How to restore fertility in a male with rheumatoid arthritis?

March 20, 2011 12:44 PM

Medical Filter: My (male) friend with rheumatoid arthritis and his wife are trying to get pregnant. After months of trying, they've learned that he has very low sperm count and mobility. The doctor suspects that this is caused by the RA medications and not by RA itself. Unfortunately, none of several doctors has been able to give specific advice about which medications are problematic and how long my friend would need to be off of them in order for his swimmers to recover. Any personal experience here, folks? Links to credible info?

Google hasn't been my friend on this one. He is on Sulfasalzine, Vicodin, Mobic, and Humira.

They are aware of other options like donor sperm/AI, adoption, etc., but want to be as informed as possible before making a decision about next steps. Have seen ob/gyn, fertility specialist, and urology is coming up. Rheumy said there were no issues with these meds but even my limited success googling suggests otherwise.

Thanks! This research is all I can really do to help them out & I appreciate your helping, too.

posted by Kalatraz to Health & Fitness (8 answers total)

Best answer: Pharmacists often are much better informed about medications than physicians. Perhaps looking for a good pharmacist in your area might be the way to go.
posted by Neiltupper at 12:52 PM on March 20, 2011 [2 favorites]

Best answer: I am not a doctor. I am on Sulfasalazine. Sulfasalazine is likely the main culprit, and my rheumatologist told me about it up front.
See wikipedia, 'temporary infertility while on sulfasalazine'.
As to whether your friend can (and should) do without the sulfasalazine for a period of time for however long it takes to get pregnant, this would be a conversation he should have with his rheumatologist. If his rheumatologist cannot advise, he should talk with another who can.
All references seem to agree that infertility will abate after discontinuation. See for example
posted by blue_wardrobe at 1:08 PM on March 20, 2011 [2 favorites]

Has he tried eliminating wheat from his diet? If it helps the RA, maybe he can discuss reducing the medications with his doctor.
posted by Earl the Polliwog at 1:30 PM on March 20, 2011

2nding sulfasalazine. He really should discuss this with his rheumatologist though, you can't just discontinue RA meds without risking a nasty flare.
posted by ruperto at 1:42 PM on March 20, 2011

Best answer: From the official UK sulfasalazine datasheet:

Oligospermia and infertility may occur in men treated with sulfasalazine. Discontinuation of the drug appears to reverse these effects within 2 to 3 months.
posted by ruperto at 1:49 PM on March 20, 2011 [1 favorite]

Best answer: Yeah, my husband switched off sulfasalazine when we were trying to conceive for that very reason.
posted by gaspode at 3:36 PM on March 20, 2011

Best answer: Totally anecdotal, but my husband was on mobic and we had no problems conceiving...
posted by leahwrenn at 7:04 PM on March 20, 2011

Best answer: We had similar problems (though with a haematological condition) when we first started trying to conceive. My OH's haematologist sought advice from the hospital pharmacy, realising that pharmacists are much more clued up than physicians about this kind of thing, and the result was that he was taken off the potentially problematic drug and we were told to use contraception for another three months, until the drug was out of his system. The time this will take depends on the drug, hence the need to talk to the pharmacist.
posted by altolinguistic at 3:39 AM on March 21, 2011