Hypertension, Medical Conditions Linked to Low Semen Quality

Laurie Barclay, MD

December 11, 2014

Medical comorbidities are linked to poor semen quality, suggesting that current health condition and genetic factors affect sperm production, according to findings of a cross-sectional study published online December 9 in Fertility and Sterility.

"About 15 percent of all couples have fertility issues, and in half of those cases the male partner has semen deficiencies," lead author Michael Eisenberg, MD, assistant professor of urology and director of male reproductive medicine and surgery at Stanford University in California, said in a university news release. "We should be paying more attention to these millions of men. Infertility is a warning: Problems with reproduction may mean problems with overall health."

As previously reported by Medscape Medical News, an earlier study by Dr Eisenberg and colleagues showed that infertile men had higher rates of all-cause and cardiovascular mortality in the years after an infertility evaluation.

"But here, we're already spotting signs of trouble in young men in their 30s," he said.

The goal of the present study was to examine the association between semen quality and current health status in a cohort of 9387 men, mean age 38 years, who underwent an infertility workup between 1994 and 2011.

Within the cohort, 44% had at least one medical diagnosis unrelated to infertility. Using the Charlson comorbidity index, the investigators showed that men with a higher index had lower semen volume, concentration, motility, total sperm count, and morphology scores.

The number of different ways in which a man's semen was deficient was statistically significantly correlated with the likelihood of having a substantial health problem. Rates of semen abnormalities were significantly higher among men with endocrine, circulatory, genitourinary, and skin diseases than in men without these conditions.

Hypertension, peripheral vascular and cerebrovascular disease, and nonischemic heart disease were all associated with higher rates of semen abnormalities.

"To the best of my knowledge, there's never been a study showing this association before," Dr Eisenberg said in the news release. "There are a lot of men who have hypertension, so understanding that correlation is of huge interest to us."

About 15% of all human genes are directly involved in reproduction, and most of these genes also play important roles in other bodily systems. Identifying other specific factors affecting male sperm production may allow better patient counseling.

For example, treatment of hypertension and heart disease, which are linked to poor semen quality, should be explored as an attempt to improve male fertility. In addition, it may be fruitful to study whether certain treatments for cardiovascular disease may themselves impair semen production.

"A man's health is strongly correlated with his semen quality," Dr Eisenberg concluded in the release. "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 American Society of Reproductive Medicine supported this study in part. The authors have disclosed no relevant financial relationships.

Fertil Steril. Published online December 9, 2014. Abstract


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