Effect of medical comorbidities over seminal parameters and sperm DNA fragmentation

Abstract

Several publications have been shown that it could be a relationship between male infertility and general health status. The aims of this study were to investigate the prevalence and effect of some medical comorbidities over sperm parameters and DNA fragmentation in an Argentinian population. Retrospective controlled cohort study. Under the approval of the institutional ethics committee, a retrospective study was performed for 1,092 men who were examined due to infertility between August 2017 and April 2019. The initial evaluations were comprised of a complete medical history, a physical examination, endocrine assessment, and at least two semen analyses. Sperm parameters and DNA fragmentation were compared between men with and without medical comorbidities. Significant medical comorbidities were found in 112 of 1092 (10.3%) men, including 3.6% with hypertension, 2,3% with hypothyroidism, 2% with mental, 2% with diabetes/dyslipemia and 0.6% with respiratory disease. Semen volume, sperm count and progressive motility were significantly lower in men with comorbidities that in men without comorbidities (p=0.045, p=0.036 and p=0.025, respectively). Regarding sperm DNA fragmentation, it was higher in patients with comorbidities (p=0.018). Sperm vitality and strict morphology were not significantly different. Within patients with comorbidities, patients with diabetes/dyslipemia and anxiety disorders presented significantly higher levels of DNA fragmentation (p=0.001). After this preliminary study, we can conclude that medical comorbidities are associated with the impairment of sperm production and function. It has been published that obesity and metabolic disorders could be associated with impair sperm function by altering physical and molecular structure of germ cells. A complete male infertility evaluation, including an exhaustive anamnesis, could offer the possibility of specific therapy in order to improve some semen parameters. We didn’t assess this theoretical benefit, however it would be very interesting to evaluate if that therapy, despite the improvement of the general health status, could improve the spermatogenesis.