Sulfasalazine, Sperm and IVF/ICSI

[hoping2021]

Hello,

I am new to this board.

My husband has a diagnosis of arthritis and is taking Sulfasalazine. We understand that it causes sperm damage.

I wanted to know if anyone here had gone through IVF/ICSI with the male partner who was on Sulfasalazine.

If so, what did you do? Did the male partner stop sulfasalazine? If so, for how long prior to the cycle?

Any experience would be great.

Many thanks

[KittyJ]

Welcome hoping, I hope you get some answers to help you. I have heard that about sulphasalazine but haven’t experience of it. Has his rheumy suggested a med change? It can’t be the first time they’ve come across this situation. Good luck 🤞🏻

[hoping2021 in reply to KittyJ]

We will make an appointment with them. My husband was only diagnosed with séronégative- arthritis last year. His consultant helpfully told him to freeze a sample before starting on it last year, so we have some sperm frozen. Interestingly, his sperm parameters all got better once starting sulfasalazine, so we thought that perhaps treatment of his underlying chronic inflammation may actually lead to success. On this basis, his urologist and our fertility doctor recommended we try using sperm whilst he is on sulfasalazine. This led to us having the worst ivf outcome we have had yet. And so I am wondering if we either use the frozen sperm before he started treatment or if he should come off treatment for our next ivf/icsi cycle. Obviously I don’t want his joint problems to flare… so I am interested to see how other couples have navigated this.

[bpeal1 in reply to hoping2021]

I know it can be difficult to get different hospital departments to work together but it might be worth a try. A bit of joined up thinking on this one could be useful. Good luck in your journey.

[burtonbradstock in reply to KittyJ]

I was taking Sulfasalazine and Methotrexate when my wife got pregnant at 40 years old, we where monitored closely but went on to have our 3 child. The first & second were pre RA. My consultant was amazed but all turned out fantastic. All the best for the future

[hoping2021 in reply to burtonbradstock]

Thank you so much for taking the time to reply. This is really reassuring to hear.

[KittyJ in reply to burtonbradstock]

I think this was meant for the poster not me buttonbradstock

[Sheila_G]

Sorry I can't help you but I pray that you will be successful in your desire to have a family.

[hoping2021 in reply to Sheila_G]

Thank you

[Belle76]

Hi I don’t know if this is helpful being I’m female but when I wanted to have another child I had to come off sulphasalazine for 3 months before I could even start trying for a baby. I can’t remember why I think it was because they were unsure of the effects it would have. But I have read that some ladies take a low dose but it’s really down to the risks you want to take.

[JustHereForGin in reply to Belle76]

Really? I was allowed to stay on it as it was pregnancy and breastfeeding friendly! I had to come off methotrexate for 6 months before trying to get pregnant.

[hoping2021 in reply to JustHereForGin]

Thank you… My understanding is that is can cause problems with sperm. Hence why I’d be really interested to know what men on sulfasalazine did with their medication during ivf/ Icsi.

[Belle76 in reply to JustHereForGin]

Yes this was 14 years ago so might of changed now and different doctors say different things. That was what I was told to do.

[bpeal1 in reply to Belle76]

I’m female and my son is now 12 but I took full dose of sulphasalazine throughout my pregnancy. It is not (or at least it wasn’t) licensed for use during pregnancy but my rheumatologist said that many ladies used it during pregnancy and there were no known issues. However because it wasn’t licensed I was very carefully monitored.

Sorry I can’t help from a male prospective other than to advise speaking to your rheumatology department and trying to get them to talk to your IVF team.

[hoping2021 in reply to bpeal1]

Thank you. I understand it is safe in pregnancy however my understanding is that it can potentially damage sperm. Hence my question regarding men on sulfasalazine inparticularly who required ivf/ Icsi.

[bpeal1 in reply to hoping2021]

I appreciate that. I was replying to Belle76. Good luck in your journey. I really hope you can get your medical teams to work together, it makes so much difference when they do. I had problems including miscarriages before my son and was very lucky that my rheumatologist and obstetrician worked together to get me through my pregnancy with my son. Good luck!

[Gigi71]

I would give the NRAS helpline a call, I’m sure they will advise you accordingly. X

[nomoreheels]

Hiya hoping2021, welcome to the NRAS site. I can't help specifically about males on RD meds & ICSI/IVF I'm afraid, but wanted to offer some support if I can. I know how it can be difficult enough for 'normal' couples to both go through the rounds, to have the added considerations re meds will be of extra concern, that's clear.

I have to say my initial thought, without really knowing, was if your husband could come off sulfasalazine &, for the necessary time required, be prescribed prednisolone, just long enough to get the business end of things sorted. This is without really knowing if that's feasible so it's really necessary to have both your teams communicating.

If I can be of any emotional support do private message me, happy to share anything from our experience.