The Effects of Sulfasalazine on Human Male Fertility Potential and Seminal Prostaglandins
Abstract
Fertility parameters of 10 men with chronic inflammatory bowel disease under treatment with sulfasalazine for at least 5 years were compared to those of 19 control subjects. Seminal parameters examined included ejaculate volume, sperm number and concentration, sperm motility index, sperm viability, pH, zinc concentration, prostaglandins E and F2-alpha, prolactin and 7 classes of sperm morphology. In addition, plasma concentrations of follicle-stimulating hormone, luteinizing hormone, testosterone and prolactin were noted. The data indicate that sulfasalazine therapy reduces semen quality and that this effect can be reversed upon removal from therapy. This reversal is independent of seminal prostaglandin concentrations.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Macrozoospermia may be of iatrogenic origin, as described after treatment with sulphasalazine for ulcerating colitis and Crohn's disease, and in this context the abnormality is reversible and may resolve when the treatment is changed.
“Alternately, macrozoospermia may be of iatrogenic origin, as described after treatment with sulphasalazine for ulcerating colitis and Crohn's disease. In this context, the abnormality is reversible and may resolve when the treatment is changed [52, 53].”
From Recommendations for Human Sperm Morphology Assessment in 2025: An Expert Review From the French BLEFCO Group (2026) · cites this paper as [53]
Cites
National Cooperative Crohn's Disease Study: Results of drug treatment
Summers, R. W., Switz, D. M., Sessions, J. T., Becktel, J. M., Best, W. R., Kern, F., & Singleton, J. W. (1979) · Gastroenterology · doi:10.1016/0016-5085(79)90385-8 · Cited by 1,238 · see citing works
THE ROLE OF INTESTINAL BACTERIA IN THE METABOLISM OF SALICYLAZOSULFAPYRIDINE
PEPPERCORN, M. A., & GOLDMAN, P. (1972) · The Journal of Pharmacology and Experimental Therapeutics · doi:10.1016/s0022-3565(25)29238-2 · Cited by 450 · see citing works
Svartz, N. (1942) · Acta Medica Scandinavica · doi:10.1111/j.0954-6820.1942.tb06841.x · Cited by 365 · see citing works
J., J. E., Ryan, T. A., Joiner, B. L., & Ryan, B. F. (1978) · Technometrics · doi:10.1080/00401706.1978.10489652 · Cited by 351 · see citing works
Dissanayake, A. S., & Truelove, S. C. (1973) · Gut · doi:10.1136/gut.14.12.923 · Cited by 342 · see citing works
Inglis, J., Ryan, T. A., Joiner, B. L., & Ryan, B. F. (1977) · Journal of the American Statistical Association · doi:10.2307/2286504 · Cited by 329 · see citing works
MALE INFERTILITY DUE TO SULPHASALAZINE
Levi, A. J., FISHER, A. M., Hughes, L., & Hendry, W. F. (1979) · The Lancet · doi:10.1016/s0140-6736(79)90292-7 · Cited by 232 · see citing works
Sulphasalazine and male infertility: reversibility and possible mechanism.
Toovey, S., Hudson, E., Hendry, W. F., & Levi, A. J. (1981) · Gut · doi:10.1136/gut.22.6.445 · Cited by 205 · see citing works
Incidence of sulphasalazine-induced male infertility.
