ASK THE EXPERTS - Can methotrexate be given safely to men with RA and planning to have children?

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Medscape Rheumatology

Posted 05 Jun 2006

Ask the Experts about Rheumatoid Arthritis and Related Conditions

Can Methotrexate Be Given Safely to Men With RA and Planning to Have Children?

Question

Can methotrexate be given safely to men with RA who are planning to

have children?

Maher Dollan, MD

Response from 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.[1] 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.[2] 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.

http://www.medscape.com/viewarticle/533259

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Not an MD