Aspectos da saúde reprodutiva em homens com miopatia inflamatória idiopática. Um estudo multicêntrico

Abstract

Objective: To evaluate reproductive health of males with idiopathic inflammatory myopathies (IIM), and comparing them with a control group. Methods: Demographic data, urologic evaluation (including pubertal parameters and sexual/ erectile function), testicular ultrasound, hormone profile, semen analysis, clinical features, and treatment of 25 IIM patients were evaluated. The control group was composed of 25 healthy males. Results: Median age of IIM patients was similar to that of the control group (24 versus 27 years, P = 0.566). The frequency of sexual activity, number of partners with spontaneous pregnancies after the onset of the disease, and use of condom were significantly lower in IIM patients than in the control group (60% versus 96%, P = 0.004; 16% versus 60%, P = 0.0031; 40% versus 76%, P = 0.021, respectively). Moreover, the frequency of testicular atrophy (28% versus 4%, P = 0.049), elevated levels of FSH and/or LH (25% versus 0%, P = 0.05), and sperm abnormalities (40% versus 0%, P = 0.0006) were statistically higher in IIM patients than in the control group. Median age of onset of IIM and current age were significantly higher in IIM patients with sexual/erectile dysfunction than in patients without this dysfunction (41 versus 12.5 years, P = 0.014; 46 versus 21 years, P = 0.027, respectively). On the other hand, differences in the age of spermarche, parameters of gonadal function, disease activity, muscle enzymes, and treatment were not observed between IIM patients with or without sexual/erectile dysfunction. Conclusion: This is the first study to identify changes in reproductive health and gonadal dysfunction in male IIM patients. Rheumatologists should discuss sexual problems with their patients, counseling them on contraceptive methods.