{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:43:34Z","timestamp":1789245814502,"version":"build-2803163510"},"reference-count":40,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T00:00:00Z","timestamp":1693526400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005275","name":"Region Hovedstaden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005275","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013276","name":"Interreg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013276","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016911","name":"ReproUnion","doi-asserted-by":"publisher","award":["NYPS 20201846"],"award-info":[{"award-number":["NYPS 20201846"]}],"id":[{"id":"10.13039\/100016911","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004914","name":"Ferring Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004914","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","fertstert.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Fertility and Sterility"],"published-print":{"date-parts":[[2023,9]]},"DOI":"10.1016\/j.fertnstert.2023.05.005","type":"journal-article","created":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:54:23Z","timestamp":1688172863000},"page":"661-669","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":16,"special_numbering":"P2","title":["Methotrexate use among men\u2014association with fertility and the perinatal health of their children: a Swedish nationwide register study"],"prefix":"10.1016","volume":"120","author":[{"given":"Peter","family":"Zar\u00e9n","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Turesson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Giwercman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.fertnstert.2023.05.005_bib1","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1038\/nrrheum.2010.5","article-title":"Methotrexate--how does it really work?","volume":"6","author":"Chan","year":"2010","journal-title":"Nat Rev Rheumatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1097\/MIB.0000000000001064","article-title":"The influence of methotrexate treatment on male fertility and pregnancy outcome after paternal exposure","volume":"23","author":"Grosen","year":"2017","journal-title":"Inflam Bowel Discharge"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib3","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1002\/bdra.23003","article-title":"Teratogen update: methotrexate","volume":"94","author":"Hyoun","year":"2012","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib4","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1136\/ard.2008.094474","volume":"68","author":"Visser","year":"2009","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib5","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1093\/rheumatology\/ket390","article-title":"No evidence for an increased risk of adverse pregnancy outcome after paternal low-dose methotrexate: an observational cohort study","volume":"53","author":"Weber-Schoendorfer","year":"2014","journal-title":"Rheumatology"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib6","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1097\/AOG.0000000000001936","article-title":"Risk of adverse pregnancy outcome after paternal exposure to methotrexate within 90 days before pregnancy","volume":"129","author":"Eck","year":"2017","journal-title":"Obstet Gynecol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib7","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.reprotox.2017.10.004","article-title":"Birth outcomes after preconception paternal exposure to methotrexate: A nationwide cohort study","volume":"74","author":"Winter","year":"2017","journal-title":"Reprod Toxicol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib8","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1016\/j.jid.2017.03.030","article-title":"Birth outcomes in children fathered by men treated with immunosuppressant drugs before conception\u2014a danish population-based cohort study","volume":"137","author":"Egeberg","year":"2017","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib9","doi-asserted-by":"crossref","first-page":"196","DOI":"10.3109\/03009742.2011.626442","article-title":"Outcomes after anti-rheumatic drug use before and during pregnancy: a cohort study among 150,000 pregnant women and expectant fathers","volume":"41","author":"Viktil","year":"2012","journal-title":"Scand J Rheumatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib10","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1002\/art.38919","article-title":"No excess risks in offspring with paternal preconception exposure to disease-modifying antirheumatic drugs","volume":"67","author":"Wallenius","year":"2015","journal-title":"Arth Rheumatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib11","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/jid.1959.161","article-title":"morphologic and physiologic effects of chemotherapeutic agents in psoriasis","volume":"33","author":"van Scott","year":"1959","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib12","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1111\/j.1365-2230.2005.01925.x","article-title":"Gynaecomastia with oligospermia: an unusual complication of low-dose methotrexate for pustular psoriasis","volume":"31","author":"Pandhi","year":"2006","journal-title":"Clin Exp Dermatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib13","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1001\/archderm.1980.01640260091025","article-title":"Psoriasis, methotrexate, and oligospermia","volume":"116","author":"Sussman","year":"1980","journal-title":"Arch Dermatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib14","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1159\/000251036","article-title":"Studies on human semen in topical corticosteroid-treated and in methotrexate-treated psoriatics","volume":"154","author":"Grunnet","year":"1977","journal-title":"Dermatology"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib15","doi-asserted-by":"crossref","first-page":"1842","DOI":"10.1136\/ard.2009.127423","article-title":"Effects of TNF antagonists on sperm characteristics in patients with spondyloarthritis","volume":"69","author":"Villiger","year":"2010","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib16","doi-asserted-by":"crossref","first-page":"177","DOI":"10.3109\/01485017908985067","article-title":"Methotrexate and fertility in men","volume":"3","author":"El-Beheiry","year":"1979","journal-title":"Arch Androl"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib17","doi-asserted-by":"crossref","first-page":"2064","DOI":"10.1053\/j.gastro.2018.02.025","article-title":"Methotrexate reduces DNA integrity in sperm from men with inflammatory bowel disease","volume":"15","author":"Ley","year":"2018","journal-title":"Gastroenterology"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib18","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.1093\/oxfordjournals.humrep.a135737","article-title":"Intracytoplasmic sperm injection three years after the birth of the first ICSI child","volume":"10","author":"Van Steirteghem","year":"1995","journal-title":"Hum Reprod"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib24","series-title":"Regression modeling strategies: with applications to linear models, logistic and ordinal regression, and survival analysis","first-page":"45","article-title":"Missing