title: Gonadal function in male patients with ankylosing spondylitis.
abstract: OBJECTIVE
  To assess reproductive function in male ankylosing spondylitis (AS) patients in comparison to healthy controls.
  
  
  METHODS
  Twenty AS patients were compared to 24 healthy male subjects with regard to demographic data, urological examination, testicular ultrasound (US), semen analysis, anti-sperm antibodies, and hormone profile. Exclusion criteria were present use of sulfasalazine or methotrexate, and ever use of biological/cytotoxic agents. Disease activity of AS was evaluated by clinical and laboratory assessments.
  
  
  RESULTS
  Demographic data were similar in AS and controls (p = 0.175). Varicocele was found significantly more frequently in AS patients than in controls (40% vs. 8%, p = 0.027). Semen analysis revealed no significant differences in sperm quality between AS patients and controls (p > 0.05). By contrast, the median of normal sperm forms was significantly lower in AS patients with vs. those without varicocele [13.5 (range 2-27) vs. 22 (range 10-32.5)%, p = 0.049] whereas no difference in sperm morphology was observed comparing AS patients and controls without varicocele (p = 0.670). Comparison of AS patients with and without varicocele showed that anti-sperm antibodies, hormones, inflammatory markers, and disease activity scores did not contribute to the impaired sperm morphology observed in AS patients with varicocele.
  
  
  CONCLUSIONS
  An increased frequency of varicocele was found in AS patients associated with sperm abnormalities but independent of therapy, anti-sperm antibodies, hormonal alterations, or disease parameters. Investigation for varicocele should be routine in AS patients with fertility problems.
authors: Department of Rheumatology, Faculty of Medicine, University of São Paulo, Av. Dr Arnaldo 455, São Paulo, Brazil.
authors: L A
authors: LA
authors: Nukumizu
authors: C
authors: C
authors: Gonçalves Saad
authors: M
authors: M
authors: Ostensen
authors: B P
authors: BP
authors: Almeida
authors: M
authors: M
authors: Cocuzza
authors: C
authors: C
authors: Gonçalves
authors: O
authors: O
authors: Saito
authors: E
authors: E
authors: Bonfá
authors: C A
authors: CA
authors: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D055101:Semen Analysis; D013076:Sperm Count; D013081:Sperm Motility / Q000502:physiology; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013737:Testis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography; D014646:Varicocele / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology*