Does Methotrexate affect sperm?

[WildflowerPetals]

Myself and my husband have been TTC baby #2 for 18 months now, in that time I had a MC in April ‘25 but no pregnancies since. We’re currently in the process of being referred to the infertility clinic.

My husband has recently found out he’s got Psoriatic Arthritis and has been prescribed Methotrexate (15mg once a week). I’ve read various articles/studies/forums about the effects of this on sperm but can’t seem to find a clear answer. His consultant has said it’s fine and won’t affect his sperm but I have a distrust for consultants/doctors and since he’s a rheumatologist and not an andrologist I don’t 100% trust what he’s saying.

Does anyone have experience with this please and can tell me whether or not this drug affected yours/your partners sperm?

Yes, it can do. It affects reproductive cells and causes miscarriage in women by preventing/impeding cell replication. Ask them to move him onto a biological if they won’t do it immediately then at his review tell them he’s getting horrific bouts of oral blisters and they should swap it over after they see his given it a try. I’m on cilia and been in full remission for 10 years. Just a single injection every 14 days. Life changing stuff. And it is a anti t f blocker so doesn’t affect sperm/reproduction that I know of

This would be enough for me to say no, I want to do out as I’m trying to get pregnant. Transient effects are still transient effects

https://scholar.google.co.uk/scholar?hl=en&as_sdt=0%2C5&q=methotrexate+spermatogenesis&oq=methotrexate+sper#d=gs_qabs&t=1776065680653&u=%23p%3DgcmgS3PDrxcJ

@GreenGodivaThanks for your reply and for linking those studies! Do the biologicals come in tablet form? My husband is needle-phobic so if it’s an injection every 2 weeks he’d have a pretty hard time with it.

Hello, I’m on the biologics for psoriasis/psoriatic arthritis and was worried about injecting. You can’t see the needle in any of the pens I’ve used, you just press it on your skin and feel a momentary sharp sensation. I don’t actually have a needle phobia so understand it may be more tricky but these drugs are life changing and I’d encourage him to consider trying.

@PinkTonicAh, that’s interesting! I’ll mention it to him, thank you 😊

It is an injection. I get phobias etc but honestly the biologics are life changing. They pretty much stopped my disease in its tracks and prevented any more joint damage right there and then. I went from being bed bound for 3-4 hours every morning and then barely hobbling about to fully mobile within a week and ever since.

you can get single use pens instead of syringes and it’s really as simple as grab a bit of skin, press the the pen to it and hold the bottom down for 5-10 seconds. It’s pretty much painless with practice.

i did try sulfazalasine but it turned my tears and saliva yellow and started staining my teeth so i gave that up very quickly.

Yes, it can do. It affects reproductive cells and causes miscarriage in women by preventing/impeding cell replication.

OP is asking about men not women where the teratogenic risks are clear.

there is no impact in male fertility.

covered in BSR guidelines & backed by a huge evidence base:

I’m not a doctor or scientist but was on methotrexate for a long time and now on biologics. My understanding is that it works as it reduces the duplication of cells, hence the use in cancer treatment and the advice for women not to use in pregnancy.

I had a pregnancy with psoriatic arthritis and it’s a bit of a minefield from a female point of view (no one tells you to avoid ibroprofen for example) and I have no idea from a male perspective. However, I would hugely recommend doing some research and hopefully someone with knowledge of male fertility comes on here to respond. There are loads of arthritis charities and research organisations that you can approach and I would definitely do so.

Good luck!