A Systematic Review and Meta-analysis on the Impact of Infertility on Men's General Health.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of observational studies
PubMed 37573151 · doi:10.1016/j.euf.2023.07.010
What was done
Systematic review and meta-analysis conducted following MOOSE and PRISMA guidelines (registered on PROSPERO) searching PubMed, EMBASE, Google Scholar, and Cochrane. The review analyzed published observational studies comparing infertile and fertile men for all-cause mortality, cancer, diabetes, and cardiovascular events using forest plots and quasi-individual patient data meta-analysis. Risk of bias was assessed with the ROBINS-E tool.
What was found
Infertile men had significantly increased risks of: - All-cause mortality: HR 1.37 (95% CI 1.04-1.81, p = 0.027), with a 30-year survival probability of 91.0% (95% CI 89.6-92.4%) vs. 95.9% (95% CI 95.3-96.4%) in fertile men (p < 0.001) - Testis cancer: RR 1.86 (95% CI 1.41-2.45, p < 0.001) - Melanoma: RR 1.30 (95% CI 1.08-1.56, p = 0.006) - Prostate cancer: RR 1.66 (95% CI 1.06-2.61, p < 0.001) - Diabetes: HR 1.39 (95% CI 1.09-1.71, p = 0.008), with a 30-year probability of 25.0% (95% CI 21.1-26.9%) vs. 17.1% (95% CI 16.1-18.1%) for fertile men (p < 0.001) - Cardiovascular events: HR 1.20 (95% CI 1.00-1.44, p = 0.049), with a major cardiovascular event probability of 15.7% (95% CI 14.3-16.9%) vs. 13.9% (95% CI 13.3-14.6%) for fertile men (p = 0.008)
Why it matters
Male infertility appears to act as a proxy for poorer general health and long-term comorbidity risk rather than an isolated reproductive problem, offering a window for early preventive screening in men.
Limits
The abstract explicitly notes an overall high risk of bias across the included studies. The number of included studies, total participant count, and specific adjustment for potential confounders are not reported in the abstract.
Cited by
- supports Infertility is associated with increased rates of metabolic syndrome, cardiovascular disease, stroke, cancer, and early mortality.