Low sperm count may signal health risk
Men with low total sperm count (TSC) have more issues to worry about other than fertility, according to an Italian study presented at ENDO 2018 in Chicago, Illinois, US, which identified an association between low TSC and poor metabolic, cardiovascular, and bone health.
A cohort of 5,177 men underwent testis ultrasound, analyses of semen and reproductive hormones, and biochemical determinations for glucose and lipid metabolism. Participants with TSC of <10 million underwent genetic testing while those with hypogonadism had dual-energy X-ray absorptiometry for BMD. [ENDO 2018, abstract OR15-5]
Compared with men with normal sperm count, those with low TSC (<39 million/ejaculate) had a high risk of having hypogonadism (odds ratio [OR], 12.2, 95 percent confidence interval [CI], 10.2–14.6), which is defined as a testosterone level of <10.5 nmol/L and/or luteinizing hormone level of >9.4 IU/L. The risk was highest among those with a TSC of <10 million or a history of cryptorchidism or undescended testicles.
Low TSC was also associated with low bone mineral density (BMD), with a 51 percent prevalence of osteoporosis/osteopenia among men with low TSC.
Compared with men with normal sperm count, those with TSC had higher body mass index, waist circumference, systolic blood pressure (BP), low-density lipoprotein-cholesterol, and triglycerides, as well as lower high-density lipoprotein-cholesterol.
“[These findings] clearly show that low sperm count by itself is associated with metabolic alterations, cardiovascular risk, and low bone mass,” said lead investigator Dr Alberto Ferlin from the University of Brescia in Brescia, Italy, but he believed that hypogonadism may be the main driver behind this association.
Hypogonadal men had a higher prevalence of metabolic syndrome and other metabolic risk factors (OR, 1.25, 95 percent CI, 1.005–1.545), which could translate to an elevated risk of developing diabetes, heart disease, and stroke.
Although the findings demonstrated an association between low TSC and markers of poor cardiometabolic health, Ferlin underscored that they did not find evidence reflecting low TSC as a cause of metabolic derangements. “[Our findings suggest that] sperm quality is a mirror of general male health.”
Therefore, male infertility treatment should not only target the achievement of pregnancy, Ferlin highlighted, especially when diagnostic results reveal other health risks.
“Infertile men are likely to have important coexisting health problems or risk factors that can impair quality of life and shorten their lives,” said Ferlin. Fertility evaluation may identify diagnostic and prognostic markers, as well as clinically important comorbidities and risk factors, thus giving men an opportunity for health assessment and disease prevention, he added.