Which agent has the potential to disrupt spermogenesis?

• A. TNF inhibitors
• B. Methotrexate
• C. Sulfasalazine
• D. Hydroxychloroquine

Answer: (A)

Disruption of sperm production is a known adverse effect of certain systemic therapies used in dermatology. Sulfasalazine is the classic agent that can cause reversible oligospermia and reduced sperm count due to its sulfapyridine component interfering with spermatogenesis. This effect typically reverses after stopping the drug. In contrast, TNF inhibitors are biologics that generally do not impair sperm production; hydroxychloroquine has no known impact on fertility; methotrexate can have gonadal toxicity in some settings but is not as consistently linked to disrupted spermatogenesis as sulfasalazine. Therefore, sulfasalazine best fits the pattern of producing reversible impairment of sperm production.