Impact of TNF-blocking agents on male sperm characteristics and pregnancy outcomes in fathers exposed to TNF-blocking agents at time of conception.

Objective. Published data were analysed to determine if the use of tumour necrosis factor (TNF) blocking agents in male patients during time of conception is associated with an increased risk of fetal abnormalities or complications during pregnancy. Moreover; we were interested in the impact of TNF-blocking agents on sperm quality characteristics. Methods. We performed a systematic literature review (Medline, online archives of Annual European Congress of Rheumatology and the American College of Rheumatology). One-hundred and thirty-nine Articles of potentially relevant reports were identified and screened for retrieval and nine articles were included in the final analysis. Results. Overall, there were sixty cases, where expectant fathers used TNF-blocking agents shortly before conception. The outcomes of the pregnancies are documented in twenty-eight events. We did not find any documentation of miscarriages or physical abnormities associated with TNF blocking treatment and paternity; however, we did find documentation evidence that sperm motility and vitality even may improve under TNF-blocking therapy. This improvement may be caused by a decrease in disease activity. Conclusion. Published data suggest that TNF-blocking therapy in male patients during time of conception does not increase the risk of adverse pregnancy outcome. In addition TNF-blocking therapy does not appear to reduce male fertility.