Department of Surgery, County Hospital Ryhov, Jönköping, Sweden.
Department of Biomedical and Clinical Sciences, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Aliment Pharmacol Ther. 2022 Jul;56(2):292-300. doi: 10.1111/apt.16984. Epub 2022 May 22.
Onset of inflammatory bowel disease (IBD) in men is most common during childbearing age, but little is known about the impact on fertility. Previous studies of fertility in men were small, which justifies this large nation-based registry study.
Fertility was assessed in a national cohort of men with IBD aged 15-44 years in 1964-2014, identified from the Swedish National Patient Register, and in a reference cohort matched for age and place of residence (ratio 1:5). Information about childbirths was found in the Swedish Multi-Generation Register. Patients with indeterminate colitis or inconsistent IBD coding were classified as IBD-unclassified (IBD-U).
The cohorts included 29,104 men with IBD and 140,901 matched individuals. IBD patients had a lower fertility rate (number of births per 1000 person years) compared with the matched individuals; 1.28 (SD 1.27) versus 1.35 (SD 1.31; p < 0.001). Fertility was somewhat impaired in all IBD subtypes compared with the matched cohort; ulcerative colitis (UC) (hazard ratio [HR] 0.93, 95% CI 0.91-0.96), Crohn's disease (CD) (HR 0.95, 95% CI 0.92-0.98) and IBD-U 0.92, 95% CI 0.89-0.95. The cumulated total parity and the parity progression were also decreased for all IBD subtypes. Within the IBD cohort disease severity, intensity of medical treatment (CD) and bowel surgery (IBD-U) were further associated with impaired fertility.
This nationwide cohort study shows only slightly impaired fertility in men with IBD.
炎症性肠病（IBD）在男性中的发病通常始于生育年龄，但关于其对生育能力的影响知之甚少。先前关于男性生育能力的研究规模较小，因此需要开展这项基于全国登记数据的大型研究。
我们从瑞典国家患者登记处确定了年龄在 15-44 岁的患有 IBD 的男性的全国性队列，并在年龄和居住地相匹配的参考队列（比例为 1:5）中进行了评估。在瑞典多代登记处中找到了关于分娩的信息。将具有不确定结肠炎或 IBD 编码不一致的患者归类为 IBD 未分类（IBD-U）。
队列包括 29104 名 IBD 患者和 140901 名匹配个体。与匹配个体相比，IBD 患者的生育率（每 1000 人年的出生人数）较低；分别为 1.28（SD 1.27）和 1.35（SD 1.31；p<0.001）。与匹配队列相比，所有 IBD 亚型的生育能力都受到一定程度的损害；溃疡性结肠炎（UC）（HR 0.93，95%CI 0.91-0.96）、克罗恩病（CD）（HR 0.95，95%CI 0.92-0.98）和 IBD-U 为 0.92，95%CI 0.89-0.95。所有 IBD 亚型的累积总产次和产次进展也均减少。在 IBD 队列中，疾病严重程度、医疗治疗强度（CD）和肠手术（IBD-U）也与生育能力受损进一步相关。
这项全国性队列研究表明，IBD 男性的生育能力仅略有受损。
