New insights to guide patient care: the bidirectional relationship between male infertility and male health
Male reproductive health and overall health are intertwined, so infertility may be harbinger of future health. Therefore, comprehensive evaluation of systemic dis- ease and medications are necessary for infertile males.
Volume 113, Issue 3, Pages 469–477
Alex M. Kasman, M.D., M.S., Francesco Del Giudice, M.D., Michael L. Eisenberg, M.D.
Male reproduction is a complex process, and numerous medical conditions have the potential to alter spermatogenesis. In addition, male factor infertility may be a biomarker for future health. In the present review, we discuss the current literature regarding the association between systemic diseases and fertility, which may impact clinical outcomes or semen parameters. A number of conditions that have systemic consequences were identified, including genetic (e.g., cystic fibrosis, DNA mismatch repair alterations), obesity, psychological stress, exogenous testosterone, and a variety of common medications. As such, the infertility evaluation may offer an opportunity for health counseling beyond the discussion of reproductive goals. Moreover, male infertility has been suggested as a marker of future health, given that poor semen parameters and a diagnosis of male infertility are associated with an increased risk of hypogonadism, cardiometabolic disease, cancer, and even mortality. Therefore, male fertility requires multidisciplinary expertise for evaluation, treatment, and counseling.