The Grapevine

Low Sperm Count Could Mean Poor Health, Not Just Indicate Infertility

In the largest ever study of sperm quality, reproductive function and metabolic risk, experts suggest that men with low sperm counts are likely to have numerous co-existing health problems. The new research was presented Sunday, March 18, at ENDO 2018: The Endocrine Society's 100th Annual Meeting and Expo in Chicago.

"Our study clearly shows that low sperm count by itself is associated with metabolic alterations, cardiovascular risk, and low bone mass," said the lead author of the study, Alberto Ferlin, associate professor of endocrinology at the University of Brescia, Italy. He previously worked at the University of Padova, Italy, where he originally conducted the study in collaboration with Professor Carlo Foresta.

As a part of the study, 5,177 male partners from infertile couples in Italy were examined through laboratory tests and sperm analyses. The comprehensive health evaluation took place at the fertility clinic of the university, including measurements of their reproductive hormones and metabolic parameters.

Low sperm count was defined as less than 39 million per ejaculate, which is the value used in the U.S. By this definition, around half the men in the study had low sperm counts.

Findings revealed that the participants who fell below this threshold were 1.2 times more likely to have a higher BMI, higher systolic blood pressure, and abnormal cholesterol. The analysis also found a higher frequency of metabolic syndrome and a measure of insulin resistance, associated with an increased risk of serious illnesses such as heart disease, stroke, and diabetes.

Many studies in the past have suggested overweight men are at greater risk of infertility. Genetic factors, inadequate sleep, sexually transmitted infections and alcohol or drug abuse may also constitute potential causes of poor sperm quality.

Researchers also noted that infertile men were 12 times more likely to have hypogonadism, a condition that leads to low testosterone levels. Bone density scans showed that half of those with low testosterone had either osteoporosis (which causes the weakening of bones) or low bone mass.

"Infertile men are likely to have important co-existing health problems or risk factors that can impair quality of life and shorten their lives," said Dr. Ferlin, who is also president of the Italian Society of Andrology and Sexual Medicine. "Fertility evaluation gives men the unique opportunity for health assessment and disease prevention."

In other words, the study should not be interpreted to mean that a low sperm count is the cause of metabolic problems, but rather that sperm quality can be an indicator of the general male health. The treatment of male fertility, Dr. Ferlin explained, should not simply focus on having children when diagnostic tests detect other health problems.

"Men of couples having difficulties achieving pregnancy should be correctly diagnosed, and followed up by their fertility specialists and primary care doctor because they could have an increased chance of morbidity and mortality," he added.