POOR SPERM QUALITY LINKED TO HYPERTENSION , OTHER HEALTH PROBLEMS
A study of men who were
evaluated for the cause of their infertility finds previously unknown
relationships between deficiencies in their semen and other, seemingly
unrelated health problems.
A study of more than
9,000 men with fertility problems has revealed a correlation between the number
of different defects in a man's semen and the likelihood that the man has other
health problems.
The study, conducted
by investigators at the Stanford University School of Medicine, also links poor
semen quality to a higher chance of having various specific health conditions,
such as hypertension, and more generally to skin and endocrine disorders.
The findings,
published online Dec. 10 in Fertility and Sterility, may spur
more-comprehensive approaches to treating male infertility. They also point to
the wisdom of performing complete physical examinations of men experiencing
reproductive difficulties.
"About 15 percent
of all couples have fertility issues, and in half of those cases the male
partner has semen deficiencies," said the study's lead author, Michael
Eisenberg, MD, assistant professor of urology and director of male reproductive
medicine and surgery at Stanford. "We should be paying more attention to
these millions of men. Infertility is a warning: Problems with reproduction may
mean problems with overall health."
A study Eisenberg
co-authored a few years ago showed that infertile men had higher rates of
overall mortality, as well as mortality linked to heart problems, in the years
following an infertility evaluation. "But here, we're already spotting
signs of trouble in young men in their 30s," he said.
Analyzing medical
records
In the new study,
Eisenberg and his colleagues analyzed the medical records of 9,387 men, mostly
between 30 and 50 years old, who had been evaluated at Stanford Hospital &
Clinics (now Stanford Health Care) between 1994 and 2011 to determine the cause
of their infertility. The men had routinely provided semen samples, which the
researchers assessed for characteristics including volume, concentration and
motility. In about half of all the male infertility cases, the problem was
abnormal semen; in the rest, the fault lay elsewhere. So, using the database,
the investigators were able to compare the overall health status of men who had
semen defects to that of the men who didn't.
With a median age of
38, this was a fairly young group of men. However, 44 percent of all the men
had some additional health problem besides the fertility problem that brought
them to the clinic. In particular, the investigators found a substantial link
between poor semen quality and specific diseases of the circulatory system,
notably hypertension, vascular disease and heart disease. "To the best of
my knowledge, there's never been a study showing this association before,"
said Eisenberg. "There are a lot of men who have hypertension, so
understanding that correlation is of huge interest to us."
In addition, as the
number of different kinds of defects in a man's semen rose, so did his
likelihood of having a skin disease or endocrine disorder. When looking at the
severity of all health problems, the scientists observed a statistically
significant connection between the number of different ways in which a man's
semen was deficient and the likelihood of his having a substantial health
problem.
Health, semen quality
'strongly correlated'
The study wasn't
designed to determine precisely how connections between semen deficiencies and
seemingly unrelated disorders, such as cardiovascular or endocrine disease,
come about. But, Eisenberg noted, some 15 percent of all genes in the human
genome are connected fairly directly to reproduction, and most of these genes also
have diverse functions in other bodily systems. He also noted that it may not
be a disease itself, but the treatment for the disease, that's actually
responsible for reproductive malfunction. He said he is exploring this
possibility now.
As we treat men's
infertility, we should also assess their overall health.
"A man's health
is strongly correlated with his semen quality," he said. "Given the
high incidence of infertility, we need to take a broader view. As we treat
men's infertility, we should also assess their overall health. That visit to a
fertility clinic represents a big opportunity to improve their treatment for
other conditions, which we now suspect could actually help resolve the
infertility they came in for in the first place."
The senior author of
the study is Mark Cullen, MD, professor of medicine at Stanford. Other Stanford
co-authors are professor of reproductive endocrinology and fertility Barry
Behr, PhD; former professor of obstetrics and gynecology Renee Reijo Pera, PhD;
and statistical programmer Shufeng Li.
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