Data","author":"Harrell","year":"2015"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib26","series-title":"Regression modeling strategies: with applications to linear models, logistic and ordinal regression, and survival analysis","first-page":"13","article-title":"General Aspects of Fitting Regression Models","author":"Harrell","year":"2015"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib27","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1097\/EDE.0000000000000864","article-title":"Web site and R package for computing E-values","volume":"29","author":"Mathur","year":"2018","journal-title":"Epidemiology"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib28","series-title":"R Core Team. R: A language and environment for statistical computing. Version 4.0.3","year":"2020"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib29","author":"Harrell"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib30","author":"Harrell"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib34","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1080\/02841860802247664","article-title":"The completeness of the Swedish Cancer Register: a sample survey for year 1998","volume":"48","author":"Barlow","year":"2009","journal-title":"Acta Oncol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib35","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1186\/1471-2458-11-450","article-title":"External review and validation of the Swedish national inpatient register","volume":"11","author":"Ludvigsson","year":"2011","journal-title":"BMC Public Health"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib36","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1016\/S0015-0282(03)00366-2","article-title":"Effect of male age on fertility: evidence for the\u00a0decline in male fertility with increasing age","volume":"79","author":"Hassan","year":"2003","journal-title":"Fertil Steril"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib37","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.fertnstert.2016.12.019","article-title":"Is advanced paternal age a health risk for the offspring?","volume":"107","author":"Nybo Andersen","year":"2017","journal-title":"Fertil Steril"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib38","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/andr.12153","article-title":"Sperm chromatin structure assay in prediction of in\u00a0vitro fertilization outcome","volume":"4","author":"Oleszczuk","year":"2016","journal-title":"Andrology"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib39","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/S0140-6736(97)10514-1","article-title":"Relation between semen quality and fertility: a population-based study of 430 first-pregnancy planners","volume":"35","author":"Bonde","year":"1998","journal-title":"Lancet"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib40","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1056\/NEJMoa003005","article-title":"Factor-Litvak P, Brazil CK, Nakajima ST, Coutifaris C, et\u00a0al. sperm morphology, motility, and concentration in fertile and infertile men","volume":"345","author":"Guzick","year":"2001","journal-title":"N Engl J Med"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib41","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1093\/humrep\/14.4.1039","article-title":"Utility of the sperm chromatin structure assay as a diagnostic and prognostic tool in the human fertility clinic","volume":"14","author":"Evenson","year":"1999","journal-title":"Hum Reprod"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib42","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0015-0282(99)00462-8","article-title":"Sperm chromatin damage impairs human fertility","volume":"73","author":"Span\u00f2","year":"2000","journal-title":"Fertil Steril"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib43","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1136\/annrheumdis-2012-202781","article-title":"Association between testosterone levels and risk of future rheumatoid arthritis in men: a population-based case-control study","volume":"73","author":"Pikwer","year":"2014","journal-title":"Ann Rheum Dis"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib44","doi-asserted-by":"crossref","first-page":"2983","DOI":"10.1007\/s10067-016-3330-x","article-title":"Hypogonadism and the risk of rheumatic autoimmune disease","volume":"35","author":"Baillargeon","year":"2016","journal-title":"Clin Rheumatol"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib45","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/S1043-4666(05)80001-8","article-title":"Cytokines and hypothalamic-pituitary function","volume":"5","author":"Jones","year":"1993","journal-title":"Cytokine"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib46","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1111\/j.1365-2605.1987.tb00208.x","article-title":"Fertility after chemotherapy for male and female germ cell tumours","volume":"10","author":"Rustin","year":"1987","journal-title":"Int J Androl"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib47","doi-asserted-by":"crossref","first-page":"280","DOI":"10.2164\/jandrol.108.006437","article-title":"Testicular function in poor-risk nonseminomatous germ cell tumors treated with methotrexate, paclitaxel, ifosfamide, and cisplatin combination chemotherapy","volume":"30","author":"Pectasides","year":"2009","journal-title":"J Androl"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib48","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1002\/art.41191","article-title":"2020 American College of Rheumatology guideline for the management of reproductive health in rheumatic and musculoskeletal diseases","volume":"72","author":"Sammaritano","year":"2020","journal-title":"Arthr Rheumato"},{"key":"10.1016\/j.fertnstert.2023.05.005_bib50","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/j.reprotox.2017.08.013","article-title":"Paternal use of azathioprine\/6-mercaptopurine or methotrexate within 3 months before conception and long-term health outcomes in the offspring-A nationwide cohort study","volume":"73","author":"Friedman","year":"2017","journal-title":"Reprod Toxicol"}],"container-title":["Fertility and Sterility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S001502822300376X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S001502822300376X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T06:18:29Z","timestamp":1762150709000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S001502822300376X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9]]},"references-count":40,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["S001502822300376X"],"URL":"https:\/\/doi.org\/10.1016\/j.fertnstert.2023.05.005","relation":{},"ISSN":["0015-0282"],"issn-type":[{"value":"0015-0282","type":"print"}],"subject":[],"published":{"date-parts":[[2023,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Methotrexate use among men\u2014association with fertility and the perinatal health of their children: a Swedish nationwide register study","name":"articletitle","label":"Article Title"},{"value":"Fertility and Sterility","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.fertnstert.2023.05.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a92023 The Authors. Published by Elsevier Inc. on behalf of the American Society for Reproductive Medicine.","name":"copyright","label":"Copyright"}]}}