Birnie, G. G., McLeod, T. I., & Watkinson, G. (1981) · Gut · doi:10.1136/gut.22.6.452 · Cited by 180 · see citing works
Inhibition of Folate Enzymes by Sulfasalazine
Selhub, J., Dhar, G. J., & Rosenberg, I. H. (1978) · Journal of Clinical Investigation · doi:10.1172/jci108921 · Cited by 137 · see citing works
Reversible Toxic Effect of Salicylazosulf Apyridine on Semen Quality
Toth, A. (1979) · Fertility and Sterility · doi:10.1016/s0015-0282(16)44000-8 · Cited by 136 · see citing works
EFFECT OF ASPIRIN ON HUMAN SEMINAL PROSTAGLANDINS
Collier, J., & Flower, R. J. (1971) · The Lancet · doi:10.1016/s0140-6736(71)90225-x · Cited by 110 · see citing works
DAVIS, J. (1975) · The Lancet · doi:10.1016/s0140-6736(75)90981-2 · Cited by 106 · see citing works
Schröder, H., Lewkonia, R. M., & Evans, D. A. P. (1973) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt1973145802 · Cited by 65 · see citing works
Prostaglandins in semen and their relationship to male fertility: a study of 145 men
Cosentino, M., Emilson, L. B. V., & Cockett, A. T. �. (1984) · Fertility and Sterility · doi:10.1016/s0015-0282(16)47547-3 · Cited by 29 · see citing works
Self-citationSperm size in patients with inflammatory bowel disease on sulfasalazine therapy
Hudson, E., Doré, C. J., Sowter, C., Toovey, S., & Levi, A. J. (1982) · Fertility and Sterility · doi:10.1016/s0015-0282(16)46399-5 · Cited by 26 · see citing works
Takihara, H., Cosentino, M., & Cockett, A. T. �. (1983) · Urology · doi:10.1016/0090-4295(83)90500-9 · Cited by 15 · see citing works
Self-citationJenks, J. P., Cosentino, M. J., & Cockett, A. T. �. (1982) · Fertility and Sterility · doi:10.1016/s0015-0282(16)46708-7 · Cited by 13 · see citing works
Self-citationEvaluation of the Infertile or Subfertile Male
Caldamone, A. A., Valvo, J. R., & Cockett, A. T. �. (1981) · Urologic Clinics of North America · doi:10.1016/s0094-0143(21)01258-1 · Cited by 9 · see citing works
Self-citation
Flagged first, then by citations
1 of the 20 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Mountifield, R. E., Bampton, P. A., Prosser, R., Muller, K., & Andrews, J. M. (2008) · Inflammatory Bowel Diseases · doi:10.1002/ibd.20839 · Cited by 233 · see citing works
Menkveld, R. (2010) · Asian Journal of Andrology · doi:10.1038/aja.2009.14 · Cited by 192 · see citing works
Measurement and significance of sperm morphology
Menkveld, R., Holleboom, C. A. G., & Rhemrev, J. P. T. (2010) · Asian Journal of Andrology · doi:10.1038/aja.2010.67 · Cited by 186 · see citing works
Sperm morphology: assessment, pathophysiology, clinical relevance, and state of the art in 2017
Gatimel, N., Moreau, J., Parinaud, J., & Léandri, R. D. (2017) · Andrology · doi:10.1111/andr.12389 · Cited by 172 · see citing works
Antibiotics: potential hazards to male fertility
Wallach, E. E., Schlegel, P. N., CHANG, T. S. K., & Marshall, F. F. (1991) · Fertility and Sterility · doi:10.1016/s0015-0282(16)54108-9 · Cited by 158 · see citing works
Antirheumatic Drugs in Pregnancy and Lactation
Temprano, K. K., Bandlamudi, R., & Moore, T. L. (2005) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2005.05.002 · Cited by 146 · see citing works
Review article: reproduction in the patient with inflammatory bowel disease
Heetun, Z. S., Byrnes, C. K., Neary, P. C., & O'Morain, C. A. (2007) · Alimentary Pharmacology & Therapeutics · doi:10.1111/j.1365-2036.2007.03397.x · Cited by 110 · see citing works
