Effects of Chronic Musculoskeletal Pain on Fertility Potential in Lean and Overweight Male Patients.

Fereshteh Dardmeh,Sten Rasmussen,Hiva Alipour,Parisa Gazerani,Hans Ingolf Nielsen

doi:10.1155/2017/4628627

Fereshteh Dardmeh, Sten Rasmussen + Show 3 more

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https://doi.org/10.1155/2017/4628627

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Abstract

Both chronic pain and obesity are known to affect reproductive hormone profiles in male patients. However, the effect of these conditions, alone or in combination, on male fertility potential has received less attention. 20 chronic musculoskeletal pain patients and 20 healthy controls were divided into lean and overweight subgroups according to their BMI. Current level of chronic pain (visual analogue scale) and pressure pain thresholds (PPTs) in 16 predefined sites, classically described and tested as painful points on the lower body, were measured. Levels of reproductive hormone and lipid profiles were assessed by ELISA. Sperm concentration and motility parameters were analyzed using a computer-aided sperm analysis system. Sperm concentration, progressive motility, and percentage of hyperactivated sperm were generally lower in the chronic pain patients in both lean and overweight groups. The overweight control and the lean chronic pain groups demonstrated a significantly lower percentage of progressively motile sperm compared with the lean control group, suggesting that musculoskeletal chronic pain may have a negative influence on sperm quality in lean patients. However, due to the potential great negative influence of obesity on the sperm parameters, it is difficult to propose if musculoskeletal chronic pain also influenced sperm quality in overweight patients. Further research in chronic pain patients is required to test this hypothesis.

Highlights

Male factor infertility accounts for approximately 40% of infertility cases [1, 2]
Overweight and lean chronic pain patients reported their minimum pain intensity levels of 5.15 ± 2.21 and 4.7 ± 1.97 cm and maximum peak pain intensities of 7.78 ± 1.97 and 8.01 ± 1.77 cm on the visual analogue scale (VAS), respectively, which corresponded to their pain within the last 3 months
Pain groups (LP and OP) demonstrated a trend towards lower pain thresholds compared with the control groups (LC and OC) (Table 2)

Summary

Introduction

Male factor infertility accounts for approximately 40% of infertility cases [1, 2]. Assessment of semen quality is the rst step in assessing male factor infertility [3, 4] and depends on several parameters including semen volume, sperm concentration, total count of spermatozoa, motility, vitality, and morphology [5]. Increased BMI has been suggested to negatively a ect spermatogenesis and the molecular structure of germ cells in the testis and sperm maturation in the epididymis [6, 7], resulting in reduced sperm quality and male subfertility [8,9,10,11,12]. Obesity has been reported to increase the conversion of androgens to estradiol, leading to elevated levels of serum estrogen; the increased estradiol in turn impacts the hypothalamus, causing stimulation of GnRH, to release FSH and LH, resulting in reduced testicular function and reduced production of testosterone (both intratesticular and circulating testosterone) [8]. Infertile men have demonstrated a lower testosterone and higher estradiol levels compared with fertile men, which may be due to the gonadotropin suppression by estradiol and can be considered as a common marker for

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