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Evaluation of the Quality of Semen and Sexual Function in Men with Inflammatory Bowel Disease

Valer, Paz MD*; Algaba, Alicia PhD*; Santos, Daniel MD; Fuentes, Manuel E. PhD; Nieto, Elva MD§; Gisbert, Javier P. MD, PhD; López, Pilar MD, PhD; Quintanilla, Elvira MD, PhD**; García-Alonso, Francisco J. MD*; Guerra, Iván MD*; Páez, Álvaro MD, PhD††; Bermejo, Fernando MD, PhD*,‡‡

doi: 10.1097/MIB.0000000000001081
Original Clinical Articles

Background: Data on fertility rates and medication safety in men with inflammatory bowel disease (IBD) are limited. The aim of this study was to evaluate whether there is a seminal alteration in patients with IBD and, if so, to evaluate the mechanisms that may play a role according to what has been described in the literature. Its secondary aim was to evaluate the impact on male sexual function of IBD.

Methods: Multicenter, cross-sectional, case series study comparing men with IBD and control subjects. Semen analysis was performed according to the recommendations of World Health Organization. The impact on male sexual function was evaluated with the International Index of Erectile Function questionnaire.

Results: On multivariate analysis, patients with Crohn's disease had lower sperm concentrations compared with those with ulcerative colitis (median [interquartile range], 34.5 [19.2–48] versus 70 [34.5–127.5], P = 0.02) and lower seminal zinc levels (mean ± SD, 1475 ± 235 μmol/L versus 2221 ± 1123 μmol/L, P = 0.04). Patients with Crohn's disease on anti–tumor necrosis factor treatment had better progressive motility (mean ± SD, 56.7 ± 17.7 versus 35.1 ± 22.1, P = 0.01) and sperm morphology (14.4 ± 7.1 versus 7.6 ± 4.9, P = 0.04) than those who were not on anti–tumor necrosis factor. Regarding sexual function, no significant differences were found across patients with IBD and control subjects.

Conclusions: Men with Crohn's disease showed a trend toward poorer semen quality than those with ulcerative colitis. Treatment with anti–tumor necrosis factor drugs does not seem to be associated with poor sperm quality. In patients in clinical remission, male sexual function is not affected by IBD.

Article first published online 16 May 2017.

*Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain;

Department of Urology, Hospital Clínico San Carlos, Madrid, Spain;

Unidad de Gestión Servicio de Medicina Preventiva, Unidad de Metodología de Investigación y Epidemiología Clínica, Hospital Clínico San Carlos, Universidad Camilo José Cela, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain;

§Department of Biochemistry, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain;

Department of Gastroenterology, Hospital Universitario de la Princesa, Madrid, Spain;

Department of Gastroenterology, Hospital Universitario Fundación de Alcorcón, Alcorcón, Spain;

**Department of Gastroenterology, Hospital Universitario Severo Ochoa, Leganes, Spain;

††Department of Urology, Hospital Universitario de Fuenlabrada, Fuenlabrada, Spain; and

‡‡Department of Communication Sciences, Universidad Rey Juan Carlos, Madrid, Spain.

Reprints: Paz Valer, MD, Department of Gastroenterology, Hospital Universitario de Fuenlabrada, Camino del Molino 2, 28942 Fuenlabrada, Madrid, Spain (e-mail:

Supported by the grant “From the theory to the practice” of the Spanish Group for the Study of Crohn's Disease and Ulcerative Colitis (GETECCU). The English Language edition was supported by Cosmos Specialized Services (Madrid, Spain).

F. Bermejo has served as a speaker and consultant from MSD and Abbvie. A. Algaba reports grants from MSD. J. P. Gisbert has served as a speaker, a consultant, and advisory member for or has received research funding from MSD, Abbvie, Hospira, Kern Pharma, Takeda, Janssen, Pfizer, Ferring, Faes Farma, Shire Pharmaceuticals, Dr. Falk Pharma, Chiesi, Casen Fleet, Gebro Pharma, Otsuka Pharmaceutical, and Vifor Pharma. The remaining authors have no conflict of interest to disclose.

Received December 21, 2016

Accepted February 06, 2017

© Crohn's & Colitis Foundation
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