Infertile men may have a higher risk of developing other health
problems such as diabetes, heart disease and substance abuse disorders,
compared with fertile men, a new study suggests.
Window into later health
"We found that infertile men developed several chronic diseases such as
diabetes in the years following an infertility evaluation," said lead
researcher Dr Michael Eisenberg, director of male reproductive medicine and
surgery at Stanford University Medical School, in Palo Alto, California.
"What's interesting is that these are young, healthy
men," he said. "Prior studies suggested a higher risk of testicular cancer or even death. But for the first time,
we are seeing higher risk of these metabolic diseases."
These findings suggest that infertility may provide a window into
later health, Eisenberg added.
Read: What is diabetes?
For the study, Eisenberg and colleagues collected data on more
than 100,000 men from an insurance claims database between 2001 and 2009. Their
average age was 33.
The researchers zeroed in on general health conditions of three
groups of males: men diagnosed with infertility, men who didn't receive an
infertility diagnosis and men who had had a vasectomy,
who were presumed to be fertile.
No direct cause-and-effect relationship
The researchers found that infertile men had a 48 percent higher
rate of heart disease and about 30 percent higher odds of diabetes, even after compensating for obesity and smoking.
They also had higher rates of alcohol and drug abuse, the researchers said.
Moreover, those with the most severe form of infertility had the
highest risk of kidney disease and alcohol abuse, Eisenberg said.
The study doesn't establish a direct cause-and-effect relationship
between infertility and chronic diseases, however.
Read: Symptoms of diabetes
But, the researchers speculated that hormonal and/or environmental
factors may be involved.
Lower levels of testosterone in infertile men may be linked to
higher rates of death and heart disease, they suggested.
Also, exposure to harmful environmental influences during foetal
development might lead to both reproductive and general health problems later
in life, Eisenberg said. Perhaps some of the same exposures that are related to
heart disease later in life also reduce sperm count, he said.
"Thus, when a couple presents for infertility, there may be
an opportunity to make a positive impact on a man's health through an
evaluation of his fertility," Eisenberg said.
A warning sign
Dr Christine Mullin, director of in vitro fertilisation at the
Centre for Human Reproduction at North Shore-LIJ Health System in Manhasset,
New York, said it does appear that men faced with infertility also face the potential
for other health problems.
Read: Causes of diabetes
"The question really is which comes first, the heart disease
or diabetes, or the infertility?" said Mullin, who wasn't involved with
Infertility affects approximately 15 percent of couples, and male
infertility is the cause in about half of all cases, Mullin said.
"Many men are seeing an infertility specialist as their first
doctor in their adult lives," she said. "It is important that these
doctors understand that the semen analysis is not only a screening tool to
diagnose male infertility but also a means to uncover other health-related
Infertility can be a warning sign of overall poor health in men,
"and as reproductive specialists we need to act as first responders in
helping men to achieve optimal health", Mullin said.
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