Is Male Infertility a "Deadly" Disease?
Can being infertile kill you? Granted, it’s a disease, but is it really a “deadly” one? You might get that impression from recent press headlines:
“Sperm Problems Tied to Death in the Near Future”
“Low Sperm Means Shorter Lifespan”
“Male Infertility as Sign of Premature Death”
Not so fast, cowboy! Let’s look at things a little closer.
A Birds Eye View
From our published work in population science, infertile men with low sperm counts appear to be at higher risk of both testicular cancer and prostate cancer later in life. It has also been reported that when infertile and fertile men are compared, pound for pound, infertile men are simply not as healthy. Importantly, these are theoretical links without a proven biological basis. In other words, these 30,000-foot associations are just that, until confirmed by more science. So, what is the data to suggest that infertile men kick the bucket sooner than fertile men?
The Danish Data
In 2009, a large, comprehensive population-based study from Copenhagen first looked at this issue. The semen quality of 43,277 men, both infertile and fertile, were examined between 1963 and 2001 and individual men were followed for 38 years! The results showed a clear association between sperm counts and death rates: As sperm counts went up, mortality went down. In fact, men with the highest sperm counts enjoyed death rates 43% lower than men with the lowest counts. Notably, this sperm count-mortality relationship was similar in both infertile and fertile men, suggesting that fertility alone is not the key issue here. Certainly a study that cannot be ignored.
The US Data
More recently, a U.S. based study was also published on this issue. It correlated semen quality and death rates among only infertile men from Texas and California. The 11,935 men who had provided semen analyses from 1989-2011 were tracked to national death indices. So, over a 7.7-year period, 0.58% of these men died. Interestingly, this death rate was much lower (by 60%) than that of the general population. This might mean that infertile men are far healthier than the general population and maybe it’s the general male population that we need to worry about the most! But as the study drilled deeper, it found that men who had two or more semen abnormalities (e.g. semen volume, sperm count or motility) were 2.3 times more likely to die than men without abnormalities.
Is this science good enough to make fact out of theory? Hardly. Remember, unlike the Danish report, the U.S. study was far shorter and less granular in detail, did not include fertile men for comparison, and did not examine fertility. And recall that, among the top five causes of death in men this age group, accidents (21-35% of deaths) and suicide (8-12%) easily outrank other “diseases.” How a low sperm count might be linked to more accidents or suicides current defies explanation. Finally, the U.S. report is “regional” by design, involving only two states, making it difficult to generalize any findings.
However, amidst the thick fog that often clouds scientific fact and fiction, what is now emerging from the shadows is a form, a relationship, between semen quality and longevity in men. One that may have nothing to do with fertility potential, but everything to do with health. Could this be the era in which the semen analysis is viewed as an early “biomarker” of men’s health? Only time will tell. Said Joseph Conrad: “Great achievements are accomplished in a blessed, warm fog.”