Methotrexate : Just a quick question well a sensitive... - NRAS

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Methotrexate

Seanstar
Seanstar

Just a quick question well a sensitive one , I’ve been on methotrexate since sept 2019 , we are trying to extend our family but my wife has had a miscarriage and I’m just wondering if it’s the methotrexate I’m on that has caused it , I keep googling but keep going round in circles.

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Hi Sean. I am sure somebody with more knowledge will be along soon, but I am sure the advice is to stop mtx before trying to get pregnant. Could you ring your specialist nurse or GP or even NRAS.

I will give my GP a ring , thank you

Hi, I'm sorry for your loss. Again we are not GPs but I'm pretty sure the health advice is for men to stay on mtx. Only the women have to come off it because studies didn't record any problems in male fertility. A miscarriage is a complex topic and what I've gathered there is mostly something wrong with the embroy which can happen randomly and to everyone. I understand though that you want to find a reason for it. It makes the loss a bit easier for you. If you are worried please contact your rheumatology team but I'm sure it was just an unfortunate situation rather then the mtx. Good luck anyway

Seanstar
Seanstar
in reply to Crazyxxx

Thank you for your reply ,

Hidden
Hidden

Very sorry for your sad loss.

I would double check with your Rheumatology team. I'm afraid I don't know, but worth checking for your piece of mind.

Seanstar
Seanstar
in reply to Hidden

Thank you

Thank you

So sorry for your loss, Seanstar.

Thank you

Hidden
Hidden

medicalnewstoday.com/articl...

Summary

Methotrexate is a first-line treatment for rheumatoid arthritis. If a person takes this drug during pregnancy, it can cause birth abnormalities. Both partners should avoid methotrexate when planning to become pregnant and during pregnancy.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that causes inflammation of the joints. It is 2–3 times more common in females than in males.

Methotrexate can help people manage their RA symptoms, but it can also cause severe toxicity.

In this article, we provide important information on how methotrexate affects women during pregnancy.

What happens if you take methotrexate during pregnancy?

Taking methotrexate for rheumatoid arthritis can cause birth abnormalities.

Methotrexate minimizes the body’s immune response and reduces folic acid in the body. Folic acid plays an essential role in how a fetus develops in the womb.

The Food and Drug Administration (FDA) do not approve the use of methotrexate during pregnancy. They state that people should avoid pregnancy if either partner is taking the drug. People should also avoid methotrexate when breastfeeding.

Taking methotrexate in pregnancy may lead to birth abnormalities that affect a child’s physical and mental development. In some cases, methotrexate can result in fetal death.

Examples of birth abnormalities that methotrexate may cause include:

Neural tube defects that affect the brain, spine, or spinal cord. These include spina bifida and encephalocele, a protrusion at the base of the skull.

A cleft palate.

A condition called cleidocranial dysostosis, which causes abnormalities in the teeth and collarbones.

Hypertelorism, which is a greater distance than normal between two body parts, often the eyes.

Effects of the father taking methotrexate

Methotrexate can affect the fetus if either parent has been taking it. Males should not take methotrexate when trying for a baby.

People can avoid unplanned pregnancies by using an effective form of birth control. These include condoms, the birth control pill, and intrauterine devices (IUDs).

Seanstar
Seanstar
in reply to Hidden

Thank you

I'm sorry your wife has had a miscarriage Sean, I do hope she's coping ok, you too? It's only natural you should wonder if taking MTX has had any bearing. This is from Versus Arthritis

What if I want to start a family?

It’s a good idea for anyone with arthritis who’s considering starting a family to speak to their rheumatology team first. They can give advice on medication and managing the condition.Women shouldn’t take methotrexate if they’re pregnant or want to get pregnant, as the drug can affect how an unborn baby develops. You should use contraception (or ask your partner to) for up to three months after stopping methotrexate. It was thought that men needed to stop the drug for three months before trying for a baby. Research now suggests that it’s safe to keep taking it, though men starting a family should still speak to their doctor about this first. versusarthritis.org/news/20...

Does it matter if the father is taking drugs for arthritis?

Some arthritis drugs can cause problems in men trying to father a child. For instance, cyclophosphamide can reduce fertility in men. Doctors advise men to stop this drug three months before trying to father a child. Many doctors used to advise men to stop taking sulfasalazine and methotrexate before trying to father a child. Current guidelines, however, advise that men do not need to stop sulfasalazine or methotrexate unless they have been trying to father a child for more than one year, and have been unsuccessful. versusarthritis.org/about-a...

If it's still concerning you then I'm sure you'll know that the only person who can advise really is your Rheumy. I do hope though that it was just one of those things & it was nature determining this just wasn't to be this time.

Thank you

You’re right, lots of conflicting info online. I would definitely ask rheumatology or pharmacist for current advice, GPS don’t tend to be as informed about the drugs. Kindest regards.

Thank you

Sorry for loss. Miscarriage is tough on all the family. I would speak to your rheumatologist. The NRAS website advises against men taking it when trying to father a child. nras.org.uk/methotrexate-in...

Thank you

I was on MTX for over 10 years (dx age 6) before I stopped it for 3 months (the advice back in 1992) before trying to start a family. I have 2 children. I got pregannt after 2-3 months and can say MTX made no difference whatsoever.

Thanks for the reply , hopefully it was just nature and not the mtx

Hi.. I just found this on the web which might be useful.

medicalnewstoday.com/articl...

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