(198) THE ASSOCIATION BETWEEN SPERM QUALITY AND UROLOGICAL AND MEDICAL COMORBIDITIES
Authors: Fendereski K , Horns J , Dehghanbanadaki H , Schardein J , Jimbo M , Gross K , Pastuszak A , Hotaling J 
Published: December 2024

Abstract

Introduction
Recent evidence suggests that sperm quality can serve as a potential marker for overall health, as various genetic and environmental factors can impact both a man's reproductive and somatic health. Previous findings indicate that poor semen quality may be associated with higher mortality from chronic conditions, decreased lifespan, and increased risks of cardiovascular disease, metabolic syndrome, and autoimmune conditions.

Objective
Our objective was to evaluate the association between sperm quality and urological and medical comorbidities in a large cohort of men with oligospermia and azoospermia.

Methods
We used TriNetX, a large, multicenter database to create a cohort of men &gt;18 y.o who underwent semen analysis and determined their comorbidities using ICD-9, -10, CPT, HCPCS, and NDC codes. We excluded individuals with HIV, Hepatitis B and C, cancer, a history of vasectomy, and retrograde ejaculation. Patients were then categorized by oligospermia and azoospermia diagnosis, and men without either diagnosis were considered normozoospermic. We determined the urological and medical comorbidities associated with impaired semen parameters in each group and ran adjusted multivariate analyses to determine their association with oligospermia and azoospermia.

Results
We collected data for 2,251,485 individuals who underwent semen analysis. Following the application of exclusion criteria, a remaining cohort of 1,885,668 was established including 5,832 (0.31%) men with oligospermia, 5,638 (0.3%) with azoospermia, and 1,874,198 (99.39%) normospermic men. Varicocele was the most prevalent urologic comorbidity in oligospermic men, with oligo and azo men showing significantly higher prevalence vs normospermic men (17.3%, 6.7%, 0.4%; p-value less than 0.001). Testicular atrophy was the most common urologic diagnosis in azoospermic men, with azo and oligo men showing higher prevalence vs normospermic men (3.5%, 2.3%, 0.1%; p-value less than 0.001). The most common medical comorbidities in oligo and azo men were autoimmune diseases (16.9%, 15.7%, 13.2%; p-value less than 0.001). Our multivariate analysis showed that severe obesity (BMI higher than 40) had a strong significant association with an increased risk of oligospermia (OR: 1.7 (1.68-1.71); p-value less than 0.001). It also demonstrated a significant association with increased risk of azoospermia (1.16 (1.56-1.7); p-value less than 0.001).

Conclusions
In conclusion, our study shows that severe obesity can lead to a higher risk of impaired sperm quality surpassing the impact of certain urological factors traditionally linked to impaired semen parameters. These findings underscore the significance of addressing obesity as a key factor in male fertility assessment.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Educational grants: boston scientific, coloplast; Consulting/equity in start ups: Inherent biosciences, Turtle health, FirmTech, Maximus, Paterna Biosciences, Carrot Fertility.