Semen Quality and Reproductive Function As Markers of General Male Health: A Prospective Cohort Study on 5177 Men

Presentation Number: OR15-5
Date of Presentation: March 18, 2018, 2018

Alberto Ferlin, MD,PHD, Andrea Garolla, MD, PhD, Marco Ghezzi, MD, Riccardo Selice, MD, Pierfrancesco Palego, MD, Nicola Caretta, MD, Antonella Di Mambro, MD, Umberto Valente, MD, Savina Dipresa, MD, Leonardo Sartori, MD, Mario Plebani, MD, Carlo Foresta, MD.
Univ of Padova, Padova, Italy.


Background Evidence suggested that infertile men are at increased risk for hypogonadism, metabolic derangements and osteoporosis, have higher long-term morbidity and mortality than controls, but data are scarce and not conclusive. Here we tested whether semen quality and reproductive function could represent a marker of general male health. Methods This prospective cohort study included 5177 males of infertile couples. All subjects had semen analysis, reproductive hormones, testis ultrasound and biochemical determinations for glucose and lipid metabolism. Hypogonadism was defined as testosterone < 10·5 nmol/L and/or LH > 9·4 IU/L. Subjects with total sperm count (TSC) <10 million had genetic testing (karyotype, Y chromosome microdeletions, CFTR gene mutations) and those with hypogonadism dual-energy x-ray absorptiometry for bone mineral density (BMD). Results Men with low sperm count (<39 million/ejaculate) have a 12-fold increased risk of having hypogonadism (OR 12·2, 95% CI 10·2-14·6) and the risk was highest in men with TSC <10 million, genetic causes, history of cryptorchidism and idiopathic forms. Men with low sperm count had higher BMI, waist circumference, systolic pressure, LDL-cholesterol, triglycerides, and HOMA-index, and lower HDL-cholesterol, and higher prevalence of metabolic syndrome (OR 1·246, 95 CI 1·005-1·545). All data were worse in men with low testosterone and milder, but significant, in men with isolated elevated LH. Low TSC per sé was associated with poor metabolic parameter. Men with hypogonadism had lower BMD and 51% prevalence of osteoporosis/osteopenia. Conclusion This large study suggests that low sperm count is associated with poorer metabolic, cardiovascular and bone health. Hypogonadism is mainly involved in this association, but low sperm count in itself is a marker of general health. Infertile patients have the great opportunity to benefit from the identification of accurate diagnostic and prognostic markers, and clinically important comorbidities and risk factors.


 A. Ferlin: None. A. Garolla: None. M. Ghezzi: None. R. Selice: None. P. Palego: None. N. Caretta: None. A. Di Mambro: None. U. Valente: None. S. Dipresa: None. L. Sartori: None. M. Plebani: None. C. Foresta: None.