Does psoriasis influence fertility?

Studies have shown that a state of systemic inflammation can disrupt male fertility. The TNF-α, involved in the pathogenesis of psoriasis, is also produced by germ cells and plays a role in the regulation of spermatogenesis. According to recent research, it has been found that levels of TNF-α in seminal plasma are generally low under physiological conditions. However, these levels tend to increase in the presence of inflammation or infection, which is associated with an impairment of the functional and genomic integrity of spermatozoa.

Furthermore, an inflammatory state would cause hypogonadism, characterised by an insufficient synthesis of sexual hormones. It has also been observed that several pro-inflammatory cytokines, such as TNF-α, IL-6 and IL-1, play a crucial role in suppressing reproductive activity during an immune response, primarily by inhibiting the hypothalamic-pituitary-gonadal axis which is responsible for regulating ovarian activity. However, there are few studies that demonstrate the link between this pathology and fertility.

A clinical study evaluated the serum of sex hormones in men suffering from psoriasis. This study allowed the observation of lower levels of testosterone and higher levels of estradiol in the psoriatic group than in the control subjects. Several studies suggest that pro-inflammatory cytokines stimulate the activity of aromatase, an enzyme responsible for the conversion of androgens into oestrogens.

The conclusion drawn in this study suggests that untreated psoriasis may harm male fertility, potentially due to the impact of systemic inflammation on the hormonal profile and inflammation of the sexual glands. However, further study is required to confirm these findings. Another clinical study analysed 14 female patients with psoriasis and 35 healthy controls. They were able to demonstrate that the number of antral follicles (AFC), which form the oocytes, was significantly lower in the patients than in the healthy subjects, potentially impacting their fertility.

In summary, although there are indications that the fertility of women and men with psoriasis could be affected, the research published to date is very limited and does not allow us to assert that there is a real link between this disease and fertility. Further studies need to be conducted to provide new data and either confirm or refute the previous results.