Does Sulfasalazine Affect Male Fertility and Sperm Quality?

Does taking Sulfasalazine affect fertility?

Hello Doctor: I have ankylosing spondylitis and have been taking Sulfasalazine (Salazopyrin) for over two years, currently at a dosage of six tablets daily.
I would like to know if this medication affects sperm count or motility, as my wife and I are trying to conceive our second child but have not been successful.
If it does have an impact, how long should I discontinue the medication to restore sperm count and quality? Are there any other methods to improve this situation? Thank you! I did not take Salazopyrin during my first pregnancy, and now that we are trying for a second child, I am wondering if this medication could be related to our difficulties in conceiving.
Thank you!

David, 30~39 year old female. Ask Date: 2013/10/16

Dr. Zeng Guosen reply Internal Medicine

Hello David, Salazopyrin may be related to your condition, but it is not necessarily the cause.
I recommend discussing this with your primary physician and obstetrician.
Stopping the medication for three months should help mitigate any potential effects.
Thank you for your question.

Reply Date: 2013/10/16

More Info

Sulfasalazine is a medication commonly used to treat inflammatory bowel diseases and conditions like ankylosing spondylitis. It works by reducing inflammation in the body. However, when it comes to male fertility, there are several considerations to keep in mind.

Research indicates that sulfasalazine can potentially affect male fertility, particularly in terms of sperm quality. Some studies have shown that sulfasalazine may lead to a decrease in sperm count and motility, which are critical factors for successful conception. The mechanism behind this effect is not entirely understood, but it is believed that sulfasalazine may interfere with the production of sperm in the testes or affect the hormonal balance necessary for sperm development.

If you have been taking sulfasalazine for over two years and are trying to conceive, it is reasonable to consider the possibility that this medication could be impacting your fertility. However, it is important to note that not all men will experience these side effects, and individual responses to medication can vary widely.

Regarding the duration of time needed for sperm quality to recover after discontinuing sulfasalazine, it is generally accepted that sperm production takes about 64 to 74 days. Therefore, if you decide to stop taking sulfasalazine, it may take approximately three months for your sperm parameters to return to baseline levels. This timeline can vary based on individual health factors, lifestyle, and any underlying conditions.

In addition to considering the discontinuation of sulfasalazine, there are other strategies you can employ to improve sperm quality. These include:
1. Healthy Lifestyle Choices: Maintaining a balanced diet rich in antioxidants (fruits, vegetables, nuts), regular exercise, and avoiding smoking and excessive alcohol consumption can positively impact sperm health.

2. Weight Management: Being overweight can affect hormone levels and sperm production. Achieving a healthy weight may improve fertility.

3. Stress Reduction: High levels of stress can negatively impact fertility. Engaging in relaxation techniques such as yoga, meditation, or deep-breathing exercises can be beneficial.

4. Avoiding Heat Exposure: Prolonged exposure to heat (such as hot baths, saunas, or tight clothing) can adversely affect sperm production. Keeping the testicular area cool is advisable.

5. Consulting a Specialist: It may be beneficial to consult a urologist or a fertility specialist who can provide personalized advice and possibly conduct a semen analysis to assess sperm quality.

Before making any changes to your medication regimen, it is crucial to discuss your concerns with your healthcare provider. They can help you weigh the benefits of continuing sulfasalazine for your ankylosing spondylitis against the potential impact on your fertility. Your doctor may also consider alternative treatments that have less impact on sperm quality.

In summary, while sulfasalazine may affect sperm quality and fertility, the extent of this effect can vary. If you are trying to conceive, it is advisable to have an open discussion with your healthcare provider about your medication and any potential adjustments that may support your fertility goals.

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