Study Finds Higher Fertility Rates Among Men With Inflammatory Joint Disease

A nationwide cohort study from Norway challenges assumptions about reproductive health in men with inflammatory joint diseases (IJD), reporting higher fertility rates and lower rates of childlessness compared to the general male population.

The study analyzed data from 7,131 men aged 25 to 65 years with psoriatic arthritis (PsA), rheumatoid arthritis (RA), or axial spondylarthritis (axSpA), compared to 35,655 matched controls without IJD. Fertility outcomes were drawn from the Medical Birth Registry of Norway.

Notably, the findings reveal that men with IJD had fewer instances of childlessness and a higher average number of children than their matched peers. “In all IJD groups, fewer men were childless compared with the control groups (P<0.001),” the authors reported. These differences were already present before the diagnosis of joint disease, suggesting that underlying disease mechanisms or pre-diagnostic characteristics may influence reproductive behavior.

The study also found that men with IJD tended to become fathers at a younger age than those without joint disease. “Men with IJD were younger than the respective controls when fathering for the first time (P<0.001),” the researchers wrote.

When comparing across diagnostic groups, men with axSpA had slightly higher rates of childlessness than those with PsA (P<0.001), although both groups still showed greater fertility than controls.

These results are especially relevant for dermatologists managing patients with PsA. Concerns about reproductive health may be less warranted in male patients than previously thought. As the authors concluded, “These findings are novel, suggesting a notable difference in fertility patterns between those with and without IJDs.”

The study’s insights emphasize the importance of discussing fertility not only in the context of disease management, but also with an understanding of patients' baseline reproductive trajectories.

Reference
Sigmo GD, Hauge S, Hetland HB, et al. Men with psoriatic arthritis, rheumatoid arthritis and axial spondylarthritis have more children and at an earlier age than matched controls: results from a nationwide cohort. RMD Open. 2025;11(3):e005770. doi:10.1136/rmdopen-2025-005770