Male Infertility Increases the Risk of Cardiovascular Diseases: A Nationwide Population-Based Cohort Study in Taiwan

Peng-Ciao Chen; Yu-Ju Chen; Chia-Chen Yang; Ting-Ti Lin; Chien-Chu Huang; Chi-Hsiang Chung; Chien-An Sun; Wu-Chien Chien

doi:10.5534/wjmh.210098

Male Infertility Increases the Risk of Cardiovascular Diseases: A Nationwide Population-Based Cohort Study in Taiwan

Chen PC, Chen YJ, Yang CC, Lin TT, Huang CC, Chung CH, Sun CA, Chien WC

Published July 2022 The world journal of men's health, 40(3), 490-500

DOI 10.5534/wjmh.210098 PMID 35021296 PMC PMC9253797

RRM Academy Synopsis

Male Infertility Linked to Higher Cardiovascular Disease Risk

Men with infertility faced higher heart and blood vessel disease risk than other men in this Taiwan cohort. This cohort study used past health records of 2,326 men with infertility and 9,304 men of similar age. About 17 out of 100 men with infertility developed it, against about 12 out of 100 others.

Key Findings

By the end of follow-up, 397 men (17.07%) with infertility had developed cardiovascular disease, compared with 1,101 men (11.83%) in the comparison group.
The hazard ratio for cardiovascular disease was 1.472 in the infertility group once age, marital status, education and other factors were adjusted for (95% CI, 1.288–1.683; p<0.001).
Adjusted hazard ratios were 2.055 for hypertension (95% CI, 1.688–2.532), 2.426 for ischemic heart disease (95% CI, 1.773–3.320) and 1.372 for other forms of heart disease (95% CI, 1.091–1.668).
The adjusted hazard ratio for stroke was 2.261 (95% CI, 1.003–4.551; p=0.045).
Mean follow-up was 11.72 years in the infertility group and 11.68 years in the comparison group.

Interpretation

The study is a matched cohort drawn from insurance claims, looking back at past records. A hazard ratio above 1 means a higher rate of the outcome over time. The design shows an association in this cohort. The authors call for more work on cause and effect. Infertility came from diagnosis codes, and the database lacked semen results, number of children, physical activity and family history. All participants were men over 18 in Taiwan. The stroke interval runs from 1.003 to 4.551. The mechanism remains unclear; low testosterone, erectile dysfunction, semen quality and long-term stress are discussed as possible links.

RRM Context

Restorative reproductive medicine looks at both partners. A man's diagnosis matters to the couple. For this Asian population, the authors consider male infertility a possible risk factor, or a biological marker, of later health problems. Infertility is a symptom to investigate. In the infertility group, heart or blood vessel disease was identified an average of 8.13 years after infertility.

Our editorial summary of this paper, not the article's abstract.

Abstract

Purpose

Some evidence suggests that male infertility increases the risk of cardiovascular diseases (CVDs). However, the evidence in Asian populations is relatively scarce. The aim of this study is to determine whether male infertility increases the risk of CVDs.

Materials and Methods

We used inpatient and outpatient data for the years 2000 to 2015 from the Taiwanese Longitudinal Health Insurance Database. We enrolled 7,016 males over 18 years old and diagnosed with male infertility. Of these, 2,326 matched our inclusion criteria and were assigned to the study group. For each infertility patient, four comparison patients were frequency-matched by age and index date to form a control cohort comprising 9,304 patients. Cox proportional hazards analysis was used to estimate the association between male infertility and CVDs.

Results

After a 15-year follow-up, the incidence rate of CVDs was higher in the infertility group than the control group (1,460.23 and 1,073.70 per 100,000 person-years, respectively). The Cox proportional hazards regression analysis revealed that the adjusted HR for CVDs was 1.472 for the infertility group (95% CI, 1.288-1.683; p<0.001) relative to the control group. The Kaplan-Meier analysis of the cumulative incidence of CVDs in the two groups showed that the cumulative risk curve for CVDs was significantly higher for the infertility group than the control group.

Conclusions

This study shows that men with infertility have a higher risk of developing incident CVDs. In the future, healthcare providers should pay attention to these patients because of their higher health risks.

Peng-Ciao Chen, Yu-Ju Chen, Chia-Chen Yang, Ting-Ti Lin, Chien-Chu Huang, Chi-Hsiang Chung, Chien-An Sun, Wu-Chien Chien

P Chen, Y Chen, C Yang, T Lin, C Huang, C Chung, C Sun, W Chien

PMID 35021296 35021296 DOI 10.5534/wjmh.210098 10.5534/wjmh.210098 Chen et al. 2022, Chen 2022

Keywords

Cardiovascular diseases, Fertility, Male infertility

Male Infertility Increases the Risk of Cardiovascular Diseases: A Nationwide Population-Based Cohort Study in Taiwan

Male Infertility Linked to Higher Cardiovascular Disease Risk

Key Findings

Interpretation

RRM Context

Abstract

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Keywords