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  1. L. F. Perez-Garcia1,
  2. E. Röder1,
  3. R. Goekoop2,
  4. J. Hazes1,
  5. M. R. Kok3,
  6. P. Kok4,
  7. H. T. Smeele1,
  8. I. Tchetverikov5,
  9. J. H. Van der Kaap1,6,
  10. A. Van der Helm - van Mil1,7,
  11. B. Krijthe1,8,
  12. R. Dolhain1
  1. 1Erasmus University Medical Centrum, Rheumatology, Rotterdam, Netherlands
  2. 2Haga Hospital, Rheumatology, Den Haag, Netherlands
  3. 3Maasstad Hospital, Rheumatology, Rotterdam, Netherlands
  4. 4Reinier de Graaf Gasthuis, Rheumatology, Delft, Netherlands
  5. 5Albert Schweitzer Hospital, Rheumatology, Dordrecht, Netherlands
  6. 6Adrz Medical Center, Rheumatology, Goes, Netherlands
  7. 7Leiden University Medical Center (LUMC), Rheumatology, Leiden, Netherlands
  8. 8Franciscus Gasthuis & Vlietland, Rheumatology, Rotterdam, Netherlands


Background: The effect of inflammatory arthritis (IA) on fertility has been mainly studied in women. Multiple factors associated with lower fertility rate in women can also be present in male patients with IA (1). The fertility rate in men with IA, however, has never been studied.

Objectives: To describe the fertility rate (number of biological children per individual) of men with IA.

Methods: We performed a multicenter cross-sectional retrospective study conducted in eight Dutch hospitals. Men with IA (Rheumatoid Arthritis (RA), Juvenile Idiopathic Arthritis (JIA) and Spondyloarthritis (SpA)) who were over 40 years old and indicated that their family size was complete were invited to participate. Men who were still planning on having biological children were excluded. Participants completed a digital questionnaire that included fertility-related questions and questions regarding their demographic and clinical information. To analyze the impact of IA on male fertility rate, patients were divided into groups according to the age at the time of their diagnosis: age<30 years, age 31-40 years and age>41 years.

Results: In total 628 participants diagnosed with IA were included. The response rate 34.87%. Information regarding their age, age at diagnosis, clinical diagnosis and number of children is presented per group in Table 1. Regarding the total number of children per man, there was a statistically significant difference between the three groups (p=<0.005). The mean total number of children was significantly lower in men diagnosed at age<30 years (1.39 {SD 1.41}) and at age 31-40 years (1.60 {SD 1.35}) compared to those diagnosed after at age>41 years (1.88 {SD 1.14}). Compared to men from the general population of the Netherlands, the total number of children of men diagnosed at age>41 years was not statistically different (1.88 vs 1.80, respectively).

Table 1.

Participants’ basic demographic and clinical characteristics, including the number of biological children per men.

Conclusion: This is the largest study ever conducted to evaluate the impact of IA on male fertility. We demonstrated that men diagnosed with IA before and during their reproductive years have a lower fertility rate than those men diagnosed with IA after their reproductive years. Multiple mechanisms (biological and non-biological) can be responsible for this association. More research is needed to identify the causes of these lower fertility rates in men with IA.

References: [1]Perez-Garcia LF, Te Winkel B, Carrizales JP, Bramer W, Vorstenbosch S, van Puijenbroek E, et al. Sexual function and reproduction can be impaired in men with rheumatic diseases: A systematic review. Semin Arthritis Rheum. 2020;50(3):557-73.

Figure 1.

Total number of biological children (mean and SD) per group.

Acknowledgements: The authors would like to acknowledge Ron Buijs, data manager of the Department of Rheumatology of the Erasmus MC, for his technical support with regards to data collection.

Disclosure of Interests: Luis Fernando Perez-Garcia Consultant of: Galapagos, Esther Röder: None declared, Robbert Goekoop: None declared, Johanna Hazes: None declared, Marc R Kok Consultant of: Novartis, Grant/research support from: Novartis, Petra Kok: None declared, Hieronymus TW Smeele: None declared, Ilja Tchetverikov: None declared, J.H. van der Kaap: None declared, Annette van der Helm - van Mil: None declared, Bouwe Krijthe: None declared, Radboud Dolhain Speakers bureau: UCB, Roche, Abbvie, Genzyme, Novartis, Consultant of: Galapagos, Grant/research support from: UCB

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