Gonadal function in male patients with ankylosing spondylitis

Scand J Rheumatol. 2012;41(6):476-81. doi: 10.3109/03009742.2012.688218. Epub 2012 Jul 24.


Objective: To assess reproductive function in male ankylosing spondylitis (AS) patients in comparison to healthy controls.

Methods: Twenty AS patients were compared to 24 healthy male subjects with regard to demographic data, urological examination, testicular ultrasound (US), semen analysis, anti-sperm antibodies, and hormone profile. Exclusion criteria were present use of sulfasalazine or methotrexate, and ever use of biological/cytotoxic agents. Disease activity of AS was evaluated by clinical and laboratory assessments.

Results: Demographic data were similar in AS and controls (p = 0.175). Varicocele was found significantly more frequently in AS patients than in controls (40% vs. 8%, p = 0.027). Semen analysis revealed no significant differences in sperm quality between AS patients and controls (p > 0.05). By contrast, the median of normal sperm forms was significantly lower in AS patients with vs. those without varicocele [13.5 (range 2-27) vs. 22 (range 10-32.5)%, p = 0.049] whereas no difference in sperm morphology was observed comparing AS patients and controls without varicocele (p = 0.670). Comparison of AS patients with and without varicocele showed that anti-sperm antibodies, hormones, inflammatory markers, and disease activity scores did not contribute to the impaired sperm morphology observed in AS patients with varicocele.

Conclusions: An increased frequency of varicocele was found in AS patients associated with sperm abnormalities but independent of therapy, anti-sperm antibodies, hormonal alterations, or disease parameters. Investigation for varicocele should be routine in AS patients with fertility problems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Humans
  • Male
  • Middle Aged
  • Semen Analysis
  • Sperm Count
  • Sperm Motility / physiology
  • Spondylitis, Ankylosing / complications
  • Spondylitis, Ankylosing / diagnostic imaging
  • Spondylitis, Ankylosing / physiopathology*
  • Testis / diagnostic imaging
  • Testis / physiopathology*
  • Ultrasonography
  • Varicocele / complications
  • Varicocele / diagnostic imaging
  • Varicocele / physiopathology*