Endocrine Abstracts

JOINT749

Background: Male infertility and semen quality have been suggested to be markers of morbidity and thus mortality, but the role of underlying disease present at time of semen quality evaluation has not been thoroughly assessed.

Objective: To determine the association between semen quality and mortality and to assess the impact of the health of the man prior to semen quality assessment.Participants, study design, sizeThe study was based on 78,284 men who had their semen quality assessed 1965-2015 at the public semen analysis laboratory in the Copenhagen area, Denmark, due to reported couple infertility. Thus, the included men covered a wide range of semen quality. Semen quality assessment included semen volume, sperm concentration and the proportion of motile and morphologically normal sperm, from which total sperm count, and total number of motile sperm was calculated. Utilizing the unique national registers, follow-up of the men regarding all-cause mortality was performed with a median follow-up of 23 years (5-95th percentile: 8-45 years) during which 8,600 (11.0%) deaths occurred.

Methods: Life expectancy was calculated according to semen quality. Furthermore, the relative differences in mortality were estimated using Cox regression analyses and presented as hazard ratios (HR) with 95% confidence intervals (CI). For a subpopulation of 59,657 men (sample delivery 1987-2015), information on diseases prior to semen sampling and educational level was available and adjusted for in Cox regression analyses.

Results: Men with a total motile count >120 mill. could expect to live 80.3 years, compared to 77.6 years among men with total motile count >0-5 mill. In Cox regression analyses, all semen parameters were negatively associated with mortality in a dose-response manner both in the total and the subpopulation (p-trend for all semen parameters <0.001), and adjustment for educational level and prior diagnoses did not change the estimates. Looking at total motile count as an example, for which men with total motile count >120 mill. served as the reference, adjusted HRs were: azoospermia: 1.39, >0-5 mill.: 1.61, >5-10 mill.: 1.38, >10-40 mill.: 1.27, >40-80 mill.: 1.16 and >120 mill.: 1.19, p-trend<0.001).

Conclusion and implications: We observed clear negative dose-response associations between all semen parameters and all-cause mortality, which were not explained by disease registered at the time of semen evaluation. Thus, some men with impaired semen quality may experience less healthy aging than men with better semen quality and could benefit from being identified at time of semen quality evaluation.