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The prevalence of infertility is greater among individuals with AD as compared to healthy individuals without AD.

Infertility is the failure to achieve a clinical pregnancy after 12 months or more of unprotected sexual intercourse. A decline in fertility rates is a significant public health concern. Infertility affects approximately 10–15% of couples across the globe. Despite the standard medical investigation, infertility remains unexplained in 30–40% of cases. Concerning the data from developed countries, female and male infertility account for 40% and 10%, respectively. The most prevalent causes of infertility include endometriosis, tubal abnormalities, pelvic adhesions, ovulatory disorders, sperm count and morphology, hyperprolactinemia, and functional disorders. Atopic dermatitis (AD) is a prevalent inflammatory skin disorder associated with extracutaneous medical conditions, such as infertility.

This nationwide prospective cohort study, published in the journal Dermatology, hypothesized the presence of a common pathophysiological mechanism in infertility and AD. The study aimed to investigate the prevalence of infertility in AD patients. The data for the study was acquired from the Clalit Health Services (CHS) large medical database. A total of 127,150 patients were included in the AD group, whereas 127,071 participants formed the comparison group of this study. Among the AD group participants, 33.5% were adults and 7.1% were diagnosed with moderate-to-severe AD.

The findings of this nationwide prospective cohort study revealed that patients with AD have a significantly higher prevalence of diabetes mellitus, hypertension, hypothyroidism, hyperthyroidism, systemic immunosuppressive medications, and obesity compared to the control group. The study findings also suggested a higher prevalence of infertility in AD patients as compared to the prevalence of infertility in the study participants in the control group. The study found statistical significance between AD and infertility.

Protein defects in the reproductive pathways and the skin of male and female AD patients are associated with the development of infertility. The systemic inflammation present in AD was associated with a higher prevalence of infertility in the study participants with AD as compared to healthy individuals in the control group. In the female participants with AD, possible mechanisms underlying the association between AD and infertility include the infiltration of inflammatory cells into the endometrial lining in the uterus and other inflammatory changes in the uterus.

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This study identified AD as an important risk factor in the development of infertility in males and females with AD. The results of the study also suggest the therapeutic potential of AD management for infertility.

References
Horev, A., Shalom, G., Weintraub, A. Y., Freud, T., & Cohen, A. D. (2022). Atopic Dermatitis and Infertility: A Nationwide Retrospective Cohort Study. Dermatology, 238(2), 313-319. https://doi.org/10.1159/000515600