Relationship between semen production and medical comorbidity

Men with medical comorbidities have a higher rate of abnormal semen parameters.

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Michael L. Eisenberg, M.D., Shufeng Li, M.S., Barry Behr, Ph.D., Renee Reijo Pera, Ph.D., Mark R. Cullen, M.D.

Volume 103, Issue 1, Pages 66-71



To study the relationship between semen quality and current health status in a cohort of men evaluated for infertility.


Cross-sectional study.


Fertility clinic.


Nine thousand three hundred eighty-seven men evaluated for infertility between 1994 and 2011.



Main Outcome Measure(s):

Charlson comorbidity index, medical diagnoses by organ system.


At the time of evaluation, 9,387 men with a mean age of 38 years had semen data available. Of these men, 44% had at least one medical diagnosis unrelated to infertility. When stratifying the cohort by the Charlson comorbidity index (CCI), differences in all measured semen parameters were identified. Men with a higher CCI had lower semen volume, concentration, motility, total sperm count, and morphology scores. In addition, men with diseases of the endocrine, circulatory, genitourinary, and skin diseases all showed significantly higher rates of semen abnormalities. Upon closer examination of diseases of the circulatory system, men with hypertensive disease, peripheral vascular and cerebrovascular disease, and nonischemic heart disease all displayed higher rates of semen abnormalities.


The current report identified a relationship between medical comorbidites and male semen production. Although genetics help guide a man’s sperm production, his current condition and health play an important role.

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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders.