A longer duration of infertility was associated with lower sperm count and other parameters of impaired sperm, according to a study recently published in BJU International. The study also shows that older age and higher body mass index were associated with a longer duration of infertility.
Researchers led by Andrea Salonia of the Division of Experimental Oncology/Unit of Urology, URI‐Urological Research Institute, IRCCS Ospedale San Raffaele, University Vita‐Salute San Raffaele in Milan, Italy, point out that approximately 15% of couples of reproductive age fail to achieve a wanted pregnancy within a 12-month period, despite regular unprotected sexual intercourse. Prolonged infertility has been considered a psychosocial stress for the infertile couple that may lead to poor marital adjustment and decreased quality of life, but the potential role of the duration of infertility in terms of couple’s reproductive health remains understudied.
The researchers analyzed data from 1644 infertile men. “Patients were grouped according to the self‐reported [duration of infertility (DI)] into 12‐month time frames,” the authors write. “Semen analysis values were assessed based on 2010 World Health Organization reference criteria. Descriptive statistics tested the difference in clinical, hormonal and seminal parameters between groups. Logistic regression models assessed the impact of DI on semen parameters.”
The group found that a DI of <12, 13–24, 25–36, 37–48, 49–60 and >60 months was found in 207 (12.6%), 651 (39.6%), 387 (23.5%), 168 (10.2%), 92 (5.6%) and 139 (8.4%) men, respectively. Patients’ age (P < 0.001) and body mass index (P < 0.001) significantly increased along with DI. Hormonal values were similar across the groups. The authors write: “Sperm concentration significantly decreased with DI (P = 0.01). Similarly, a higher rate of non‐obstructive azoospermia (NOA) was more frequently found in men with a longer DI (P = 0.03). There were no differences in semen volume, sperm progressive motility, total motile sperm count (TMSC), and normal morphology across groups. Multivariable logistic regression analysis showed that DI was significantly associated with the risk of oligozoospermia (P < 0.001), TMSC <5 × 106 (P < 0.001), and [non-obstructive azoospermia (NOA)] (P < 0.001).”
Based on these results, the authors conclude: “This cross‐sectional study showed that DI had a negative impact on semen parameters in primary infertile men. Sperm concentration was negatively associated with DI and patients with a longer DI reported higher rates of azoospermia. Furthermore, DI was significantly associated with a higher risk of oligozoospermia, low [total motile sperm count], and NOA.”
”Our results suggest that duration of infertility should be considered a potential risk factor for impaired sperm parameters in infertile men. Also, infertile couples should be made aware of the associations found in this study,“ says lead author Luca Boeri, of IRCCS San Raffaele Hospital and University Vita-Salute San Raffaele.