American Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH, USA.
School of Natural Medicine, University of the Western Cape, Cape Town, South Africa.
Am J Reprod Immunol. 2021 May;85(5):e13389. doi: 10.1111/aji.13389. Epub 2021 Jan 27.
Autoimmune disorders currently affect 5%-8% of the global population, characterized by an aberrant chronic inflammatory response to self-antigens. The aim of this study was to systematically review the current available evidence investigating the impact of systemic autoimmune diseases and associated immunosuppressive treatment on fertility parameters of adult men. Clinical trials, observational studies, and case reports written in English and reporting semen analysis, evaluation of seminal oxidative stress, and/or sperm DNA fragmentation in patients affected by psoriasis and psoriatic arthritis, celiac disease, inflammatory bowel diseases, systemic lupus erythematosus, ankylosing spondylitis, hidradenitis suppurativa, uveitis, dermatomyositis, and rheumatoid arthritis were collected by searching on PubMed, EMBASE, OVID, Scopus, and Cochrane Library databases, with no limit of time. The study quality and the extent of bias in design, methods, and outcome assessment were evaluated by applying the Joanna Briggs Institute Critical Appraisal tools. Evidence suggested that various autoimmune diseases or relevant medications can adversely affect male fertility parameters and that patients may benefit of counseling and sperm cryopreservation. Clinical trials further investigating any adverse effect of autoimmunity and related thereby on male infertility are warranted, to develop appropriate guidelines for males diagnosed and treated for autoimmune disorders.
自身免疫性疾病目前影响全球 5%-8%的人口，其特征为针对自身抗原的异常慢性炎症反应。本研究旨在系统综述目前可获得的证据，以调查系统性自身免疫性疾病及相关免疫抑制治疗对成年男性生育参数的影响。通过检索 PubMed、EMBASE、OVID、Scopus 和 Cochrane Library 数据库，收集了以英文发表的、评估银屑病和银屑病关节炎、乳糜泻、炎症性肠病、系统性红斑狼疮、强直性脊柱炎、化脓性汗腺炎、葡萄膜炎、皮肌炎和类风湿关节炎患者精液分析、评估精液氧化应激和/或精子 DNA 碎片化的临床试验、观察性研究和病例报告，无时间限制。应用 Joanna Briggs 研究所批判性评估工具评估研究质量和设计、方法以及结果评估中的偏倚程度。证据表明，各种自身免疫性疾病或相关药物可能会对男性生育参数产生不利影响，患者可能需要咨询和精子冷冻保存。需要进一步开展临床试验，以调查自身免疫和相关疾病对男性不育的任何不良影响，为诊断和治疗自身免疫性疾病的男性制定适当的指南。
