Which drug is known to cause low sperm count in the management of rheumatoid arthritis?

Sulfasalazine is known to cause low sperm count in the management of rheumatoid arthritis. This medication, which is an anti-inflammatory drug used primarily to treat autoimmune diseases like rheumatoid arthritis and inflammatory bowel disease, can affect male fertility.

Studies have indicated that sulfasalazine can lead to reversible male infertility, primarily by causing changes in sperm production and quality. This effect is usually mild and reversible upon discontinuation of the medication, which is an important consideration for healthcare providers when discussing treatment options with male patients who are concerned about fertility.

Other medications listed, such as methotrexate, etanercept, and hydroxychloroquine, have different mechanisms of action and side effect profiles. For example, methotrexate can have a range of side effects but is not specifically associated with low sperm count in the same way. Etanercept and hydroxychloroquine are biological and immunomodulatory therapies that do not typically affect sperm production adversely. Understanding the specific effects of medications like sulfasalazine helps healthcare providers make informed decisions regarding treatment and patient counseling, particularly addressing potential impacts on fertility.