Male infertility poses increased death risk

Infertile men are at higher risk of death, especially those with the most severe form of infertility, although the overall risk is small and lower than that seen in the general population, a study reports.

The study included 134,796 infertile men (oligospermia, n=18,826; azoospermia, n=12,630) and 242,282 controls who were followed for a mean of 3.6 and 3.1 years, respectively. The mean age of the overall population was 35 years, and the two groups had comparable rates of smoking (13.0 percent and 13.4 percent) and obesity (9.9 percent and 8.4 percent).

Within the follow up period, 643 (0.47 percent) infertile men and 615 (0.25 percent) controls died. Multivariable Cox analysis showed infertility to be associated with about a 40-percent higher risk of mortality (hazard ratio [HR], 1.42, 95 percent confidence interval [CI], 1.27–1.60). This risk increase was consistent across all age groups.

Compared with normal fertility, azoospermia was associated with a twofold increased risk of death (HR, 2.01, 95 percent CI, 1.60–2.53) and oligospermia with a 17-percent risk increase (HR, 1.17, 95 percent CI, 0.92–1.49).

The estimates were similar in an analysis excluding men with prevalent cardiovascular and malignant disease (alone and combined). This suggests that the risk of death could not be attributed to prevalent disease, which is known to be generally higher among infertile men.

Additional studies are needed to confirm the findings, better understand the aetiology of mortality in the present population, and establish whether screening should be altered for infertile men.