By Jasminee Sahoye
Researchers at Stanford University School of Medicine believe they have found a way to better treat male infertility following a recent study published online in Fertility and Sterility.
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 he has other health problems.
The study by investigators at 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, according to the researchers, could lead to more-comprehensive approaches to treating male infertility and point to the wisdom of performing complete physical examinations of men experiencing reproductive difficulties.
“About 15% of all couples have fertility issues and in half of those cases the male partner has semen deficiencies,” said the lead author, Dr. Michael Eisenberg, 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.
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 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 problem was elsewhere.
With the database, 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. Yet, 44% of all the men had some additional health problem besides the fertility problem that brought them to the clinic.
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.
While the study had a specific focus, Eisenberg noted, some 15% 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 explained 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.
“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.”