title: Influence of tumor necrosis factor α inhibitors on testicular function and semen in spondyloarthritis patients.
abstract: OBJECTIVE
  To evaluate sperm parameters and sexual hormones in young males affected with spondyloarthritis (SpA) before and after 1 year of anti-tumor necrosis factor (TNF) α treatment.
  
  
  METHODS
  Prospective case-control study.
  
  
  METHODS
  Rheumatology and human reproduction pathology units at a university hospital.
  
  
  METHODS
  Ten SpA outpatients attending the rheumatology clinic; 20 healthy control subjects attending the unit of human reproduction pathology within an infertility prevention program.
  
  
  METHODS
  At baseline and after a 12-month treatment, disease activity was assessed and an andrologic evaluation made.
  
  
  METHODS
  Rheumatologists assessed anamnestic, clinical, functional, and biomarker data. Andrologists evaluated semen analysis, fluorescence in situ hybridization for chromosomes X, Y, 13, 18, and 21, FSH, LH, and T plasma levels, and testicular color Doppler ultrasound.
  
  
  RESULTS
  At baseline, SpA patients showed reduced sperm motility, higher plasma LH and FSH, and lower T levels compared with control subjects; a significant correlation between disease activity and sperm quality was found. After treatment, a statistically significant decrease in sperm aneuploidies and normal hormone levels were observed.
  
  
  CONCLUSIONS
  Although inflammation in SpA appears to be related to impaired testicular function, anti-TNF-α agents seem to be safe on testicular function and fertility.
authors: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors: Roberta
authors: R
authors: Ramonda
authors: Unit of Human Reproduction Pathology, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors: Carlo
authors: C
authors: Foresta
authors: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors: Augusta
authors: A
authors: Ortolan
authors: Unit of Human Reproduction Pathology, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors: Alessandro
authors: A
authors: Bertoldo
authors: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors: Francesca
authors: F
authors: Oliviero
authors: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors: Mariagrazia
authors: M
authors: Lorenzin
authors: Unit of Human Reproduction Pathology, Department of Molecular Medicine, University of Padua, Padua, Italy.
authors: Damiano
authors: D
authors: Pizzol
authors: Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
authors: Leonardo
authors: L
authors: Punzi
authors: Unit of Human Reproduction Pathology, Department of Molecular Medicine, University of Padua, Padua, Italy. Electronic address: andrea.garolla@unipd.it.
authors: Andrea
authors: A
authors: Garolla
mesh_terms: D000068879:Adalimumab; D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012661:Semen / Q000187:drug effects / Q000502:physiology*; D055101:Semen Analysis / Q000379:methods; D013167:Spondylitis, Ankylosing / Q000097:blood / Q000000981:diagnostic imaging* / Q000188:drug therapy; D013737:Testis / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000502:physiology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab
keywords: Anti–TNF-α drugs; gonadal function; sex hormones; sperm parameters; spondyloarthritis