The association between hidradenitis suppurativa and male and female infertility: A population-based study

Background: Endocrine and metabolic associations have been recently reported in patients with hidradenitis suppurativa (HS); however, fertility was only rarely investigated in women and not at all in men. Objective: To evaluate the association of HS with male and female infertility. Methods: A cross-sectional, matched controlled, population-based study was designed. The association between HS and male and female infertility was evaluated in patients with HS (n = 4191) and age- and gender-matched controls (n = 20 941), while utilising the Clalit Health Services databases, the largest community-based health maintenance organisation in Israel. Results: Hidradenitis suppurativa was associated with infertility in males and females over all reproductive-age groups, especially among individuals aged 36–45 years (OR 4.50, 95%CI 2.55–7.93, P < 0.001), and in female patients (OR 3.10, 95%CI 2.57–3.74, P < 0.001). After adjustment for demographic and clinical factors, the association remained significant only in females (OR 1.26 95%CI 1.04–1.55, P < 0.05). Conclusion: Patients with HS are at increased risk of infertility, particularly females and patients in the 36- to 45-year age group. Physicians should take the additional physiological and psychological burden of infertility among HS patients into account, primarily among female patients at procreative age.