Table 3. Association between medical therapy and pregnancy-related factors in men with inflammatory bowel disease.
Sexual dysfunction & infertility | Adverse events of pregnancy | Recommendation | |
---|---|---|---|
Sulfasalazine | • Erectile dysfunction | Possible (congenital malformations) [10] | Stop medication or switch to a different class of 5-ASA medications |
• Oligospermia | |||
• Poor sperm motility | |||
• Increased forms of abnormal sperm (reversible) [41,42,43,44,45] | |||
Mesalamine | Oligospermia [46] | No | Discontinue only in patients with stable disease |
Corticosteroids | No | No | Recommended short-term use |
Thiopurines | No | Controversial [51,58,59] | Counsel regarding the possibility of teratogenic effects on sperm |
MTX | Erectile dysfunction Altered spermatogenesis Oligospermia Teratogenicity [62,63,64,65] | No [10] | Discontinue in patients with erectile dysfunction |
Cyclosporine | Decreased sperm motility and testosterone (high dose) [38,72] | No [73] | No recommendations |
Infliximab | Decreased sperm motility and abnormal sperm morphology [72] | No [79] | No recommendations |
Other biological agents | No [83] | No [10,81,82,83,84] | No recommendations |
5-ASA: 5-aminosalicylic acid, MTX: methotrexate.