30, at 34%, than it was among those diagnosed between age 31 and 40, at 27%, or age 41 and older, at 17%, they said.

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About 12% of those in the younger group identified as "involuntarily childless," compared with 10% and 4% in the two older groups, according to the researchers.

In addition, 17% of men diagnosed before or at age 30 years said they were dissatisfied with their final number of children, while 10% of those diagnosed in their 30s and 6% of those diagnosed in their 40s did so.

On average, men with these conditions prior to their 30th birthdays had 1.32 children, compared with 1.56 for those diagnosed between ages 31 and 40 and 1.88 for those diagnosed when they were age 41 years or older, the data showed.

In addition, men diagnosed before or when they were age 30 also had fewer pregnancies, 1.45 on average, than those diagnosed between ages 31 and 40 years, 1.73 on average, or the older men, 1.98 on average, according to the researchers.

Compared with the older age group, more of those diagnosed with inflammatory arthritis before or during peak fertility years reported having been assessed for poor sperm quality, they said.

There are some plausible biological explanations for the associations found, given that reduced sperm production and poor sperm quality are common side effects associated with many of the medications used to treat inflammatory arthritis, according to the researchers.

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In addition, proteins believed to be involved in the development of inflammatory arthritis, including as tumor necrosis facto, are also involved in testicular stability and sperm production.

"Due to problems or concerns associated with [the diagnosis] and its treatment and based on medical advice (or the lack of it), men with [inflammatory arthritis] and their partners decided to become voluntarily childless or to delay their plans to become parents," the researchers wrote.

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