Safety of Methotrexate for Men Planning to Have Children
Safety of Methotrexate for Men Planning to Have Children
Can methotrexate be given safely to men with RA who are planning to have children?
Maher Dollan, MD
Robert I. Fox, MD , PhD
Member, Rheumatology and Medicine Department, Scripps Memorial Hospital, La Jolla, California
From my knowledge and search of the literature, there are no reports on the adverse effects on pregnancy outcomes among men exposed to methotrexate before conception.
Comment:
Opinions in the literature differ on the effects of methotrexate on male fertility.
Several case reports and studies report no effect; others report reversible sterility. Most of the literature regarding methotrexate and fertility is derived from combination chemotherapy using high-dose methotrexate and is not applicable to patients with rheumatoid arthritis. Small studies reporting methotrexate use with no other agents suggest no increased infertility. Motherisk (a database in Canada: www.motherisk.org) is currently following men who are taking methotrexate alone for psoriatic arthritis to see whether it affects fertility; present results show no increased problems in babies of fathers who received methotrexate.
Question
Can methotrexate be given safely to men with RA who are planning to have children?
Maher Dollan, MD
Response From the Expert
Robert I. Fox, MD , PhD
Member, Rheumatology and Medicine Department, Scripps Memorial Hospital, La Jolla, California
From my knowledge and search of the literature, there are no reports on the adverse effects on pregnancy outcomes among men exposed to methotrexate before conception.
Comment:
Opinions in the literature differ on the effects of methotrexate on male fertility.
Several case reports and studies report no effect; others report reversible sterility. Most of the literature regarding methotrexate and fertility is derived from combination chemotherapy using high-dose methotrexate and is not applicable to patients with rheumatoid arthritis. Small studies reporting methotrexate use with no other agents suggest no increased infertility. Motherisk (a database in Canada: www.motherisk.org) is currently following men who are taking methotrexate alone for psoriatic arthritis to see whether it affects fertility; present results show no increased problems in babies of fathers who received methotrexate.
Source...