(123) THE IMPACT OF ENVIRONMENTAL FACTORS AND CHRONIC MEDICAL CONDITIONS ON SEMEN QUALITIES: A TEN-YEAR LONGITUDINAL ANALYSIS
Authors: Scott M , Rodriguez A , Marciano O , Lundy S , Raheem O 
Published: December 2024

Abstract

Introduction
Environmental factors, lifestyle choices, and chronic medical conditions appear to negatively impact semen quality and further hinder male reproductive capabilities. Reduced semen parameters can be associated with increased morbidity and mortality in men and are often used as a biomarker for men’s overall health.

Objective
In this longitudinal analysis, we aim to evaluate the correlations between various demographic factors, medical conditions, and recreational substances and semen studies in adult men at a large reproductive urology center.

Methods
In this retrospective chart review, male patients’ ≥18 of age with documented semen analyses were included. Data collected included patient racial demographics, comorbid medical conditions, and recreational alcohol, tobacco, or marijuana use. Semen analyses included sperm concentration, total sperm count, and total motile sperm. Patients were further subdivided into groups diagnosed with oligospermia and azoospermia based on the WHO 10th Global Conference guidelines. The data was analyzed using univariate and multivariate linear regression and logistic regression.

Results
2322 patients were included in the study. White and Black non-Hispanic men had lower total sperm counts, sperm concentrations, and total motile sperm (p &lt; 0.001) compared with Asian men, and older men (p = 0.002) had lower total sperm counts than younger men. Among comorbidities, individuals with higher HbA1C (p = 0.026), higher LDL cholesterol (p = 0.004), anemia (p = 0.003), an enlarged prostate (p &lt; 0.001), testicular cancer (p = 0.006), scrotal varices (p &lt; 0.001) had lower total sperm counts. Individuals with hypertension (p = 0.04), anemia (p &lt; 0.001), an enlarged prostate (p &lt; 0.001), chronic kidney disease (p = 0.008), heart failure (p &lt; 0.001) had lower sperm concentrations. Adrenocortical insufficiency (p = 0.002), type 2 diabetes mellitus (p = 0.04), hypertension (p = 0.02), anemia (p &lt; 0.001), chronic kidney disease (p = 0.002), and heart failure (p &lt; 0.001), were associated with lower motility among comorbidities. Among recreational drug parameters, tobacco use (p &lt; 0.001) and marijuana use (p &lt; 0.001) were associated with lowered sperm counts, concentration, and motility, while alcohol use (p &lt; 0.001) was associated with lower sperm concentration and motility (Figs. 1 and 2).

Conclusions
In this study, high HbA1C or type 2 diabetes, anemia, hypercholesterolemia, chronic kidney disease, heart failure, testicular cancer, scrotal varices, White or Black race, tobacco use, alcohol use, and marijuana use were associated with reduced semen quantities or qualities. Sexual and reproductive medicine practitioners can use these predictive factors to more effectively screen and treat men who may be at risk of infertility. Future studies are warranted to explore more infertility associations and provide holistic counseling and treatment to patients and practitioners.

Disclosure
No.