Epidemiological characteristics and risk factors of reproductive dysfunction in male infertility: a meta-analysis.

Abstract

Background: Reproductive dysfunction, encompassing semen abnormalities and sexual dysfunction, is a significant global concern with diverse etiological factors. This meta-analysis investigated the demographic, lifestyle, and health-related risk factors that contribute to reproductive dysfunction in men.

Methods: A comprehensive search of electronic databases yielded 3,931 publications, of which 28 articles (44 studies) involving 23,316 infertile men and 40,934 healthy controls were included. Data extraction and analysis followed the PRISMA guidelines. Risk factors were assessed using standardized mean difference (SMD) and odds ratio (OR) metrics, with stratified and subgroup analyses based on the population and condition.

Results: Advanced age was identified as a significant risk factor for reproductive dysfunction (SMD = 1.15, 95% CI [0.68, 1.61], P < 0.001, I² = 99.6%) and subgroup analyses revealed associations across European, Asian, and Caucasian populations, as well as conditions such as asthenozoospermia, teratozoospermia, and erectile dysfunction. Elevated BMI (SMD = 1.68, 95% CI [0.17, 3.18], P < 0.001, I² = 100%) and obesity (OR = 1.43, 95% CI [1.02, 1.99], P < 0.001, I² = 76.2%) were also notable contributors. Lifestyle factors, such as smoking (OR = 1.33, 95% CI [1.16, 1.53], P < 0.001, I² = 79.2%) and alcohol consumption (OR = 1.36, 95% CI [1.00, 1.85], P < 0.001, I² = 94.8%), were consistently associated with reproductive dysfunction across multiple populations and conditions. Health-related factors, including hypertension (OR = 1.34, 95% CI [1.04, 1.74], P = 0.003, I² = 67.5%), diabetes (OR = 2.53, 95% CI [1.48, 4.33], P = 0.008, I² = 68.1%), depression (OR = 4.24, 95% CI [1.25, 14.41], P < 0.001, I² = 91.9%), and anxiety (OR = 2.16, 95% CI [1.60, 2.90], P = 0.714, I² = 0.0%) were also significantly associated with reproductive dysfunction, emphasizing the multifaceted nature of its etiology.

Conclusions: This meta-analysis highlights advanced age, elevated BMI, smoking, alcohol consumption, hypertension, diabetes, and mental health disorders as critical risk factors for male reproductive dysfunction. These findings underscore the importance of targeted interventions and lifestyle modifications in mitigating these risks.

Clinical trial number: Not applicable.