Some aspects relating to the evaluation of the effects of chemicals on male fertility
Mangelsdorf, I., Buschmann, J., & Orthen, B. (2003) · Regulatory Toxicology and Pharmacology · doi:10.1016/s0273-2300(03)00026-6 · Cited by 101 · see citing works
Review article: Structure and function of the epididymis
Cosentino, M., & Cockett, A. T. �. (1986) · Urological Research · doi:10.1007/bf00256565 · Cited by 93 · see citing works
Self-citationHargreaves, C. A., Rogers, S., Hills, F. A., Rahman, F., Howell, R. J. S., & Homa, S. T. (1998) · Human Reproduction · doi:10.1093/humrep/13.7.1878 · Cited by 92 · see citing works
Paolo, M. C. D., Paoluzi, O. A., Pica, R., Iacopini, F., Crispino, P., Rivera, M., Spera, G., & Paoluzi, P. (2001) · Digestive and Liver Disease · doi:10.1016/s1590-8658(01)80108-0 · Cited by 85 · see citing works
Testicular Dysfunction in Systemic Disease
Handelsman, D. J. (1994) · Endocrinology and Metabolism Clinics of North America · doi:10.1016/s0889-8529(18)30071-9 · Cited by 84 · see citing works
Mouyis, M., Flint, J., & Giles, I. (2018) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2018.07.011 · Cited by 77 · see citing works
Pérez-García, L. F., Dolhain, R. J. E. M., Vorstenbosch, S., Bramer, W. M., van Puijenbroek, E., Hazes, J. M. W., & Winkel, B. T. (2020) · Human Reproduction Update · doi:10.1093/humupd/dmaa022 · Cited by 71 · see citing works
Mountifield, R. E., Andrews, J. M., & Bampton, P. A. (2014) · Journal of Crohn s and Colitis · doi:10.1016/j.crohns.2013.12.019 · Cited by 57 · see citing works
Pyrimethamine: an approach to the development of a male contraceptive.
Cosentino, M., Pakyz, R. E., & Fried, J. (1990) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.87.4.1431 · Cited by 54 · see citing works
Self-citationNon-neoplastic diseases of the testis
Nistal, M., & Paniagua, R. (2008) · Elsevier eBooks · doi:10.1016/b978-0-323-01970-5.50014-2 · Cited by 50 · see citing works
Infertility in men with inflammatory bowel disease
Shin, T., & Okada, H. (2016) · World Journal of Gastrointestinal Pharmacology and Therapeutics · doi:10.4292/wjgpt.v7.i3.361 · Cited by 49 · see citing works
Immunosuppressants and Male Reproduction
Drobnis, E. Z., & Nangia, A. K. (2017) · Advances in experimental medicine and biology · doi:10.1007/978-3-319-69535-8_12 · Cited by 39 · see citing works
Sharma, G., Naushad, M., ALOthman, Z. A., Iqbal, J., & Bathula, C. D. (2022) · Chemosphere · doi:10.1016/j.chemosphere.2022.136162 · Cited by 37 · see citing works
Finelli, R., Leisegang, K., Finocchi, F., MASI, S. D., Agarwal, A. K., & Damiani, G. B. (2021) · American Journal of Reproductive Immunology · doi:10.1111/aji.13389 · Cited by 36 · see citing works
Urologic complications of nonurologic medications
Thomas, A., Woodard, C., Rovner, E. S., & Wein, A. J. (2003) · Urologic Clinics of North America · doi:10.1016/s0094-0143(02)00111-8 · Cited by 31 · see citing works
Inflammatory bowel disease in subfertile men and the effect of mesalazine on fertility
Shin, T., Kobori, Y., Suzuki, K., Iwahata, T., Yagi, H., Soh, S., Arai, G., & Okada, H. (2014) · Systems Biology in Reproductive Medicine · doi:10.3109/19396368.2014.952391 · Cited by 29 · see citing works
