Effects of anti-TNF agents on fertilization and pregnancy outcomes from a paternal perspective

Anti-TNF drugs are effective in the treatment of inflammatory arthritis. However, concerns about the impact of anti-TNF therapy on fertility, particularly in male patients, have been insufficiently explored. This study aimed to investigate the effects of anti-TNFs on male fertility and examine the pregnancy outcomes of their partners. This study was conducted on male patients with inflammatory arthritis undergoing anti-TNF therapy. Male patients whose female partners became pregnant during the anti-TNF therapy were evaluated regarding their partners' pregnancy outcomes. The characteristics of infertile patients were also analyzed. Additional evaluations included patient age, disease duration, anti-TNF treatment duration, as well as partners' comorbid conditions and the pregnancy outcomes of their partners prior to the initiation of anti-TNF therapy. A total of 101 male patients were included in the study. Of the total cohort, 70 male patients (69.3 %) did not desire children and were using contraception. The female partners of 27 male patients successfully conceived while their partners were receiving anti-TNF therapy. The remaining 4 couples were considered infertile. There were 52 pregnancies in total. Of these, 36 resulted in term births, 1 in a preterm birth, 1 in a stillbirth, 4 in elective abortions, and 10 in spontaneous abortions. Among the 27 female partners who conceived during anti-TNF therapy, 11 had also experienced pregnancies prior to the initiation of treatment. There were no statistically significant differences between the two periods in either the number of pregnancies or pregnancy outcomes. Anti-TNF therapy appears to be safe in terms of both fertility and pregnancy outcomes, although further investigations are warranted to better clarify its impact on male reproductive health.