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Minor sperm abnormalities in young male post-pubertal patients with juvenile dermatomyositis
A J P Moraes1, R M R Pereira, M Cocuzza
1Unidade de Reumatologia Pediátrica, Departamento de Pediatria, Universidade de São Paulo, São Paulo, SP, Brasil.
Abstract:
The objective of the present study was to identify sperm abnormalities in young male patients with juvenile dermatomyositis (JDM). In 2005, 18 male JDM patients, diagnosed according to the criteria of Bohan and Peter, were followed at the Pediatric Rheumatology Unit and Rheumatology Division, of our Institution. Of the 18 males, 11 were pre-pubertal and 7 were post-pubertal. Two of 7 post-pubertal JDM male patients were excluded: one for orchidopexy for cryptorchidism and the other for testicular ectopia in the left testis. The remaining 5 post-pubertal JDM patients were prospectively evaluated on the basis of two semen analyses, according to the World Health Organization (WHO), urologic evaluation, testicular Doppler ultrasound hormone profile. The data of the JDM patients were compared with those of 5 age-matched healthy controls. The median age 18, was similar in JDM patients and controls. All JDM patients had teratozoospermia (abnormal sperm morphology), as did 4 (80%) of the controls. One of JDM patients had previous oligoasthenoteratozoospermia treated with intravenous cyclophosphamide with normalization of the number and concentration of the sperm after 5 years. All sperm parameters (sperm concentration, total sperm count and total motile sperm count by WHO, and sperm morphology by Kruger strict criteria), testicular volumes by Prader orchidometer and ultrasound, and hormones were similar in JDM patients compared with controls. The frequency of anti-sperm antibodies was similar in both groups. All JDM patients had minor sperm abnormalities in the head, midpiece, and/or tail of spermatozoids. Serial semen analyses in larger study populations are necessary to identify the extent and duration of sperm abnormalities in male patients with idiopathic inflammatory myopathies.
Insights
Young males with juvenile dermatomyositis (JDM) showed minor sperm abnormalities, particularly teratozoospermia. However, overall sperm parameters and hormone profiles were similar to healthy controls, suggesting JDM may not severely impact male fertility.
Area of Science:
- Pediatric Rheumatology
- Reproductive Urology
- Spermatozoa Morphology
Background:
- Juvenile dermatomyositis (JDM) is an idiopathic inflammatory myopathy affecting children.
- Potential impacts of JDM on male reproductive health, specifically sperm parameters, are not well-established.
- Understanding these impacts is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate and identify sperm abnormalities in young male patients diagnosed with juvenile dermatomyositis (JDM).
- To compare semen analysis, testicular function, and hormone profiles of JDM patients with age-matched healthy controls.
Main Methods:
- Prospective evaluation of 5 post-pubertal male JDM patients using World Health Organization (WHO) criteria for semen analysis.
- Inclusion of urologic evaluation, testicular Doppler ultrasound, and hormone profiling.
- Comparison with 5 age-matched healthy controls.
Main Results:
- All JDM patients exhibited teratozoospermia (abnormal sperm morphology); 80% of controls also showed this.
- Sperm concentration, total sperm count, total motile sperm count, testicular volumes, and hormone levels were similar between JDM patients and controls.
- Minor sperm abnormalities (head, midpiece, and/or tail) were observed in all JDM patients.
Conclusions:
- Male JDM patients frequently present with minor sperm abnormalities, predominantly teratozoospermia.
- Despite these abnormalities, key sperm parameters, testicular volumes, and hormone profiles are comparable to healthy controls.
- Further serial semen analyses in larger cohorts are warranted to fully elucidate the extent and duration of these sperm abnormalities in idiopathic inflammatory myopathies.
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