THU0681 SEXUAL FUNCTION AND REPRODUCTION CAN BE IMPAIRED IN MEN WITH RHEUMATIC DISEASES: A SYSTEMATIC REVIEW
Authors: Luis Fernando Perez, Bernke Te Winkel, Juan Pablo Carrizales-Luna, Wichor Bramer, Saskia Vorstenbosch, Eugène van Puijenbroek, Johanna Hazes, Radboud Dolhain
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Sexual function and reproduction are important aspects of quality of life for the majority of men (1,2). In the last decade inflammation has been associated with male factor infertility and sexual dysfunction (3,4). Because many patients with rheumatic diseases have a chronic state of inflammation, it is reasonable to believe that this can result in impaired sexual function and reproduction. Previous research on this topic in Rheumatology mainly focused on the effect of drugs on fertility parameters. <h3>Objectives</h3> Our objective is to summarize the information on the influence of rheumatic diseases on male sexual function and reproduction. <h3>Methods</h3> A systematic search of Embase, Medline, Web of science and Cochrane Central was carried out in May 2018 to find relevant papers. The search strategy was extensive and included a complete list of immune mediated diseases from Rheumatology, Dermatology and Gastroenterology and several keywords for our outcomes (sexual function, fertility and pregnancy outcome). This review was registered in PROSPERO(5). The search yielded 6568 articles. Titles and abstracts were screened independently by LP and JC, resulting in 177 papers selected for full text review. Methodological quality of the studies was assessed with the Newcastle Ottawa Scale (6). <h3>Results</h3> Regarding rheumatic diseases a total of 104 papers were included in the final analysis. 4 diseases (Spondyloarthropathies (SpA), Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc)) represented 60% of the articles. The overall quality of the studies was low to moderate. Sexual dysfunction (SD) is a common problem for patients with rheumatic diseases and it is usually undiagnosed. It was reported in approximately half of men with RA, SLE and SpA and in almost all the men diagnosed with SSc. It should be noted that, although in several studies increasing age was correlated with a higher prevalence and severity of SD, young patients with SpA or SLE can also be affected. Regarding fertility and reproduction, different results per disease were found. Hypogonadism might be a common problem in men with RA and SLE. Many men with SLE and RA have endocrine axis abnormalities. Interestingly, these disturbances were not detected in SpA patients (See Table 1). Semen quality abnormalities are frequent in SLE patients and this was found to be associated not only with medication toxicities but also with disease activity. The number of children of male patients diagnosed with SLE and SSc was lower than healthy controls. A brief summary of our findings per disease are presented in Figure 1. <h3>Conclusion</h3> Our findings suggest that not only medication can have detrimental effects on sexual function and reproduction of men with rheumatic diseases but also the disease itself. Therefore, clinicians should be aware of a high prevalence of sexual and reproduction problems in this population and take this into account when counseling them. More research focusing on this association is needed. <h3>References</h3> [1] Flynn KE, et al. The journal of sexual medicine. 2016;13(11):1642-50. [2] Ilacqua A, et al. Reprod Biol Endocrinol. 2018;16(1):115. [3] Haervig KK, et al.Hum Fertil (Camb). 2018;21(2):146-54. [4] Fijak M, et al. Hum Reprod Update. 2018 Jul 1;24(4):416-441 [5] Perez LF, et al. Retrived from: www.crd.york.ac.uk/prospero/display_record.php?RecordID=99845) [6] Wells GA, et al. Retrieved from: www.ohri.ca/programs/clinical_epidemiology/oxford.asp <h3>Disclosure of Interests</h3> Luis Fernando Perez: None declared, Bernke te Winkel: None declared, Juan Pablo Carrizales-Luna: None declared, Wichor Bramer: None declared, Saskia Vorstenbosch: None declared, Eugène van Puijenbroek: None declared, Johanna Hazes: None declared, Radboud Dolhain Grant/research support from: UCB Pharma B.V