Banerjee Antara, Scarpa Marco, Pathak Surajit, Burra Patrizia, Sturniolo Giacomo C, Russo Francesco P, Murugesan Ram, D'Incá Renata
Department of Surgery, Oncology and Gastroenterology, Gastroenterology/Multivisceral Transplant Unit, University Hospital Padova, Padova, Italy.
Faculty of Allied Health Science (FAHS), Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Chennai, India.
Endocr Metab Immune Disord Drug Targets. 2019;19(7):959-974. doi: 10.2174/1871530319666190313112110.
Sexual functions are sometimes adversely affected by the therapeutic drugs delivered for treating IBD. Much attention has been focused on pregnancy/sexual issues in women. Relatively less attention has been poured in to address this issue in men. This systematic review assesses the drugs having potential detrimental effects on fertility in men.
Three databases were searched by two researchers independently for potentially relevant publications between 1964 to 2015 and 249 papers were retrieved. Studies that dealt with sexual problems after IBD drugs administration were included in the purview of this review.
Fourteen studies with 327 human patients and 110 animals were analysed. Sulphasalazine treated patients had lower spermatozoa count, lower sperm motility and higher risk of oligospermia compared to mesalazine treated ones. Biologics seem to be safe to use while attempting to conceive however, proper clinical studies reporting male fertility problems in IBD patients are lacking. Azathioprine caused oligospermia but a meta-analytical approach was not possible due to heterogeneity in studies. Some animal studies showed methotrexate affects abnormal testis structure and spermatogenesis.
This study summarises the current literature and safety issues affecting fertility parameters in men and animals treated with IBD therapeutic drugs, which can further assist clinicians in better management of adult male IBD patients.
治疗炎症性肠病（IBD）的药物有时会对性功能产生不利影响。人们对女性的妊娠/性问题给予了很多关注。而在男性中解决这个问题的关注相对较少。本系统评价评估了对男性生育能力有潜在不利影响的药物。
两名研究人员独立检索了三个数据库，以查找1964年至2015年间可能相关的出版物，共检索到249篇论文。本综述纳入了那些涉及服用IBD药物后出现性问题的研究。
分析了涉及327名人类患者和110只动物的14项研究。与接受美沙拉嗪治疗的患者相比，接受柳氮磺胺吡啶治疗的患者精子数量更低、精子活力更低且少精子症风险更高。生物制剂在尝试受孕时似乎使用安全，然而，缺乏关于IBD患者男性生育问题的适当临床研究。硫唑嘌呤导致少精子症，但由于研究的异质性，无法进行荟萃分析。一些动物研究表明甲氨蝶呤会影响睾丸结构异常和精子发生。
本研究总结了当前关于IBD治疗药物对男性和动物生育参数影响的文献及安全问题，这可以进一步帮助临床医生更好地管理成年男性IBD患者。
