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P152. Role of inflammatory bowel disease in fertility of male patients

P. Valer1, A. Algaba1, E. Nieto2, I. Guerra1, M. Chaparro3, P. López-Serrano4, E. Quintanilla5, B. Piqueras1, A. Bermejo1, J.P. Gisbert3, Á. Paéz6, F. Bermejo1, 1Hospital Universitario de Fuenlabrada, Gastroenterology, Fuenlabrada, Spain, 2Hospital Universitario de Fuenlabrada, Laboratory, Fuenlabrada, Spain, 3Hospital Universitario de La Princesa, and Instituto de Investigación Sanitaria Princesa (IP), Madrid Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Gastroenterology, Madrid, Spain, 4Hospital Universitario Fundación Alcorcón, Gastroenterology, Alcorcón, Spain, 5Hospital Severo Ochoa, Gastroenterology, Leganés, Spain, 6Hospital Universitario de Fuenlabrada, Urology, Fuenlabrada, Spain

Background

Relatively little attention has been focused on the fertility of men with inflammatory bowel disease (IBD). The aim of the present study was to evaluate the effect of IBD on male reproductive function, sperm quality and circulating sex hormones.

Methods

Prospective study in males with IBD and controls (CTR). A blood sample for sex hormones [prolactin, testosterone, luteinizing hormone, follicle stimulating hormone] and zinc (Zn) determination was obtained from each subject. A 24 hour urine sample was obtained to determine urinary Zn excretion. Semen samples were collected after 3–5 days of sexual abstinence. Volume, pH, sperm concentration, motility, vitality and morphology were evaluated according to WHO guidelines. Semen Zn levels and antisperm antibodies were also analyzed.

Results

82 men, 19 controls and 63 patients with IBD (38 Crohn's disease (CD), 24 ulcerative colitis (UC) and 1 unclassified colitis) were included. 33% were on treatment with mesalazine, 3% on budesonide, 51% on thiopurines and 25% on anti-TNF-σ drugs. According to clinical indexes 87% of patients had no activity at the time of inclusion. In patients with IBD we observed a trend to higher levels of prolactin (CD 18.1±10.2 ng/ml; UC17.9±6.4; CTR 12.2±2.7; p = 0.052) close to the threshold of statistical significance. There were no differences between testosterone, luteinizing hormone and follicle stimulating hormone. The progressive motility “a” (CD 8.7±13.7%; UC 21.2±28.6; CTR 34.7±27.5) was significantly lower in patients with CD compared to CTR (p = 0.004). There was a trend to lower levels in sperm concentration in CD patients (CD 59.5±89.26 mill/mml; UC 116±137.1; CTR 74.4±53.8 p = 0.062). There were no differences in semen volume (CD 2.7±1.44 ml; UC 2.9±1.3; CTR 3.3±0.9; p = 0.317), vitality (CD 66±14.7%; UC 65±20.4; CTR 69.7±13.1; p = 0.621) and non progressive motility “c” (CD 8.4±6.7%, UC 8.7±4.4; CTR 9.5±4.9; p = 0.585). The antisperm antibodies were all negative. We observed a trend to higher levels in Zn levels in urine sample (CD 14.1±9.9 µmol/24; UC 14.5±8.6; CTR 10.1±5.6; p = 0.06) and semen (CD 1958±1513 µmol/L; UC 2017±1147; CTR 1639±1091) in patients with IBD compared to CTR (p = 0.06).

Conclusion

IBD could have a negative effect on sperm quality and circulating sex hormones. However further evaluation is required to know the clinical significance of these findings on fertility.