iFAME

To improve care for men with arthritis who wish to conceive, a specialized outpatient clinic was established at the Department of Rheumatology.
The goal of the iFAME project is to determine the effects of immune-mediated diseases and immunosuppressive drug exposure on various aspects of male sexual health, including sexual function, fertility, and reproduction.
We are pleased to announce that the first phase of our study has been successfully completed, setting the foundations for future research. With our current and upcoming research projects, we aim to deepen our understanding of the mechanisms responsible for these effects. This knowledge will enable us to develop better treatment strategies and offer improved care to our patients.

Men with immune-mediated diseases and a wish to become fathers represent an important yet neglected population. The question of how they should be treated to improve, or at least not impair, their chances of achieving a successful pregnancy and a healthy offspring remains a challenge for physicians and researchers worldwide.
We published the results of an extensive systematic review on this topic, concluding that rheumatic diseases and male sexual health should no longer be considered unrelated conditions. Our findings provide valuable insights into this complex interplay.

To enhance our current knowledge and comprehensively evaluate male sexual health, our project consists of several studies focusing on the following outcomes of interest:
1. Immunosuppressive Drug Exposure and Male Reproductive Toxicology
Evaluating the effects of various immunosuppressive drugs on male reproductive health and fertility.
2. Sexual Health in Men Diagnosed with Inflammatory Arthritis other Immune-mediated Inflammatory Diseases
Assessing sexual function and overall sexual health in men suffering from inflammatory arthritis and other immune-mediated inflammatory diseases.
3. Fertility in Men Diagnosed with Inflammatory Arthritis and other Immune-mediated Inflammatory Diseases
Investigating fertility parameters and reproductive success rates in men with inflammatory arthritis and other immune-mediated inflammatory diseases.
4. Pregnancy Outcomes of Partners of Men Diagnosed with Inflammatory Arthritis
Analyzing the pregnancy outcomes and health of offspring born to partners of men with inflammatory arthritis and other immune-mediated inflammatory diseases.

We are currently working on the next phase of this project, aiming to answer new questions that are crucial for patients and healthcare professionals. This ongoing research is essential to developing more effective treatment strategies and improving the quality of life for men with immune-mediated diseases wishing to conceive.

Paternal inflammatory arthritis is associated with a higher risk of miscarriage: results of a large multicentre study (iFAME-Fertility).
Perez-Garcia LF, Röder E, Smeele HTW, et al.
Rheumatology (Oxford). 2022 Aug 3;61(8):3390-3395. doi: 10.1093/rheumatology/keab910. PMID: 34875039; PMCID: PMC9348772

Impaired fertility in men diagnosed with inflammatory arthritis: results of a large multicentre study (iFAME-Fertility)
Perez-Garcia LF, Röder E, Goekoop RJ, et al.
Ann Rheum Dis. 2021 Dec;80(12):1545-1552. doi: 10.1136/annrheumdis-2021-220709. Epub 2021 Aug 9. PMID: 34373257; PMCID: PMC8600610.

It is not just about sex: viewpoints of men with inflammatory arthritis on the overall impact of the disease on their sexual health
Perez-Garcia LF, Röder E, Pastoor H, Bolt JM, van Exel J, Dolhain RJEM.
RMD Open. 2021 Sep;7(3):e001821. doi: 10.1136/rmdopen-2021-001821. PMID: 34580174; PMCID: PMC8477326.

The effect of paternal exposure to immunosuppressive drugs on sexual function, reproductive hormones, fertility, pregnancy and offspring outcomes: a systematic review.
Perez-Garcia LF, Dolhain RJEM, Vorstenbosch S, et al.
Hum Reprod Update. 2020 Nov 1;26(6):961-1001. doi: 10.1093/humupd/dmaa022. PMID: 32743663; PMCID: PMC7600290.

Sexual function and reproduction can be impaired in men with rheumatic diseases: A systematic review.
Perez-Garcia LF, Te Winkel B, Carrizales JP, et al.
Semin Arthritis Rheum. 2020 Jun;50(3):557-573. doi: 10.1016/j.semarthrit.2020.02.002. Epub 2020 Feb 14. PMID: 32165034.

Male Sexual Health and Reproduction in Cutaneous Immune-Mediated Diseases: A Systematic Review.
Perez-Garcia LF, Dolhain R, Te Winkel B, et al.
Sex Med Rev. 2021 Jul;9(3):423-433. doi: 10.1016/j.sxmr.2020.07.004. Epub 2020 Sep 1. PMID: 32883623.

Is methotrexate safe for men with an immune-mediated inflammatory disease and an active desire to become a father? Results of a prospective cohort study (iFAME-MTX).
Perez-Garcia LF, Röder E, Krijthe BP, et al. Is
Ann Rheum Dis. 2023 Aug;82(8):1068-1075. doi: 10.1136/ard-2023-224032. Epub 2023 Jun 1. PMID: 37263756; PMCID: PMC10359513.

 

Contact us: ifame@erasmusmc.nl

Prof. Radboud Dolhain, MD PhD
Laura Kranenburg van Koppen, MD Msc
Luis Perez, MD, PhD
Esther Röder, MD PhD
Lydia Witte - Quaack, MD
Tania Vargas Aguirre
Hetty Wintjes
Anneke van Steensel - Boon
Els Berenschot