FERTILITY IN MEN DIAGNOSED WITH ANKYLOSING SPONDYLITIS - A POPULATION-BASED STUDY.

Introduction. Disease activity, drug exposure , infectious factors, smoking, excessive alcohol intake and stress were identified to have a negative impact on spermatogenesis and gonadal function. Population-based studies on fertility in ankylosing spondylitis (AS) men are lacking. It is not known, if men with AS have a reduced number of children. Our objective was to determine fertility in a masculine AS group by determining the family size. Patients and methods. Men diagnosed with AS responded to a questionnaire comprising of several domains, focused on the preconception/conception period. Demographic parameters, disease related information, sexual relationship status, infertility treatment use in the couple, time to pregnancy achievement (TTP), comorbidities, exposure to gonadotoxic medication or radiation in the past, smoking, number of pregnancies and children born in the couple and couples' decision to limit family size were registered. Results. Out of 122 AS patients, 76 accepted to participate to the interview. Hundred-eleven pregnancies were registered in the couples and 99 children were born. Forty-two men (55.26%) with AS onset fathered 58 children and 34 (44.73%) men fathered 41 children before AS onset . No statistic difference was found between the 2 subgroups when average number of children/ family was compared (1.38 vs 1.20). A statistic significant number of men, with AS onset at conception (14/42; 33.33%), decided to limit the family size (p=0.02). Twenty-seven patients (35.52%) recalled a decrease in sexual desire. In 19 (25%) of them, this phenomenon was linked to the disease burden. Decrease of sexual desire in the 2 groups showed a borderline statistic significant difference, p=0.051. No statistic significant difference was obtained when TTP in the two groups were compared. Conclusion. A lower fertility in AS patients was described in our group in comparison to general population and this phenomenon could be linked mostly to psychological factors impacting family size decision. No correlation between the low fertility and disease presence at conception was found. [ABSTRACT FROM AUTHOR]