The intravaginal absorption of male generated hormones and their possible effect on female behaviour
Ney, P. G. (1986) · Medical Hypotheses · doi:10.1016/0306-9877(86)90128-3 · Cited by 28 · see citing works
Paternal exposure to antirheumatic drugs—What physicians should know: Review of the literature
Micu, M. C., Østensen, M., Villiger, P. M., Micu, R., & Ionescu, R. M. (2018) · Seminars in Arthritis and Rheumatism · doi:10.1016/j.semarthrit.2018.01.006 · Cited by 25 · see citing works
The effect of salicylazosulphapyridine (sulphasalazine) on male fertility. A review
Giwercman, A., & Skakkebæk, N. E. (1986) · International Journal of Andrology · doi:10.1111/j.1365-2605.1986.tb00866.x · Cited by 25 · see citing works
Influence of biological sex in inflammatory bowel diseases
Tshikudi, D. M., Bernstein, C. N., Mishra, S., Ghia, J., & Armstrong, H. (2025) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-025-01038-y · Cited by 24 · see citing works
Pregnancy and inflammatory bowel diseases: Current perspectives, risks and patient management
Hosseini‐Carroll, P. (2015) · World Journal of Gastrointestinal Pharmacology and Therapeutics · doi:10.4292/wjgpt.v6.i4.156 · Cited by 22 · see citing works
Prospects for Pharmacological Male Contraception
Matlin, S. A. (1994) · Drugs · doi:10.2165/00003495-199448060-00002 · Cited by 20 · see citing works
Clinical Interpretation of Semen Analysis
Krausz, C. G., & Farnetani, G. (2022) · Springer eBooks · doi:10.1007/978-3-031-11701-5_13 · Cited by 17 · see citing works
The Effects of Chronic Administration of Pyrimethamine on Spermatogenesis and Fertility in Male Rats
Awoniyi, C. A., Chandrashekar, V., Hurst, B. S., Kim, W. K., & Schlaff, W. D. (1993) · Journal of Andrology · doi:10.1002/j.1939-4640.1993.tb00376.x · Cited by 17 · see citing works
Testicular Dysfunction in Systemic Diseases
Sartorius, G. A., & Handelsman, D. J. (2010) · Springer eBooks · doi:10.1007/978-3-540-78355-8_18 · Cited by 16 · see citing works
Raji, Y., Awobajo, F. O., Olufadekemi, ., T. K.-A., Gbadegesin, M. A., & Bolarinwa, A. F. (2005) · International Journal of Pharmacology · doi:10.3923/ijp.2006.9.14 · Cited by 14 · see citing works
The effects of sulphasalazine on male fertility
Marmor, D. (1995) · Reproductive Toxicology · doi:10.1016/0890-6238(95)00002-r · Cited by 12 · see citing works
Regulation of male fertility by pyrimethamine in adult mice
Kalla, N. R., Saggar, S., Puri, R., & Mehta, U. (1997) · Research in Experimental Medicine · doi:10.1007/s004330050054 · Cited by 9 · see citing works
6-mercaptopurine and spermatogenesis in the young rat
Karl, P. I., Katz, R., Daum, F., & Fisher, S. E. (1991) · Digestive Diseases and Sciences · doi:10.1007/bf01296399 · Cited by 8 · see citing works
Salarkia, E., Sepehri, G., Torabzadeh, P., Abshenas, J., & Saberi, A. (2017) · International Journal of Reproductive BioMedicine (IJRM) · doi:10.29252/ijrm.15.10.5 · Cited by 8 · see citing works
Urologic Manifestations of Drug Therapy
Bissada, N. K., & Finkbeiner, A. E. (1988) · Urologic Clinics of North America · doi:10.1016/s0094-0143(21)01788-2 · Cited by 8 · see citing works
Hypogonadismus und infertilität bei systemischen Erkrankungen
Sartorius, G. A., & Handelsman, D. J. (2009) · Springer eBooks · doi:10.1007/978-3-540-92963-5_18 · Cited by 7 · see citing works
Reproduction in the patient with inflammatory bowel disease.
