New research reveals a dose-dependent relationship between male infertility and mortality risk, suggesting semen quality may serve as a universal biomarker for long-term health outcomes.
Study: Semen quality and lifespan: a study of 78 284 men followed for up to 50 years. Image Credit: natrot / Shutterstock.com
In a recent study published in Human Reproduction, researchers determine how low semen quality may impact mortality risk.
How does male infertility impact mortality?
In addition to its direct effects on reproduction, male infertility may also reflect an individual’s susceptibility to certain diseases and premature mortality. In fact, several studies have reported a dose-dependent relationship between semen quality and impaired health, as well as sperm concentrations and mortality risk.
Although most men who are seeking reproductive counselling are young and less likely to be diagnosed with chronic health conditions, infertile men often have more comorbidities than comparable fertile men. Despite these observations, it remains unclear how the presence of existing health issues prior to semen quality assessment impact the potential association between male infertility and mortality.
Semen parameters are related to increased morbidity and shorter life expectancy..thus, semen quality may be a universal biomarker of morbidity and mortality.”
About the study
The current study included 78,284 men with a median age of 32 years who underwent semen quality screening due to couple infertility. All semen analyses were performed in a public laboratory between 1965 and 2015 in Copenhagen, Denmark. Mortality data were gathered from national registers over a median period of 23 years, with the longest follow-up period being 50 years.
Life expectancy and survival differences were calculated between groups and stratified by semen quality. In a subgroup with later results obtained between 1987 and 2015, educational status and medical conditions were also recorded to allow for the analysis to consider the impact of these factors on patient outcomes.
Study findings
Among the study cohort, the median sperm concentration was 51 million/mL in men with a diagnosed illness at the time of testing as compared to 47 million/mL in healthy men. Lower median sperm counts were more likely to be reported in individuals with a history of cancer, cardiovascular disease, and diseases of the reproductive tract.
Throughout the follow-up period, 8,600 deaths were reported, which reflected 11% of the study cohort. A dose-dependent relationship was observed between survival rates and decreasing semen quality. All semen parameters exhibited the same pattern, even after adjusting for education and the presence of illnesses at the time of the examination.
Men with a total motile sperm count (TMSC) of 120 million or more had a life expectancy (LE) of about 80.3 years. Comparatively, men with azoospermia, which is defined as a TMSC of zero, experienced a reduction in their life expectancy rates by 2.7 years to an average of 77.6 years. Men with azoospermia also had a 39% increased risk of death as compared to fertile men.
Men with a TMSC between zero and five million had a median life expectancy of 78 years. The risk of death was 61% higher in men with TMSC between five and 10 million, thus making these individuals at the greatest mortality risk.
In obstructive azoospermia, the man is healthy and sperm production is normal; however, sperm cells cannot be released into the semen due to a blockage. In non-obstructive azoospermia, sperm production is very low or absent, thus indicating underlying disease. The current study did not differentiate between individuals with obstructive or non-obstructive azoospermia.
The mortality risk was 38%, 27% and 16% higher for those with sperm counts between 10-40, 40-80, and 80-120 million, respectively. As compared to healthy men, men with pre-existing health conditions had a higher mortality risk in each stratum, thus indicating that disease activity was likely already severe.
Implications
Some men with low semen quality are more likely to die from any cause at relatively earlier ages. In the current study, reduced semen quality parameters, even when greater than the male infertility threshold, led to lower overall survival rates.
Previous studies suggest that declining health is associated with impaired semen quality. Thus, as compared to healthy men, survival outcomes are reduced for infertile men who were already diagnosed with one or more diseases.
Male reproductive function is a biomarker of long-term survival.”
Conclusions
Lower semen quality predicted a shorter lifespan, with this association consistent across all semen parameters. Men with high-quality semen were found to live 2.7 years longer as compared to men with the lowest semen quality.
There was no difference in patient outcomes after considering educational status and pre-existing disease conditions. Thus, additional studies are needed to validate these findings and identify exactly what diseases are associated with lower semen quality.
Future research should also identify at-risk populations with greater specificity to support the development of preventive programs.
Journal reference:
- Priskorn, L., Lindahl-Jacobsen, R., Jensen, T. K., et al. (2025). Semen quality and lifespan: a study of 78 284 men followed for up to 50 years. Human Reproduction. doi:10.1093/humrep/deaf023.
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