PSA levels higher in infertile men

Levels of prostate-specific antigen (PSA) are higher in infertile men than in their fertile counterparts, a recent study has shown. Moreover, PSA >1 ng/mL is more common among infertile men younger than 40 years of age.

The researchers conducted a cross-sectional analysis of 956 infertile men (median age, 38 years), in whom circulating hormone levels, prolactin, and PSA values were measured after an overnight fast. A parallel group of 102 fertile men (median age, 25 years) was also included.

The median PSA values were significantly higher in infertile men (0.7 vs 0.6 ng/mL; p=0.02). Similarly, the proportion of participants with PSA >1 ng/mL was also greater in infertile than fertile men (32 percent vs 20 percent; p=0.02). Testis volume and follicle-stimulating hormone levels were also higher in infertile men.

In the subgroup of participants ≤40 years of age, PSA levels >1 ng/mL occurred more frequently in infertile vs fertile men (p=0.04).

Multivariable linear regression analysis was then performed to determine potential predictors of serum PSA. Age emerged as the strongest predictor, such that a man older by 10 years would have, on average, a 0.2-ng/mL higher SA (β, 0.20, 95 percent confidence interval [CI], 0.11–0.31; p<0.001). Infertility also significantly correlated with PSA in the overall cohort (β, 0.21, 95 percent CI, 0.02–0.39; p=0.03).

“[C]onsidering the known association between male factor infertility and a greater risk of prostate cancer, we could speculate that infertile men may deserve further attention and comprise an easily accessible category of patients who may eventually benefit from early screening with PSA testing,” the researchers said.