Guest guest Posted February 27, 2004 Report Share Posted February 27, 2004 We just found out today by ultrasound that our baby died, I am 11 weeks pregnant. My doctor told us that there is a chance that Urso and/or Cholestyramine could have changed his ph balance causing a decline in healthy sperm. Has anyone heard that before. Our GI doctor indicated both drugs were safe. My doctor did not say this is what actually caused the baby to die. She was just thinking out loud. Any thoughts? , wife of Mark PSC 2003 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 27, 2004 Report Share Posted February 27, 2004 Hi and Mark, I am so sorry to hear about the loss of your baby. Please accept my condolences. My heart goes out to you both. I have not read anything to indicate that Ursodiol or cholestyramine influence sperm. In my reading on PSC and UC I have only found one medication that adversely affects sperm fertility, and that is Sulfasalazine (Sulphasalazine), which used to be employed for treating inflammatory bowel disease. This drug has now largely been replaced by mesalazine (or mesalamine) (Asacol) [or other slow- release 5-aminosalicyclic acid compounds]. Asacol does not have the same adverse effect on sperm fertility as the older drug sulfasalazine. _________________ Gut 22: 445-451 (1981) Sulphasalazine and male infertility: reversibility and possible mechanism. Toovey S, Hudson E, Hendry WF, Levi AJ Earlier observations on infertility related to sulphasalazine treatment were extended and semen samples obtained from 28 patients with inflammatory bowel disease on treatment with sulphasalazine at 2- 4 g per day. Semen was examined for changes in density, motility, and morphology before, during, and after withdrawal of sulphasalazine. Gross semen abnormalities were seen in 18 patients on this drug for more than two months. Semen quality improved after sulphasalazine had been withdrawn for more than two months and 10 pregnancies are reported after sulphasalazine withdrawal. Preliminary endocrine and acetylator phenotype studies do not elucidate the mechanism of this important new side-effect of this drug. The time course of the drug's effect on semen quality is consistent with the hypothesis that sulphasalazine or a metabolite, possibly sulphapyridine, is directly toxic to developing spermatozoa. These studies confirmed the preliminary report and suggest that prolonged treatment with sulphasalazine may universally depress semen quality and cause reversible infertility. PMID: 6114897 _________________ Birth defects can be caused by thalidomide, which has seen a resurgence in use in recent years for the treatment of Crohn's disease: _________________ Ann. Med. 33: 516-525 (2001) Thalidomide treatment for refractory Crohn's disease: a review of the history, pharmacological mechanisms and clinical literature. Ginsburg PM, Dassopoulos T, Ehrenpreis ED Department of Gastroenterology, University of Chicago Hospitals, IL 60637, USA. Several recent case reports and clinical trials have demonstrated that thalidomide is emerging as an efficacious alternative in the treatment of selected patients with refractory Crohn's disease. The effects of thalidomide are at least partly mediated by down- regulation of tumour necrosis factor (TNF)-alpha, a potent proinflammatory cytokine. However, thalidomide is also known to inhibit angiogenesis, and it has several other well-described immunomodulatory properties. Clinical studies have confirmed that previously refractory Crohn's disease patients respond to thalidomide, and many enter clinical remission. Efficacy usually occurs within 4 weeks. Thalidomide also has steroid-sparing properties, and it is particularly useful in treating oral and fistulous complications of Crohn's disease. Although it is usually tolerable, careful monitoring is recommended to prevent toxicities, such as birth defects and peripheral neuropathy. This review provides a detailed summary of the literature to date on the use of thalidomide treatment for Crohn's disease. Special attention is directed towards its history, mechanisms, and proposed role. The recent development of thalidomide analogues is also discussed briefly. Publication Types: Review Review, Tutorial PMID: 11730158 ___________________ If your husband has not been taking thalidomide or Sulfasalazine (Sulphasalazine) I cannot offer a logical explanation for your loss. Again please accept my deepest sympathies, Best regards, Dave http://home.insightbb.com/~rhodesdavid/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 28, 2004 Report Share Posted February 28, 2004 Thank you Dave. I appreciate all the info and condolences as well. Re: fertility question Hi and Mark, I am so sorry to hear about the loss of your baby. Please accept my condolences. My heart goes out to you both. I have not read anything to indicate that Ursodiol or cholestyramine influence sperm. In my reading on PSC and UC I have only found one