Is male fertility affected by rheumatic disease?
• Vasculitis: decreased fertility if testicular involvement in PAN; patients with Behçet’s disease have normal fertility. Data is lacking for other forms of vasculitis.
• Ankylosing spondylitis: higher rates of varicocele, but no other changes in sperm.
• RA: active RA is associated with hypogonadism as well as decreased sperm production and function.
• SLE: decreased libido, erectile dysfunction, and failure to ejaculate, though it is difficult to sort out medication effect.