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Effects of TNF antagonists on sperm characteristics in patients with spondyloarthritis
  1. Peter M Villiger1,
  2. Gion Caliezi1,
  3. Véronique Cottin2,
  4. Frauke Förger1,
  5. Alfred Senn3,
  6. Monika Østensen1
  1. 1Department of Rheumatology, Clinical Immunology and Allergology, University Hospital and University of Bern, Switzerland
  2. 2Laboratory Viollier, Bern, Switzerland
  3. 3Centre de Procréation Medicalement Assistée et d'Endocrinologie Gynécologique, Lausanne, Switzerland
  1. Correspondence to Professor Peter M Villiger, Department of Rheumatology, Clinical Immunology and Allergology, University Hospital and University of Bern, CH-3010 Bern, Switzerland; peter.villiger{at}


Objective To study the influence of tumour necrosis factor (TNF) antagonists on spermatogenesis in a cohort of patients with spondyloarthritis (SpA).

Patients and methods Semen samples of 26 patients with SpA were analysed according to WHO 1999 guidelines with and without TNF blocking agents (infliximab, etanercept or adalimumab). Results were compared with semen samples of 102 healthy volunteers.

Results Sperm abnormalities were found in 10/11 patients without anti-TNF therapy. The sperm of these 11 patients had significantly poorer motility (p=0.001) and vitality (p=0.001) than found in 15 patients tested during longstanding anti-TNF therapy, but sperm concentration and morphology were similar in the two groups. There was no significant difference of sperm quality between healthy controls and anti-TNF treated patients with SpA. Notably, sperm abnormalities were also found in 102 healthy controls.

Conclusion Sperm abnormalities are a common finding in healthy men, they are more pronounced in patients with active SpA. The sperm quality of patients with SpA with inactive disease receiving long-term TNF inhibition is comparable to that in healthy controls. The data support continuation of anti-TNF treatment when fatherhood is planned.

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  • Funding This study was supported by an unrestricted grant from Wyeth.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the ethical committee of Bern, Switzerland.

  • Provenance and peer review Not commissioned; externally peer reviewed.