The prognosis for systemic lupus erythematosus (SLE), an autoimmune disease that mainly affects women in their reproductive years, has improved recently, prompting a shift toward improving quality of life.
For men with SLE, concerns have been raised about their future fertility. However, no studies have been conducted to date on testes function and its relevance to sperm abnormalities in male SLE patients. A new study published in the July 2007 issue of Arthritis & Rheumatism examined gonad function in male SLE patients and found that they have a high frequency of sperm abnormalities associated with reduced testicular volume. In addition, the study identified intravenous treatment with the immunosuppressant cyclophosphamide (IV CYC) as the major factor in permanent damage to the testes.
Led by Polyanna Maria F. Soares of the University of so Paulo in so Paulo, Brazil, the study included 35 men with SLE and 35 healthy controls, who underwent an exam of the genitalia, and semen analysis to determine sperm count, morphology and motility. For SLE patients, analysis of antisperm antibodies (which can adversely affect fertilization), testicular ultrasound, and hormone evaluation were also conducted.
The results showed that SLE patients had lower median testicular volumes in both testes, compared with controls, a lower median sperm count, and lower motility. SLE patients also had lower sperm volume and a lower percentage of normally formed sperm. Since all SLE patients had some type of semen abnormality, they were divided into two groups according to the severity: group 1 had abnormal sperm morphology, while group 2 had no sperm or abnormal sperm morphology, coupled with low sperm count and/or low sperm motility. Those in group 2 had a higher frequency of treatment with IV CYC than those in group 1, along with lower testicular volumes and higher levels of follicle-stimulating hormone.