Login to Access Video or Poster Abstract: MP35-04
Sources of Funding: none

Introduction

A close relationship has been shown between male infertility and general health status. The aims of this study were to investigate the prevalence and effect of medical comorbidities on spermatogenesis in Japanese men and to determine whether the treatment of medical comorbidities is effective for improving semen parameters.

Methods

Under the approval of the institutional ethics committee, a retrospective chart review was performed for 5,337 men with a mean age of 35 years who were consecutively examined due to male infertility between April 2007 and September 2016. The initial evaluations were comprised of a history, a physical examination, at least two semen analyses, and endocrinology examinations in the morning. Further blood tests were ordered when surgery was indicated. Hormonal and spermatogenic parameters were compared between men with and without medical comorbidities. For men who were diagnosed with medical comorbidities during the infertility evaluation, the semen parameters were compared between those who did and did not undergo treatment of the comorbidities.

Results

Significant medical comorbidities were found in 525 of 5,337 (9.8%) men, including 1.9% with mental (e.g., depression), 1.8% with circulatory (e.g., hypertension), 1.7% with skin (e.g., atopic dermatitis), 1.3% with kidney, 1.2% with respiratory diseases, 1.2% with diabetes, 1.0% with hyperuric acid and 0.9% with dyslipidemia. Fifty-three men (1%) exhibited a Charlson comorbidity index of more than 1 point. Testicular size (p<0.05), semen volume (p<0.01), sperm concentration and motility (p<0.001) and serum testosterone were significantly lower, and FSH was significantly higher (p<0.01) in men with comorbidities than in men without comorbidities. Of the 115 (2.2%) men who were diagnosed with comorbidities during the infertility evaluation (mainly hypertension, diabetes, hyperuric acid, and dyslipidemia) and underwent no specific infertility treatment (e.g., varicocelectomy, hormonal therapy), significant improvements in sperm concentration and motility were observed after six months of follow-up in men who underwent immediate treatment for the medical comorbidities (n=73) compared to men who did not receive treatment (n=42) (p<0.05).

Conclusions

Medical comorbidities are associated with the impairment of sperm production. Male infertility evaluation offers not only specific corrective therapy to improve semen parameters but also therapy for non-specific medical comorbidities, which may be beneficial for restoring general health status and spermatogenesis.

Funding

none