Systemic lupus erythematosus and male reproductive health: A systematic review and meta-analysis

Objective: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect various organs. Male SLE patients often face reproductive health challenges, but research on male sexual and reproductive health in SLE remains limited. This systematic review and meta-analysis aimed to explore the effects of SLE and its related factors on male sexual function and reproductive health. Methods: The PubMed, Cochrane library, Embase, Web of Science, Wanfang Data, and China National Knowledge Infrastructure (CNKI) databases were examined from January 2000 to December 2024. Data extraction and quality assessment were performed by two reviewers. Meta-analysis was carried out using Review Manager 5.3 software, and the risk of bias was assessed using the AHRQ checklist. The following outcomes were evaluated: sexual function, reproductive hormones and fertility. Results: In the literature search, 5002 articles were identified, of which 9 studies met the inclusion criteria. Meta analysis showed a significantly higher incidence of erectile dysfunction (ED) in SLE patients (OR = 7.44; 95 % CI = 5.00 to 11.06, p < 0.001). SLE patients also had higher levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) compared to controls (FSH: MD = 4.02; 95 % CI = 1.47 to 6.57; p = 0.002; LH: MD = 2.21; 95 % CI = 1.10 to 3.32; p < 0.001). Semen analysis showed a significant decrease in sperm count in SLE patients (MD =-0.54; 95 % CI =-0.86 to-0.22; p < 0.001). Conclusions: Male SLE patients are more likely to have problems with sexual function, reproductive hormones and sperm quality. These findings emphasize the need for increased clinical awareness and interventions focused on male sexual and reproductive health in SLE patients.