Male Infertility and Future Cardiometabolic Health: Does the Association Vary by Sociodemographic Factors?

Abstract

ObjectiveTo determine whether the association between male infertility and incident cardiometabolic disease is modified by socioeconomics, race, or geographic region. Materials and MethodRetrospective review of data from insurance claims from Optum's de-identified Clinformatics Data Mart Database. Subjects were men, 18-50 years old, with an associated diagnosis of infertility in the United States between 2003 and 2016. Analytical sample were men captured by the Optum's de-identified Clinformatics Data Mart Database with an associated diagnosis of infertility. Men were classified as either infertile, or not, based on diagnosis or procedural codes. Cardiometabolic health outcomes were then assessed using current procedural terminology codes for diabetes, hypertension, hyperlipidemia, and heart disease. Confounding factors were controlled for such as race, education, socioecomonic status, and region. The main outcomes were development of diabetes, hypertension, hyperlipidemia, and heart disease. ResultsA total of 76,343 males were diagnosed with male factor infertility, 60,072 males who underwent fertility testing, and 183,742 males that underwent vasectomy (control population). For all men, infertile men had a higher risk of incident hypertension, diabetes, hyperlipidemia, and heart disease when compared to those undergoing vasectomy. Identical associations were found across all education, income, racial, and geographic strata. ConclusionOur study suggests that men with infertility have a higher risk of cardiometabolic disease in the years following a fertility evaluation regardless of race, region, or socioeconomic status.