Infertility in men with inflammatory bowel disease

Table 1 Possible causes of infertility in men with inflammatory bowel disease

Causes of infertility in men with IBD	Ref.
Surgery	[17,19-25]
Medications	[4,5,7,15,16,28-32,42,43]
Active disease	[15,16,76]
Poor nutrition	[15,77]
Alcohol use	[15,81-83]
Tobacco use	[15,83,86,87]
Psychological factor	[7,88,89]

IBD: Inflammatory bowel disease.

Table 2 Studies of sexual function after proctocolectomy in men

Ref.	Year	No. of patients	Disease	Time since surgery	Sexual dysfunction after surgery
					ED	EjD
Michelassi et al[23]	1993	24	UC	1.5 yr (median)	0%	19%
Damgaard et al[24]	1995	26	UC	2.8 yr (median)	3.80%	3.80%
Farouk et al[22]	2000	762	UC	1 yr	1%
		215	UC	12 yr	2%
Slors et al[17]	2000	40	Benign disease	2.8 yr (median)	10%	12.50%
Lindsey et al[25]	2001	156	CD, UC	6.2 yr (median)	14%	0%
Berndtsson et al[19]	2004	25	UC	1 yr	0%	12%
Hueting et al[20]	2004	35	CD, UC	3.5 yr (median)	25.70%
Gorgun et al[21]	2005	122	CD, UC, others	3.6 yr (median)	12%	8.20%

CD: Crohn’s disease; ED: Erectile dysfunction; EjD: Ejaculatory dysfunction; UC: Ulcerative colitis.

Table 3 Effects of medications used for inflammatory bowel disease on male fertility

	Infertility	Pregnancy complications	Recommendations
Sulfasalazine	Reversible	One study	Switch to a different 5-ASA
Mesalazine	One study	None reported	Discontinue only in stable disease
Corticosteroids	No	None reported	Only use short periods
Thiopurines	No	Controversial	No recommendation
Methotrexate	Unclear	None reported	Discontinue in the case of erectile dysfunction
Ciclosporine	No	None reported	No recommendation
Infliximab	Unclear	None reported	No recommendation

5-ASA: 5-Aminosalicylate.