Study Finds Nearly Half Of Men With Fertility Challenges Have Additional Health Issues

Source: Fertility & Sterility – December 9, 2014

Researchers from the Stanford University School of Medicine recently found men with fertility challenges are also likely to have at least one other medical condition unrelated to infertility.

In the study, researchers evaluated the fertility potential of 9,387 men using the Stanford Reproductive Endocrinology and Infertility semen database. They found 44% of the men were diagnosed with one condition at least 1 year prior to seeking care for infertility, while another 30% of men had two or more conditions diagnosed 1 year prior to seeking care.

The most common conditions these men had were conditions related to the cardiovascular, skin, endocrine, urinary, and reproductive systems. While the researchers concluded these conditions were connected to a secondary infertility diagnosis, they noted they were planning to investigate how these conditions contributed to an infertility diagnosis.

Editor’s Note: Dr. Cozzolino is a male infertility specialist with Brandywine Urology Consultants.

It’s well known that infertility in men is sometimes a sign of stress. When your body is under stress, it doesn’t want to reproduce. If you examine infertility cases involving men and women, there is a male factor involved about 50% of the time. Stress from other conditions such as diabetes and obesity can impact sperm production. We also find when men are going through work-up, we discover they have these other medical issues. You can definitely find other health issues when you’re working up somebody for infertility.

As a general rule, I tell my patients that if someone is unhealthy, their sperm count is going to be unhealthy as well. A man’s sperm count can be a gauge of his overall health. If he has untreated high cholesterol or diabetes, then his sperm count will tend to be low. We also ask our patients to make lifestyle changes to aid sperm production. For example, we tell them to stop smoking and limit alcohol use. Prolonged heat can be detrimental to sperm production, so we also ask them to avoid hot tubs, saunas or jacuzzis.

The most common reasons we see for male infertility at our center are varicoceles, which is a fixable anatomical issue. The semen analysis for these patients usually tells us their sperm count, motility, and morphology are low. These patients also tend to have a low testosterone level because varicoceles can affect testosterone production in the testicles. We have to be careful when treating men with low testosterone, as putting these men on testosterone supplement can shut down sperm production.

We usually use medications like clomid to boost up these patients’ natural testosterone, and that can help to stimulate sperm production. With any treatment for improving a man’s fertility, it can take about 3 months for the process of sperm production to go from an immature to mature sperm.

A low sperm count can also be a genetic issue, such as a Y chromosome deletion—someone missing a piece of their Y chromosome—or Kleinfelter Syndrome, where a man has an extra chromosome as well as a Cystic Fibrosis mutation which can lead to obstruction or absence of the vas deferens.

If we suspect a genetic issue, we will consult with RADfertility’s Genetic Counselor, Stephanie Hill. Those genetic issues come into play with intra-cytoplasmic sperm injection (ICSI) and IVF. If you use sperm for IVF from someone who has a genetic issue, then that could result in a baby who either has that genetic issue or is a carrier.

When partnering with RADfertility, I look at both the man and the woman when treating male factor infertility. If time is a concern due to advanced maternal age, we may encourage some men to go through IVF first, and then come back to improve their general health by treating a low sperm count or low testosterone levels.