Methotrexate use in men attempting to father a child

(Date: June 2020. Version: 3)

This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.

What is it?

Methotrexate (Maxtrex®, Metoject®) is used to treat a number of auto-immune illnesses such as Crohn’s disease, rheumatoid arthritis and psoriasis, and in the treatment of certain types of cancer.

Should methotrexate be used by male partner while a couple is attempting to conceive?

Because of the way that methotrexate works, there are theoretical concerns that it could damage sperm, and potentially affect the development of a baby conceived while the father is using it.

The babies of around 360 men who were using methotrexate around the time of conception have been studied and while there is currently no suggestion of any links with miscarriage, stillbirth, birth defects, low infant birth weight, or preterm birth, ongoing research is required to confirm that there are no ill effects.

As a precaution, the manufacturers of methotrexate usually advise that couples where the male partner takes methotrexate use contraception and wait at least three months after stopping treatment before attempting to conceive. This is because it takes approximately three months for a sperm to form.

In practice, because there is no clear evidence of ill effects, if a couple is planning a pregnancy and the man’s medical condition is well-controlled with methotrexate, a specialist will be able help them weigh up the potential risks and benefits of continuing the medication so that informed decisions can be made about treatment. Do not make any change to your medication without first talking to your doctor.

Will the baby need extra monitoring during pregnancy?

Most women will be offered a scan at around 20 weeks of pregnancy to look for birth defects as part of their routine antenatal care. No additional monitoring of pregnancies conceived while the father was using methotrexate are required.

Who can I talk to if I have questions?

If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from

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General information 

Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks.  They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.

Medicines use in pregnancy

Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby.  There are, however, some medicines that can harm a baby’s normal development.  How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.

If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.

When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.   

Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.

Disclaimer: This information is not intended to replace the individual care and advice of your health care provider. New information is continually becoming available. Whilst every effort will be made to ensure that this information is accurate and up to date at the time of publication, we cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes following decisions made on the basis of this information. We strongly advise that printouts should NOT be kept for any length of time, or for “future reference” as they can rapidly become out of date.

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