The researchers examined the influence of azathioprine (AZA) on semen quality, and reported their findings in November's Gastroenterology.
Long-term treatment with AZA is well established in inflammatory bowel disease (IBD).
AZA is metabolized to 6-mercaptopurine, which interacts in purine metabolism and is therefore considered to have mutagenic potentials.
A total of 23 IBD patients treated with AZA were enrolled in the study.
Semen quality was examined and compared with World Health Organization (WHO) standards. Sperm density, motility, morphology, ejaculate volume, and total sperm count were all assessed.
In 10 of these patients, a semen sample was assessed before and during AZA treatment. In another 5 subjects, semen analysis was performed twice during at least 2 years of AZA therapy.
Eighteen patients were treated with 1.5-2 mg/kg AZA daily, for at least 3 months, but without sulfasalazine. In these, sperm density was a median of 94 Mio/mL (94% within WHO standard).
Motility was a median of 60% (67% within WHO standard), and the proportion of sperm with normal morphology was 44% (67% within WHO standard).
| During the study period, 6 patients fathered 7 healthy children.
| Gastroenterology |
The researchers found that ejaculate volume was 3.4 ml (89% within WHO standard), and total sperm count was 297 Mio (94% within WHO standard).
No changes in semen parameters were noted after a median of 11 months of AZA administration or during long-term treatment (median, 49 months).
Sulfasalazine administration in 5 patients was associated with markedly reduced semen morphology.
During the study period, 6 patients fathered 7 healthy children.
Author Clemens Dejaco, of the Division of Gastroenterology and Hepatology, of the University Hospital of Vienna, concluded on behalf of the group, "Our data show that AZA does not reduce semen quality, and thereby male fertility, in IBD."