Lupus Drug May Cause Male Infertility

A new study shows a lupus treatment may lead to fertility problems in men.

Researchers found sperm damage linked to infertility is common in men with lupus and appears to be related to a commonly used treatment for the disease.

Because the disease tends to strike during the reproductive years, researchers say the results suggest freezing and storing sperm should be discussed early in the treatment of men diagnosed with lupus.

Lupus is an autoimmune disease in which the body's immune system turns on itself and attacks healthy tissue and joints, causing organ damage, severe pain, and often debilitating disability. The disease is nine times more common in women than in men, and researchers say this is the first study to look at how the disease and its treatments affect male reproductive health.

In the study, published in Arthritis & Rheumatism, researchers at the University of Sao Paulo in Brazil compared sperm count, shape, and function in 35 men with lupus to a group of healthy men. The results showed men with lupus had lower average sperm counts and sperm motility. They also had a lower sperm volume and a lower percentage of normally formed sperm.

In addition, researchers examined the men's sexual organs including the testes, which produce sperm, and found men with lupus had smaller testicular volumes in both testes than the healthy men.

Their analysis showed men with lupus who had more treatments of intravenous cyclophosphamide (also known as Cytoxan) were much more likely to have permanent sperm damage tied to infertility than men who had received the treatment less often.

They say it's not possible to predict which men with lupus will become infertile as a result of this treatment. But this study suggests that about five years of treatment with Cytoxan is associated with severe sperm damage and reinforces the need to discuss storing sperm prior to treatment.

By Jennifer Warner
Reviewed by Louise Chang, M.D.
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