title: The toxicity of methotrexate in male fertility and paternal teratogenicity.
abstract: There is a high prevalence of methotrexate (MTX) use in males of reproductive age. The scope of this paper reviews what is known regarding risks to fertility and partners' pregnancy outcomes with regard to MTX use in men. Areas covered: This paper reviews the evidence for current recommendations for MTX use and male fertility and aims to educate professionals regarding MTX use in reproducing males so that patients may be counseled appropriately. A literature search included peer-reviewed sources from PubMed searches and the literature referenced within. Expert opinion: There is a lack of evidence regarding effects of MTX on male fertility. The recommendation to stop MTX three months prior to conception is safe, but is not evidenced by an understanding of the impact of MTX on spermatogenesis or paternal-mediated teratogenicity but rather the timeframe of spermatogenesis. Given the unclear evidence, patients treated with MTX must be counseled on the likelihood of adverse effects of MTX and role of sperm cryopreservation. Future studies are needed to help elucidate the unclear evidence of MTX effects on male fertility and pregnancy outcomes.
authors: a Department of Surgery (Urology) , Brown University , Providence , Rhode Island , USA.
authors: Jennifer Christine
authors: JC
authors: Gutierrez
authors: b Division of Urology , Rhode Island Hospital , Providence , Rhode Island , USA.
authors: Kathleen
authors: K
authors: Hwang
mesh_terms: D000818:Animals; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D000013:Congenital Abnormalities / Q000209:etiology*; D005220:Fathers; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000139:chemically induced*; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage / Q000009:adverse effects*; D010353:Patient Education as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D012662:Semen Preservation / Q000379:methods; D013091:Spermatogenesis / Q000187:drug effects; D013997:Time Factors
chemical_list: D018501:Antirheumatic Agents; D008727:Methotrexate
keywords: Male infertility; methotrexate; psoriasis; rheumatoid arthritis; spermatogenesis