Selinger, C. P. (2013) · PubMed · Cited by 6 · see citing works
Mane, S., & Chatterjee, S. (2021) · ChemistrySelect · doi:10.1002/slct.202101986 · Cited by 6 · see citing works
The effects of antirheumatic drugs on reproductive function
Brent, L. H., Beckman, D. A., & Brent, R. L. (1997) · Reproductive Toxicology · doi:10.1016/s0890-6238(97)89175-7 · Cited by 6 · see citing works
Testicular Dysfunction in Systemic Diseases
Handelsman, D. J. (2001) · Springer eBooks · doi:10.1007/978-3-662-04491-9_12 · Cited by 5 · see citing works
Testicular Dysfunction in Systemic Diseases
Sartorius, G. A., & Handelsman, D. J. (2023) · Springer eBooks · doi:10.1007/978-3-031-31574-9_34 · Cited by 7 · see citing works
A Case Report of Intratesticular Hematoma in a Patient with Reiter’s Syndrome
Jhang, J.-J., Chen, S., Huang, C., Chen, H., Lin, W., Chen, Y., & Chen, W. (2023) · Diagnostics · doi:10.3390/diagnostics13121993 · Cited by 4 · see citing works
Impact of long-term and short-term therapies on seminal parameters
Elia, J., Imbrogno, N., Delfino, M., Mazzilli, R., Spinosa, V., & Mazzilli, F. (2013) · Archivio Italiano di Urologia e Andrologia · doi:10.4081/aiua.2013.1.20 · Cited by 4 · see citing works
HISTOLOGICAL DETERMINATION OF SITE OF ANTIFERTILITY ACTION OF SULFASALAZINE IN MALE ALBINO RATS
Jain, G., Sharma, S., & Pareek, H. (2007) · Cited by 3 · see citing works
Pregnancy Counseling in Rheumatic Diseases: Where Science Meets the Steps
Balakrishnan, A., Mehta, P., & Gupta, L. (2020) · Indian Journal of Rheumatology · doi:10.4103/injr.injr_79_20 · Cited by 3 · see citing works
Hypogonadismus und Infertilität bei systemischen Erkrankungen
Handelsman, D. J. (2000) · Springer eBooks · doi:10.1007/978-3-662-05739-1_12 · Cited by 3 · see citing works
Rothmann, S. A., & Bort, A.-M. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-801238-3.64936-x · Cited by 4 · see citing works
Gatimel, N., Barbotin, A., Mery, L., Beauvillard, D., Bendayan, M., Boursier, A., Boueilh, T., Pereira, B., Chammas, J., Jacquet, J., et al. (2026) · Andrology · doi:10.1111/andr.70134 · Cited by 2 · see citing works
Sadeghipour, H., Vosooghi, M., Sattarian, M., Zahmatkesh, M., & Noori, M.-H. (2010) · Reproductive Sciences · doi:10.1177/1933719110370371 · Cited by 1 · see citing works
Adverse effects of environmental chemicals and drugs on the male reproductive system
Bruckner, J. V., Fenig, D. M., & Lipshultz, L. I. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511635656.015 · Cited by 1 · see citing works
Fertility in men diagnosed with ankylosing spondylitis – a population-based study
Micu, M. C., Micu, R., & Ionescu, R. A. (2018) · Romanian Journal of Rheumatology · doi:10.37897/rjr.2018.2.3 · Cited by 1 · see citing works
Testicular Function in Critical Illness
Plymate, S. R., & Jones, R. E. (1997) · Humana Press eBooks · doi:10.1007/978-1-4757-2584-1_14 · Cited by 1 · see citing works
Langman, M. J. S. (1986) · Side effects of drugs annual · doi:10.1016/s0378-6080(86)80043-5 · Cited by 1 · see citing works
Review Article: Structure and Function of the Epididymis
Cosentino, M. J., & Cockett, A. T. �. (1987) · The Journal of Urology · doi:10.1016/s0022-5347(17)44529-0
