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Ibuprofen Safe for ART Patients, Says Study

A new government study claims people who take the anti-inflammatory medication, ibuprofen, should not worry about how it might affect their odds of having a child using assisted reproduction.1

Does Blocking Prostaglandins Affect Fertility?
Physicians with the National Institutes of Health (NIH) and Walter Reed Army Medical Center in Washington, DC, launched this study to answer more questions about the possible effect that ibuprofen use may have on men's fertility or pregnancy success using assisted reproductive techniques (ART), such as in vitro fertilization (IVF).

These questions have been raised because high levels of prostaglandins are found in semen, the fluid in which sperm reside. Prostaglandins are proteins that promote inflammation in the body as part of the immune response.2 As such, medications like ibuprofen that fall in a class of medicines known as non-steroidal anti-inflammatory drugs, or NSAIDs (EN-seds) inhibit the production of prostaglandins in the body.

Previous animal studies have suggested that the use of NSAIDs don't affect sperm counts or their health, according to the authors of this latest research. "To date, however, no evaluation of ART pregnancy outcome based on NSAID usage, like ibuprofen, has been performed," they wrote.

Pregnancy Affected?
To make a more definitive assessment, the investigators evaluated the effect of ibuprofen use among nearly 1,100 male patients who underwent semen analyses in their fertility clinic between 2002 and 2004. Prior to undergoing the analyses, the patients completed a questionnaire about their use of dietary supplements and medications, as well as information about their smoking habits, exercise, occupations, and alcohol consumption.

Each semen analysis consisted of measurements of sperm motility (movement ability) and morphology (appearance), among other things, the investigators reported.

The researchers then evaluated any associations between reported ibuprofen use at all among these patients and the health of their sperm, based on their semen analyses at the clinic. Any differences in sperm health between patients who reported using ibuprofen regularly compared to those who did not were also assessed for the study.

No Changes in Sperm Health
Among the 68 patients who reported taking ibuprofen regularly in a three-month period prior to their semen analyses, there were no differences in the health of their sperm compared to those who reported using the drug either intermittently or not at all, the study found. Sperm count, motility and morphology was all generally the same between these two groups of men.

The study investigators then examined whether any men who had reported regular use of ibuprofen had needed to undergo an assisted reproductive procedure known as intracytoplasmic sperm injection (ICSI) because of low sperm count. This is often advised for men who are infertile. The procedure is a form of micromanipulation. Doctors retrieve a single sperm from the male partner, and inject it directly into the female partner's egg using a glass needle. In cases in which there are low numbers of sperm, or sperm that are not of high quality or dysfunctional, ICSI increases the odds of a successful fertilization.3

However, in this study, the number of men requiring ICSI as an intervention was not much different for those who reported using ibuprofen regularly (27.9 percent) versus those who reported little or no use of the medication (29.1 percent).

"Overall, pregnancy rates were likewise equal between groups (58.9% regular users versus 58.4% non-users)," the investigators reported.

In conclusion, they wrote: "Despite previous studies which show that NSAIDs induce a reduction in seminal prostaglandins, this does not translate to reduced clinical pregnancy rates in ART in regular ibuprofen users."

1. Robinson N, Gustofson RL, Larsen FW. Walter Reed Army Medical Center ART Program. Regular use of ibuprofen does not affect semen analysis parameters, need for ICSI, or ART clinical pregnancy rate. Conjoint Meeting of the American Society for Reproductive Medicine 61st Annual Meeting and the Canadian Fertility and Andrology Society 51st Annual Meeting. 2005 Oct 15-19. Montreal, Quebec, Canada.
2. Warner TD, Mitchell JA. Cyclooxygenases: new forms, new inhibitors, and lessons from the clinic. FASEB J 2004 May;18(7):790-804.
3. American Society for Reproductive Medicine (ASRM). Intracytoplasmic Sperm Injection. Available at:
http://www.asrm.org/Patients/FactSheets/ICSI-Fact.pdf. Accessed November 30, 2005.

John Martin is a long-time health journalist and an editor for CuraScript. His credits include overseeing health news coverage for the website of Fox Television's The Health Network, and articles for the New York Post and other consumer and trade publications.



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