MP21-14 CAUSAL FACTORS REPRESENT THE PATHOPHYSIOLOGICAL CONNECTION BETWEEN MALE FACTOR INFERTILITY AND GENERAL HEALTH STATUS: INFERENCE FROM REAL LIFE DATA

Abstract

You have accessJournal of UrologyInfertility: Epidemiology & Evaluation I (MP21)1 Sep 2021MP21-14 CAUSAL FACTORS REPRESENT THE PATHOPHYSIOLOGICAL CONNECTION BETWEEN MALE FACTOR INFERTILITY AND GENERAL HEALTH STATUS: INFERENCE FROM REAL LIFE DATA Eugenio Ventimiglia, Luca Boeri, Paolo Capogrosso, Edorado Pozzi, Belladelli Federico, Giuseppe Fallara, Luigi Candela, Nicolò Schifano, Costantino Abbate, Corsini Christian, Colagrande Gianmarco, Francesco Montorsi, and Salonia Andrea Eugenio VentimigliaEugenio Ventimiglia More articles by this author , Luca BoeriLuca Boeri More articles by this author , Paolo CapogrossoPaolo Capogrosso More articles by this author , Edorado PozziEdorado Pozzi More articles by this author , Belladelli FedericoBelladelli Federico More articles by this author , Giuseppe FallaraGiuseppe Fallara More articles by this author , Luigi CandelaLuigi Candela More articles by this author , Nicolò SchifanoNicolò Schifano More articles by this author , Costantino AbbateCostantino Abbate More articles by this author , Corsini ChristianCorsini Christian More articles by this author , Colagrande GianmarcoColagrande Gianmarco More articles by this author , Francesco MontorsiFrancesco Montorsi More articles by this author , and Salonia AndreaSalonia Andrea More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002006.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with male factor infertility (MFI) have an increased risk of developing comorbid diseases during their lifetime compared to the general population, although a biological explanation for this observation is still lacking. We hypothesize that the underlying causal factors represent an appraisal of both MFI and systemic status, determining both MFI severity and general health status impairment. METHODS: We collected complete clinical and demographic data of 1768 primary infertile men. Comorbidities were categorized with the Charlson Comorbidity index (CCI). Six different causal categories for MFI (genetic abnormalities, cryptorchidism, obstructive causes, hypogonadism, varicocele, and other causes) were established. Odds ratios (ORs) and 95%CIs for the association between causal categories and presence of comorbidities (CCI>0) have been estimated, adjusting for possible confounding variables (age; educational status). Similarly, we tested the association between causal factors and total motile sperm count (TMSC) <5, as a proxy of MFI severity (Hamilton et al, 2015). RESULTS: Median (IQR) age of the study cohort was 37 (33, 41) years. Of all, comorbidities (CCI>0) were found in 117 (7%) patients. The most commonly identified cause for MFI was hypogonadism (any type) (655, 37%), whereas 367 (21%) men had idiopathic MFI. Men with comorbidities were older (age: 40 (36, 45) vs. 37 (34, 40) in the and more frequently azoospermic (35% vs. 24%) compared to men with CCI=0. Causes with a potential systemic action, such as genetic abnormalities and hypogonadism, were more prevalent in men with comorbidities vs. those without comorbidities (7% vs. 5% for genetic factors, and 47% vs. 36% for hypogonadism), whereas local ones were more frequent in healthy men (e.g. varicocele, 28% vs. 13%). Genetic causes and hypogonadism were causal factor showing the strongest association with both presence of comorbidities (OR 3.16 [95% CIs: 1.27, 7.91] and OR 2.38 [1.29, 4.40], respectively) and MFI severity (OR 5.6 [2.10-14.94] and OR 3.32 [2.29-4.81], respectively). Men with varicocele had the most favourable profile in terms of both comorbidities (OR 0.63 [0.34-1.38]) and MFI (OR 1.18 [0.83-1.70]). CONCLUSIONS: Specific causes of MFI, especially systemic ones, are associated with decreased general health status as well as impaired sperm production. In this context, patients with genetic abnormalities and hypogonadism should be more carefully followed-up due to their very high risk of developing comorbid diseases. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e351-e351 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eugenio Ventimiglia More articles by this author Luca Boeri More articles by this author Paolo Capogrosso More articles by this author Edorado Pozzi More articles by this author Belladelli Federico More articles by this author Giuseppe Fallara More articles by this author Luigi Candela More articles by this author Nicolò Schifano More articles by this author Costantino Abbate More articles by this author Corsini Christian More articles by this author Colagrande Gianmarco More articles by this author Francesco Montorsi More articles by this author Salonia Andrea More articles by this author Expand All Advertisement Loading ...