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The Safety of Therapeutic Drugs in Male Inflammatory Bowel Disease Patients Wishing to Conceive

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Sunanda Kane, M.D., a gastroenterologist at Mayo Clinic, discusses a recent study in Alimentary Pharmacology & Therapeutics about how male fertility can be impacted with therapeutic drugs used to treat inflammatory bowel disease. Dr. Kane focuses on the effects of azathioprine, sulfasalazine, and methotrexate.

Hello i’m dr. soon and akane and i’m professor of medicine at mayo clinic in rochester minnesota we’re going to spend a few minutes talking not about females this time but males and in terms of fertility issues with medications used to treat inflammatory bowel disease it’s well known and well studied that medications used in women and their effects on fertility but

Very little has been talked about in terms of men so what do we know there’s been a recent review article just put out about medications and in males and so i thought it might be just worth talking about for a few minutes there was a very famous article that came out now over ten years ago about the effect of using 6mp or is a fibrin also known as pair nettle or

Emmure an in men and the potential effect it had on the offspring of those men using it and it turns out that that was a very small study and that that follow-up data to that did not suggest that there was any risk so unfortunately the first study is always the most famous and does not necessarily represent the truth and so i’m here to tell you that there are other

Things that are more damaging to sperm then staying on your eyes of fibrin and what would those be so sulfasalazine for gentlemen who are on that for treating ulcerative colitis or their joint symptoms with their ulcerative colitis or their crohn’s disease definitely affect sperm it affects that the number of sperm and then there also their motility methotrexate is

Still a little controversial there are some data to suggest that it’s toxic to sperm but other studies that don’t so it sort of depends on how much you’re taking and whether you can be off methotrexate in order to try to father a child certainly in women methotrexate is absolutely contraindicated but for men it’s not so much that issue we’ve already talked about the

Mu honor is a fibrin and how that is not damaging to sperm and then if that is helping your disease that you should stay on it because overall good health is important for sperm health steroids actually if taken at high doses for long periods of time may also be potentially damaging but again it’s only potential and not a strong relationship has been seen we talked

About sulfasalazine the other mesalamine product so lialda a sakala prezzo and the like have not been associated with sperm issues so if you are taking sulfasalazine then we usually recommend that you be transferred over to one of the other medications interestingly antibiotics particularly cipro is associated with sperm damage and so if you can get off of cipro

And be on a different antibiotic or on no antibiotics at all that would be helpful and then what do we know about the biologics the biologics actually have not been shown to cause damage to to sperm and so we do not recommend that we stop that if you wish to father children to other things that caused way more damage to sperm are poor nutrition and then also excess

Alcohol use and then tobacco also regular tobacco is known to have toxic effects on sperm so not necessarily medications unless it’s sulfasalazine cipro or high doses of steroids for a long time are the medications that are particularly of concern to us the other medications that if they’re used to control disease we do not recommend that they be stopped in order to father a child

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The Safety of Therapeutic Drugs in Male Inflammatory Bowel Disease Patients Wishing to Conceive By Mayo Clinic