Imuran(azathioprine) and fertility
DG
year. My wife and I are considering extending our family but are getting
conflicting advice on how safe this would be. Does anyone out there have any
reliable information of the likelihood of azathioprine, when taken by the
male, increasing the risk of birth defects?
Thank you/ Dan
sdores
about it you taking the med doesn't appear to be of danger but it can be if
it were your wife. This has a section on pregnancy and the fda catagory for
this med and pregnancy. Hope it helps. UM MOM Susan
"DG" <dan...@gortzak.freeserve.co.uk> wrote in message
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Bruce
I don't believe there is any definitive information on how safe
azathioprine is in regards to male fertility and it's effects on sperm.
The general recommendation however always seems to be that anyone
planning on having children should not do so until they've been off
azathioprine or 6-MP for at least three months.
I've included two studies below for 6-MP (azathioprine is just the
pro-drug for 6-MP), one indicates that taking 6-MP within three months
of conception resulted in a significant increase in birth defects.
Another study however demonstrated that azathioprine/6-MP did not
require discontinuation during pregnancy.
Since azathioprine is able to cross the placenta I would guess that the
risk is greater if the mother is using azathioprine however this is
something I would discuss with your physician before making a decision.
BACKGROUND & AIMS: 6-mercaptopurine/azathioprine is effective in IBD
patients. However, data regarding toxicity associated with pregnancy are
lacking, raising both patients' and physicians' concerns and sometimes
resulting in elective abortion.
METHODS: To evaluate potential toxicity of 6-mercaptopurine (6-MP), we
reviewed the records of 485 patients who had received the drug. We
contacted 462, of whom 155 had conceived at least 1 pregnancy after
developing IBD. Pregnancies were analyzed as to whether the patient had
taken 6-MP before, or at the time of, conception. These were compared
with IBD patients who had their pregnancies before taking 6-MP. We
collected data on live births, spontaneous abortions, prematurity,
abortions secondary to birth defects, major and minor congenital birth
defects, infections, and neoplasia. Outcomes were analyzed comparing
pregnancies from men and women who had taken or were currently taking
6-MP to controls.
RESULTS: There was no statistical difference in conception failures
(defined as a spontaneous abortion), abortion secondary to a birth
defect, major congenital malformations, neoplasia, or increased
infections among male or female patients taking 6-MP compared with
controls (RR = 0.85 [0.47-1.55], P = 0.59).
CONCLUSIONS: 6-MP use before or at conception or during pregnancy
appears to be safe. Discontinuation of the drug before and during
pregnancy is not indicated.
OBJECTIVE: The outcomes of pregnancies after maternal use of
6-mercaptopurine (6-MP) for inflammatory bowel disease (IBD) during
pregnancy have been reported, but data are lacking for outcomes when the
fathers use this drug.
METHODS: Subjects were male patients with IBD seen at one center between
1970 and 1997. Patients and their wives were interviewed. Group 1
comprised pregnancies fathered by men who were taking 6-MP. This group
was further subdivided into those conceived within 3 months of 6-MP use
and those conceived at least 3 months after 6-MP was stopped. Group 2
comprised pregnancies fathered by men with IBD, similar in
characteristics to group 1, who had not taken 6-MP before fertilization.
Information was collected regarding the fathers, the mothers, and the
pregnancies, as well as the health of the children, in a historical
cohort study.
RESULTS: There were 50 pregnancies in group 1 (13 in 1A and 37 in 1B)
and 90 pregnancies in group 2. Four of the 13 pregnancies in group 1A
were associated with complications. There were two spontaneous
abortions, and two congenital anomalies including a missing thumb in one
and acrania with multiple digital and limb abnormalities in the other.
Risk of complications was significantly increased when compared with
group 1B (p < 0.013) and group 2 (p < 0.002).
CONCLUSION: The incidence of pregnancy-related complications was
significantly increased when the fathers used 6-MP within 3 months of
conception.
Michael
at the same time I've done research and asked other doctors and the
consensus is they do not know for sure. Sperm only live 3 months, so the
theory is if you wait 3 months you will have all new sperm and therefore no
problems. If it were me, I'd try going without it for 3 months. When you
restart it, it will pick up where it left off relatively quickly. You won't
have to wait 3-9 months to get the effects.
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