Eugenio Ventimiglia1, Paolo Capogrosso1, Luca Boeri2, Alessandro Serino2, Michele Colicchia2, Silvia Ippolito1, Roberta Scano2, Enrico Papaleo3, Rocco Damiano4, Francesco Montorsi1, Andrea Salonia5. 1. Division of Experimental Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy; Università Vita-Salute San Raffaele, Milan, Italy. 2. Division of Experimental Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy. 3. Infertility Unit, Unit of Obstetrics/Gynecology, IRCCS Ospedale San Raffaele, Milan, Italy. 4. Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy. 5. Division of Experimental Oncology/Unit of Urology; URI, IRCCS Ospedale San Raffaele, Milan, Italy; Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy. Electronic address: salonia.andrea@hsr.it.
Abstract
OBJECTIVE: To evaluate the prevalence, and clinical and seminal impact of comorbidities in white European men presenting for couple infertility. DESIGN: Cross-sectional study. SETTING: Academic reproductive medicine outpatient clinic. PATIENT(S): Cohort of 2,100 consecutive infertile men (noninterracial infertile couples). INTERVENTION(S): Obtaining complete demographic, clinical, and laboratory data from 2,100 consecutive infertile men with health-significant comorbidities scored via the Charlson comorbidity index (CCI; categorized 0 vs. 1 vs. ≥2) and semen analysis values assessed based on 2010 World Health Organization reference criteria. MAIN OUTCOME MEASURE(S): Assessment of the rate of comorbidities by means of CCI scores and possible associations between CCI, semen and hormonal parameters. RESULT(S): Descriptive statistics and regression models tested the associations among semen parameters, clinical characteristics, and CCI. When assessing general comorbidity prevalence, CCI 0, CCI 1, and CCI ≥2 was found in 1,921 (91.5%), 102 (4.9%), and 77 (3.6%) patients, respectively. Patient age and follicle-stimulating hormone levels increased as the general health status decreased. Conversely, the total testosterone levels and sperm concentration decreased as CCI scores increased. A higher rate of oligozoospermia and nonobstructive azoospermia was observed in patients with CCI ≥1. No differences were observed among the considered comorbidity groups in terms of testicular volume or further hormonal or seminal parameters. Both continuously coded and categorized sperm concentrations were independent predictors of CCI ≥1. Patients with sperm concentration <45.6 million/mL (most informative cutoff value) had a 2.74-fold increased risk of having a CCI ≥1. CONCLUSION(S): Decreased general health status appears to be associated with impaired male reproductive health, including lower sperm concentration, lower total testosterone levels, and higher follicle-stimulating hormone values.
OBJECTIVE: To evaluate the prevalence, and clinical and seminal impact of comorbidities in white European men presenting for couple infertility. DESIGN: Cross-sectional study. SETTING: Academic reproductive medicine outpatient clinic. PATIENT(S): Cohort of 2,100 consecutive infertile men (noninterracial infertile couples). INTERVENTION(S): Obtaining complete demographic, clinical, and laboratory data from 2,100 consecutive infertile men with health-significant comorbidities scored via the Charlson comorbidity index (CCI; categorized 0 vs. 1 vs. ≥2) and semen analysis values assessed based on 2010 World Health Organization reference criteria. MAIN OUTCOME MEASURE(S): Assessment of the rate of comorbidities by means of CCI scores and possible associations between CCI, semen and hormonal parameters. RESULT(S): Descriptive statistics and regression models tested the associations among semen parameters, clinical characteristics, and CCI. When assessing general comorbidity prevalence, CCI 0, CCI 1, and CCI ≥2 was found in 1,921 (91.5%), 102 (4.9%), and 77 (3.6%) patients, respectively. Patient age and follicle-stimulating hormone levels increased as the general health status decreased. Conversely, the total testosterone levels and sperm concentration decreased as CCI scores increased. A higher rate of oligozoospermia and nonobstructive azoospermia was observed in patients with CCI ≥1. No differences were observed among the considered comorbidity groups in terms of testicular volume or further hormonal or seminal parameters. Both continuously coded and categorized sperm concentrations were independent predictors of CCI ≥1. Patients with sperm concentration <45.6 million/mL (most informative cutoff value) had a 2.74-fold increased risk of having a CCI ≥1. CONCLUSION(S): Decreased general health status appears to be associated with impaired male reproductive health, including lower sperm concentration, lower total testosterone levels, and higher follicle-stimulating hormone values.
Authors: Haotian Wu; Alexandra M Huffman; Brian W Whitcomb; Srinihaari Josyula; Suzanne Labrie; Ellen Tougias; Tayyab Rahil; Cynthia K Sites; Jonathan Richard Pilsner Journal: Reprod Biomed Online Date: 2018-11-16 Impact factor: 3.828
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