Inflammatory bowel diseases and human reproduction: A comprehensive evidence-based review

Table 2 Effects of inflammatory bowel disease medications on erectile dysfunction, male infertility and partner’s pregnancy

	Erectile dysfunction	Infertility	Pregnancy complications	Recommendations
5-ASA (except sulfasalazine)	No	Single reversible case	No reports	No recommendations to discontinue prior to conception
Sulfasalazine	Single case	Yes, reversible, not dose dependent	One study	Switch to other 5-ASA preparations
AZA/6-MP	No reports	No	Controversial	No recommendations to discontinue prior to conception
Cyclosporine A	No reports	No	No reports	No recommendations to discontinue prior to conception
Methotrexate	Yes	Controversial	No reports	Discontinue 3-4 mo prior to conception
Steroids	No reports	No	No reports	Lack of data to discontinue
TNF-α inhibitors (infliximab, and only a case report for adalimumab)	No reports	Reduce sperm quality, but no infertility	No	No recommendations to discontinue prior to conception, but barrier methods during pregnancy

5-ASA: 5-aminosalicylates; AZA: Azathioprine; 6-MP: 6-mercaptopurine; TNF: Tumor necrosis factor.