medication that adversely affects sperm fertility, and that is Sulfasalazine (Sulphasalazine), which used to be employed for treating inflammatory bowel disease. This drug has now largely been replaced by mesalazine (or mesalamine) (Asacol) [or other slow- release 5-aminosalicyclic acid compounds]. Asacol does not have the same adverse effect on sperm fertility as the older drug sulfasalazine. _________________ Gut 22: 445-451 (1981) Sulphasalazine and male infertility: reversibility and possible mechanism. Toovey S, Hudson E, Hendry WF, Levi AJ Earlier observations on infertility related to sulphasalazine treatment were extended and semen samples obtained from 28 patients with inflammatory bowel disease on treatment with sulphasalazine at 2- 4 g per day. Semen was examined for changes in density, motility, and morphology before, during, and after withdrawal of sulphasalazine. Gross semen abnormalities were seen in 18 patients on this drug for more than two months. Semen quality improved after sulphasalazine had been withdrawn for more than two months and 10 pregnancies are reported after sulphasalazine withdrawal. Preliminary endocrine and acetylator phenotype studies do not elucidate the mechanism of this important new side-effect of this drug. The time course of the drug's effect on semen quality is consistent with the hypothesis that sulphasalazine or a metabolite, possibly sulphapyridine, is directly toxic to developing spermatozoa. These studies confirmed the preliminary report and suggest that prolonged treatment with sulphasalazine may universally depress semen quality and cause reversible infertility. PMID: 6114897 _________________ Birth defects can be caused by thalidomide, which has seen a resurgence in use in recent years for the treatment of Crohn's disease: _________________ Ann. Med. 33: 516-525 (2001) Thalidomide treatment for refractory Crohn's disease: a review of the history, pharmacological mechanisms and clinical literature. Ginsburg PM, Dassopoulos T, Ehrenpreis ED Department of Gastroenterology, University of Chicago Hospitals, IL 60637, USA. Several recent case reports and clinical trials have demonstrated that thalidomide is emerging as an efficacious alternative in the treatment of selected patients with refractory Crohn's disease. The effects of thalidomide are at least partly mediated by down- regulation of tumour necrosis factor (TNF)-alpha, a potent proinflammatory cytokine. However, thalidomide is also known to inhibit angiogenesis, and it has several other well-described immunomodulatory properties. Clinical studies have confirmed that previously refractory Crohn's disease patients respond to thalidomide, and many enter clinical remission. Efficacy usually occurs within 4 weeks. Thalidomide also has steroid-sparing properties, and it is particularly useful in treating oral and fistulous complications of Crohn's disease. Although it is usually tolerable, careful monitoring is recommended to prevent toxicities, such as birth defects and peripheral neuropathy. This review provides a detailed summary of the literature to date on the use of thalidomide treatment for Crohn's disease. Special attention is directed towards its history, mechanisms, and proposed role. The recent development of thalidomide analogues is also discussed briefly. Publication Types: Review Review, Tutorial PMID: 11730158 ___________________ If your husband has not been taking thalidomide or Sulfasalazine (Sulphasalazine) I cannot offer a logical explanation for your loss. Again please accept my deepest sympathies, Best regards, Dave http://home.insightbb.com/~rhodesdavid/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted March 2, 2004 Report Share Posted March 2, 2004 , I am so sorry that your baby died. In regards to Urso and Asacol (for UC), my husband's doctor has stated that the medications are safe when it comes to having a baby. In our case, I have been trying to get pregnant for almost a year now without any success. However, I read one article on the internet no to long ago that stated that Asacol may decreased fertility in men's sperm. I can not recall the name of the article, but I found it on "google" searching under "Asacol and fertility". I have not found anything else for Urso and fertility. Again, sorry for your the loss of your baby. Vivian, Miami, FL Husband has UC (2000) and PSC (2003) RE: fertility question We just found out today by ultrasound that our baby died, I am 11 weeks pregnant. My doctor told us that there is a chance that Urso and/or Cholestyramine could have changed his ph balance causing a decline in healthy sperm. Has anyone heard that before. Our GI doctor indicated both drugs were safe. My doctor did not say this is what actually caused the baby to die. She was just thinking out loud. Any thoughts? , wife of Mark PSC 2003 Quote Link to comment Share on other sites More sharing options...
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