Reproductive & Maternal Health Resource Center

Reproductive & Maternal Health Resource Center

Disclosures: The authors report no relevant financial disclosures.
October 28, 2020
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Male infertility linked to higher mortality risk

Disclosures: The authors report no relevant financial disclosures.
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Infertile men, especially those who were azoospermic, were at an increased risk for mortality compared with fertile men, according to an analysis of United States claims data published in Urology.

“There have been several studies suggesting an association between male infertility and later health problems,” Michael L. Eisenberg, MD, director of male reproductive medicine and surgery at the Stanford University School of Medicine, told Healio Primary Care. “We wanted to examine this further and help understand more about the association.”

itle: A higher risk for mortality exists among infertile vs. fertile men, even when excluding: First Bar = HR = 1.56 Variable A = CVD Second Bar = HR = 1.32 Variable B = Prevalent cancers Third Bar = HR = 1.59  Variable C = Other chronic diseases
Reference: Del Guidice F, et al. Urology. 2020;doi:10.1016/j.urology.2020.07.087.

The researchers reviewed claims data from 134,796 infertile men (oligozoospermic men, 18,826; azoospermic men, 12,630) and 242,282 fertile men. The mean age of all men in the study was 35 years. Both cohorts had similar smoking and obesity rates.

Michael L. Eisenberg

Eisenberg and colleagues reported that 76 men (0.40%) with oligospermia and 88 men (0.70%) with azoospermia died during the 3.1 years of follow-up (P = .0001). There were also 615 (0.25%) fertile men who died during 3.6 years of follow-up (P < . 0001). The men with azoospermia had a significantly increased risk for death (HR = 2.01; 95% CI, 1.6-2.53) vs. the men with oligospermia (HR = 1.17; 95% CI, 0.92-1.49). In addition, the cohort of infertile men had a higher risk for death (HR = 1.42; 95% CI, 1.27-1.6) than the cohort of fertile men.

The researchers said that a higher risk for death among infertile men also existed when CVD (HR =1.56; 95% CI, 1.17-2.07), prevalent cancers (HR = 1.32; 95% CI, 0.92-1.89) and other chronic diseases such as COPD, depression, infectious diseases, liver diseases and renal disease (HR = 1.59; 95% CI, 1.33-1.91) were excluded. This suggests that baseline health alone does not explain why infertile men are at increased risk for mortality, according to the researchers.

“It is possible that genetics, epigenetic, lifestyle or developmental factors may explain the association,” Eisenberg said.

The findings, he added, offer physicians “an opportunity to engage infertile men more broadly about health.”

“Since we do not know the etiology, there is no need to be alarmist,” he said. “But we can certainly explain that health is important both for longevity but also reproduction.”