Department of Maternal-Infant and Urological Sciences, "Sapienza" Rome University, Policlinico Umberto I Hospital, Rome, Italy.
Department of Urology, Stanford University School of Medicine, Stanford, CA, USA.
Investig Clin Urol. 2020 Jul;61(4):355-371. doi: 10.4111/icu.2020.61.4.355. Epub 2020 Jun 8.
Ongoing evidence has suggested the role of male factor infertility as a potential predictor of mortality and general health status. The aim of the present review is to update the current knowledge base regarding the association between male factor infertility and general health through a critical review of the literature.
A systematic review of the literature was carried out from inception to November 2019 in order to evaluate significant associations between male infertility and adverse health outcomes such as cardiovascular, oncologic, metabolic and autoimmune diseases as well as overall mortality.
In all, 27 studies met inclusion criteria and were critically examined. Five studies examined male infertility and cardiovascular disease risk, 11 examined oncologic risk (e.g., overall cancer risk, testis and prostate cancer), 8 examined aggregate chronic medical diseases and 5 infertility related to incidence of mortality, for a total of 599,807 men diagnosed with any male factor infertility covering a period from 1916 to 2016.
A man's fertility and overall health appear to be interconnected. Therefore, a diagnosis of male infertility may allow a window into future comorbidity and/or mortality which may help guide clinical decisions and counseling. Several possible etiologies such as genetic, epigenetic, developmental, and lifestyle-based factors need to be further evaluated in order to establish the underlying mechanisms between male infertility and health.
不断有证据表明男性因素不孕是死亡和总体健康状况的潜在预测因素。本综述的目的是通过对文献的批判性回顾,更新目前关于男性因素不孕与总体健康之间关联的知识基础。
系统地回顾了从开始到 2019 年 11 月的文献,以评估男性不育与心血管、肿瘤、代谢和自身免疫性疾病以及总体死亡率等不良健康结局之间的显著关联。
共有 27 项研究符合纳入标准并进行了批判性检查。五项研究检查了男性不育与心血管疾病风险的关系,11 项研究检查了肿瘤风险(例如,总体癌症风险、睾丸和前列腺癌),8 项研究检查了总慢性疾病,5 项研究与与死亡率相关的不育症,共有 599807 名被诊断为任何男性因素不孕的男性,涵盖了 1916 年至 2016 年的时间段。
男性的生育能力和整体健康似乎是相互关联的。因此,男性不育的诊断可能为未来的合并症和/或死亡率提供一个窗口,这可能有助于指导临床决策和咨询。需要进一步评估遗传、表观遗传、发育和基于生活方式等几种可能的病因,以确定男性不育与健康之间的潜在机制。