Self-citationPerspectives in Pediatric Pathology, Chapter 22. Testicular Involvement in Systemic Diseases
Nistal, M., Paniagua, R., González‐Peramato, P., & Reyes‐Múgica, M. (2014) · Pediatric and Developmental Pathology · doi:10.2350/14-09-1556-pb.1
Effects of Ponazuril on Reproductive Function of Stallions
Brinsko, S. P., Blanchard, T. L., Love, C. C., Varner, D. D., Rigby, S. L., Roser, J. F., Davis, W. L., & Kennedy, T. J. (2002)
Testicular Dysfunction in Systemic Diseases
Handelsman, D. J. (1997) · Springer eBooks · doi:10.1007/978-3-662-03455-2_12
Hypogonadismus, Infertilität und sexuelle Dysfunktion bei systemischen Erkrankungen
Sartorius, G. A., & Handelsman, D. J. (2021) · Springer Reference Medizin · doi:10.1007/978-3-662-61904-9_34-1
Yi̇ği̇t, S., BİNGÖL, S. A., Yayla, M., ATALAY, F. D., Eyerci, N., Aydın, T., & Kacı, F. N. (2023) · Research Square · doi:10.21203/rs.3.rs-2713835/v1
Hypogonadismus, Infertilität und sexuelle Dysfunktion bei systemischen Erkrankungen
Sartorius, G. A., & Handelsman, D. J. (2023) · Springer Reference Medizin · doi:10.1007/978-3-662-61901-8_34
Antibiotic therapy of male infertility
Mostafa, T., Abdel‐Hamid, I. A., & Zohdy, W. (2024) · Elsevier eBooks · doi:10.1016/b978-0-323-93047-5.00026-x
Nonneoplastic diseases of the testis
Nistal, M., Paniagua, R., & González‐Peramato, P. (2014) · Elsevier eBooks · doi:10.1016/b978-1-4557-4327-8.00012-7
Der Einfluß von Antibiotika auf die Fertilität
Neal, D. E. (1997) · Springer eBooks · doi:10.1007/978-3-642-60440-9_37
Rothmann, S. A., & Bort, A.-M. (2018) · Elsevier eBooks · doi:10.1016/b978-0-443-21477-6.00616-7
Fertility and Birth Outcomes in Rheumatoid Arthritis: A Narrative Review
Ermer, N. L., Sammaritano, L. R., & Siegel, C. H. (2026) · Rheumatology and Therapy · doi:10.1007/s40744-026-00877-8
- Authors
- Cosentino, M. J., Chey, W. Y., Takihara, H., & Cockett, A. T. K.
- Affiliations
- University of Rochester Medicine (US)
- Venue
- Journal of Urology
- Published
- 1984-10
- Volume
- 132
- Issue
- 4
- Pages
- 682-686
- ISSN
- 0022-5347 (ISSN-L)
- 1527-3792
- OpenAlex
- W170686684
- Cited by
- 68
- References
- 20
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 2 · 2021: 3 · 2020: 2 · 2018: 5 · 2017: 3 · 2016: 1 · 2015: 1 · 2014: 4 · 2013: 2
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Urology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Sperm and Testicular Function
- Health Sciences › Health Professions › General Health Professions › Male Reproductive Health Studies
- Health Sciences › Medicine › Rheumatology › Urologic and reproductive health conditions
- Keywords
- sulfasalazine, male fertility, semen quality, prostaglandin E, prostaglandin F2alpha, sperm motility, sperm viability, sperm morphology, prolactin, inflammatory bowel disease, drug-induced infertility, testosterone, luteinizing hormone, follicle-stimulating hormone
- MeSH terms
- Adult, Fertility, Follicle Stimulating Hormone, Humans, Inflammation, Intestinal Diseases, Luteinizing Hormone, Male, Prolactin, Prostaglandins, Prostaglandins E, Prostaglandins F, Sulfasalazine, Semen, Sperm Count, Sperm Motility, Spermatozoa, Testosterone, Zinc, Dinoprostone, Dinoprost
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
