Association of the serum metabolomic profile by nuclear magnetic resonance spectroscopy with sperm parameters: a cross-sectional study of 325 men

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To determine whether 155 circulating metabolic measures relevant to lifestyle and metabolic health are associated with sperm parameters, as measured by concentration, motility, and total motile sperm count (TMSC). Cross sectional. University hospital. Three hundred twenty-five men prospectively recruited between April 1, 2017 and March 31,2019. Detailed demographic, lifestyle, fertility, medical history, and semen analysis with quantification of nonfasting serum lipids, lipoprotein subclasses, and low-molecular weight metabolites (including amino acids, glycolysis, and inflammatory markers) by nuclear magnetic resonance (NMR) spectroscopy. Association of serum metabolic profiles with sperm parameters. The age of the participants was mean 37.2 years, with a median sperm concentration of 35 million/mL and median motility of 53%. Of these men, 76% had a TMSC >15 million, 10% had 5-15 million, and 14% had <5 million. In both univariate and confounder adjusted analyses, an extensive range of lipids and lipoproteins, glycolysis-related metabolites, amino acids, ketone bodies, creatinine, or albumin showed no strong statistically significant association with sperm concentration, motility, or the odds of having a reduced or low TMSC. Higher levels of glycolysis metabolites and ketone bodies were associated with an increased odds of TMSC <15 million compared with ≥15 million (odds ratios of ∼1.2-1.3), and several lipids/lipoprotein concentrations appeared to protect against very low TMSC (<5 million compared with ≥5 million) with odds ratios of ∼0.8 or greater. Several metabolites exhibited potentially clinically relevant strength of association with the odds of a low TMSC and warrant replication.