Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)
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  • Published on:
    Correspondence on ‘Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)’ by Perez-Garcia et al.
    • Zhenhan Deng, Orthopedic Surgeon The First Affiliated Hospital of Shenzhen University, Shenzhen Second People’s Hospital
    • Other Contributors:
      • Wei Lu, Orthopedic Surgeon
      • Zhiqin Deng, Researcher
      • Yizi Zheng, Researcher

    We read with deep interest the article by Perez-Garcia LF et al1, which was aimed at investigating the impact of inflammatory arthritis (IA) on male fertility outcomes, fertility rate, family planning, childlessness and fertility problems. The authors concluded that IA could impair male fertility. We really appreciate the work done by the authors. However, there are some worthwhile issues that need to be explored.
    Firstly, although the patients were divided into three groups by age, it was not analyzed in detail whether there were differences in sample size between each disease (Spondyloarthritis (SpA) and rheumatoid arthritis (RA) etc.) in the group. Since older patients usually had longer disease course and even more serious disease, it might introduce bias to the study results. Therefore, the average onset age of each group should be consistent. Additionally, since the actual mean total number of children per man in all patients was 1.69, almost the same as the estimated number 1.7, it could hardly draw the conclusion that diagnosed with IA could impair fertility in men. Moreover, why was the mean total number of children per man in patients over 40 (1.88) higher than the estimated number and the actual number (1.79)? Was longer IA disease course associated with higher mean total number of children per man?
    Secondly, the authors mentioned that the men still having future fertility intentions were excluded in the study. As stated by the authors, the peak of r...

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    Conflict of Interest:
    None declared.
  • Published on:
    Correspondence on ‘Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)’ by Perez-Garcia et al.
    • Shu-Lin Chen, Postgraduate Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine
    • Other Contributors:
      • Hui-Juan Zheng, Postgraduate
      • Qiang Xu, Rheumatology physician, Dr of Rheumatology

    With great interest, we read the paper by Perez-Garcia et al for reporting the impaired fertility of 628 male patients with inflammatory arthritis (IA) from multiple hospitals in the Netherlands.1 Based on the result, the authors suggested that treatment strategies should be appropriately re-concerned for male IA patients who want to have children. Although the author has stated the limitations of the research, some details need to be addressed clearly.
    Firstly, Disease duration may be an interfering factor of fertility.2 In this research, men diagnosed ≤40 years had a longer disease duration than men diagnosed ≥41 years, with a higher rate of low sperm quality and a lower number of children. Besides, smoking and drinking history were not included in the demographic characteristics of patients, since those factors may have great effects on male fertility.3 Then, the age of the partners of the participants were not taken into calculation which may have a great effect on the number of children of the male IA patients, and the willingness of the partners to have children as well. 4 5 The effects of disease and drugs on the results were not distinguished in the study, and both of them may have effects on the fertility.6
    Secondly, all data were collected from a questionnaire survey, including the patient’s partner time to pregnancy, female fertility evaluation, and the patient’s sperm quality, which may cause subjective bias. We noticed that out of 628 patients, onl...

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    Conflict of Interest:
    None declared.