Affiliation:
1. Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
2. Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
3. NHC Key Laboratory of Birth Defects and Reproductive Health, Chongqing Population and Family Planning Science and Technology Research Institute, Chongqing, PR China
Abstract
ImportanceNumerous studies have documented the association of self-rated health (SRH) with chronic diseases. However, few studies have investigated its association with semen quality.ObjectiveTo examine the association of SRH with semen quality among men undergoing assisted reproductive technology (ART) in China.Design, Setting, and ParticipantsThis cross-sectional study recruited male partners in couples undergoing ART treatment at the Center for Reproductive Medicine, Tongji Hospital, Wuhan, China. A total of 1262 men underwent 2 semen examinations and completed a questionnaire on SRH between December 2018 and January 2020. Data analysis was performed from November 20, 2022, to March 24, 2023.ExposureSRH, including overall physical and mental health, as well as reproductive-related physical and mental health specifically, were reported at baseline recruitment.Main Outcomes and MeasuresSperm concentration, sperm progressive motility, sperm motility, and sperm count as semen quality parameters.ResultsThe study included 1262 men with a mean (SD) age of 32.79 (5.25) years and body mass index of 24.37 (3.68). Men with poorer SRH had lower semen quality (eg, sperm concentration among poor vs very good overall physical health: percentage variation, −14.67%; 95% CI, −23.62% to −4.66%). Among 4 components of SRH, a greater reduction in semen quality was estimated for reproductive-related SRH compared with overall SRH, whereas the greatest reduction was observed for reproductive-related physical SRH. In comparison with men with very good reproductive-related physical SRH, men with poor reproductive-related physical SRH had differences of −24.78% (95% CI, −32.71% to −15.93%) and −25.61% (95% CI, −33.95% to −16.22%) in sperm count and concentration, respectively, and regression coefficients of −9.38 (95% CI, −12.01 to −6.76) and −9.24 (95% CI, −11.82 to −6.66) for sperm motility and sperm progressive motility, respectively.Conclusions and RelevanceIn this cross-sectional study of Chinese men, poorer SRH was associated with lower semen quality, and reproductive-related physical SRH was the most pronounced indicator. Our findings suggest that SRH, especially reproductive-related physical SRH, was a good indicator of semen quality, which should inform public and clinical regulatory decisions.
Publisher
American Medical Association (AMA)