Is Male Infertility A Health Hazard?
I’ve heard that infertile men are at higher than normal risk of heart disease, diabetes and other diseases. Can you tell me if this is true and, if so, why?
Andrew Weil, M.D. | June 14, 2016
A 2015 investigation from the Stanford University School of Medicine did report that infertile men have a higher risk of diabetes and heart disease. They also had increased incidence of other medical problems including alcohol and drug abuse that are apparently unrelated to their reproductive health.
To determine what health problems developed before and after the men were tested for fertility problems researchers reviewed the medical records of more than 115,000 reproductive-age men filed between 2001 and 2009 in an insurance claims database. They then compared the health problems in men who had been diagnosed with infertility to men with no diagnosed fertility problems and to men who had had vasectomies.
The results of the analysis showed that infertile men had higher rates of heart disease and diabetes, even when results were adjusted for obesity, smoking and other risk factors. They also found that men with the most severe form of male infertility had the highest risks of kidney disease and alcohol abuse. The infertile men identified in the study were surprisingly young – their average age was in the 30s.
The researchers did not determine why infertile men should be at higher risk of health problems, but in a press release accompanying publication of the study lead author Michael L. Eisenberg, M.D., director of male reproductive medicine and surgery at Stanford, noted that infertile men have lower levels of circulating testosterone, which previously has been linked to higher rates of cardiovascular disease and death.
Dr. Eisenburg also suggested that exposure to harmful environmental influences during fetal development could lead to both lower sperm counts and heart disease later in life. In fact, a study published in January 2016 from an international team of researchers including Dr. Eisenberg concluded that declining fertility rates in Europe, Japan and the United States appear to be due to a developmental disorder known as testicular dysgenesis syndrome (TDS). While TDS can result from genetic mutations, the 2016 study found that today it most often stems from adverse environmental exposures during fetal life.
Earlier, semen abnormalities were linked with a risk of death that is higher than that of men with normal semen. A 2014 study from Stanford found that while no single semen abnormality predicted death, men with two or more abnormalities had more than twice the risk of death of men with no abnormalities over the eight years following their first fertility examination. The more abnormalities, the higher the risk of death, researchers reported.
The latest Stanford findings suggest that whatever is causing male reproductive difficulties is negatively influencing men’s health in a broader way. That should encourage men diagnosed with infertility to be checked for other health problems.
Andrew Weil, M.D.
Michael L. Eisenberg et al. “Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data.” Fertility and Sterility, December 2015 DOI:10.1016/j.fertnstert.2015.11.011
Michael L. Eisenberg et al, “Male Reproductive Disorders and Fertility Trends: Influences of Environment and genetic Susceptibility.” Physiological Reviews, January 2016 doi: 10.1152/physrev.00017.2015