Background and Aims: Sexual functions are sometimes adversely affected by the therapeutic
drugs delivered for treating IBD. Much attention has been focused on pregnancy/sexual issues in
women. Relatively less attention has been poured in to address this issue in men. This systematic review
assesses the drugs having potential detrimental effects on fertility in men.
Methods: Three databases were searched by two researchers independently for potentially relevant
publications between 1964 to 2015 and 249 papers were retrieved. Studies that dealt with sexual problems
after IBD drugs administration were included in the purview of this review.
Results: Fourteen studies with 327 human patients and 110 animals were analysed. Sulphasalazine
treated patients had lower spermatozoa count, lower sperm motility and higher risk of oligospermia
compared to mesalazine treated ones. Biologics seem to be safe to use while attempting to conceive
however, proper clinical studies reporting male fertility problems in IBD patients are lacking. Azathioprine
caused oligospermia but a meta-analytical approach was not possible due to heterogeneity in
studies. Some animal studies showed methotrexate affects abnormal testis structure and spermatogenesis.
Conclusion: This study summarises the current literature and safety issues affecting fertility parameters
in men and animals treated with IBD therapeutic drugs, which can further assist clinicians in better
management of adult male IBD patients.