Presentation Authors: Luca Boeri, Paolo Capogrosso, Eugenio Ventimiglia, Walter Cazzaniga, Edoardo Pozzi, Nicolò Schifano, Francesco Chierigo*, Federico Belladelli, Rani Zuabi, Costantino Abbate, Federico Dehò, Milan, Italy, Vincenzo Mirone, Naples, Italy, Franco Gaboardi, Montanari Emanuele, Francesco Montorsi, Andrea Salonia, Milan, Italy
Introduction: Serum cholesterol is the main source for steroid synthesis and plays a determinant role in both steroidogenesis and spermatogenesis. Not unique findings focused on the associations between lipid concentrations and semen quality of infertile men. We analysed the associations among lipid profiles and semen quality in a homogenous cohort of with-European primary infertile men.
Methods: Data from 754 patients were analysed. Comorbidities were scored with the Charlson Comorbidity Index (CCI). Semen analysis was based on 2010 WHO reference criteria. Serum hormones and sperm DNA fragmentation index (SDF) (SDF â‰¥30% as pathologic) were measured in every patient. Circulating triglyceride (TGL), total cholesterol (Chol), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were measured. Each lipid parameter was categorized into quartiles. The association of the hormonal milieu and semen parameters with the lipid profile was analysed.
Results: Medians (IQR) age and BMI were 38 (35-42) years and 25.2 (23.3-27.2) kg/m2, respectively. Median lipids values were triglyceride [89 (65-131) mg/dl], Chol [203 (176-228) mg/dl], HDL [52 (44-61) mg/dl] and LDL [128 (106-155) mg/dl]. Sperm concentration increased across quartiles of CHOL (8.1 vs. 9.8 vs. 10 vs. 15 mil/ml, respectively; p=0.026) and TGL (8.0 vs. 8.2 vs. 9.0 vs. 18 mil/ml; p=0.04). According to quartile comparisons, men over the 3rd Chol and TGL quartile had 1.66-fold and 2.32-fold lower ORs of oligozoospermia than those within the lowest quartile, respectively. This was not the case for normal sperm morphology and progressive sperm motility. No association was observed between HDL and LDL values and semen parameters. Total testosterone (tT) (3.7 vs. 4.1 vs. 4.5 vs. 4.7 ng/mL, pâ‰¤0.001), SHBG (30 vs. 33 vs. 34 vs. 38 nmol/L, pâ‰¤0.001) and AMH (3.9 vs. 4.1 vs. 4.7 vs. 5.1 ng/mL, p=0.03) values significantly increase across HDL quartile groups. Conversely, tT (4.6 vs. 4.2 vs. 4.1 vs. 3.7 ng/mL, pâ‰¤0.001) and SHBG (38.2 vs. 37.8 vs. 31 vs. 29 nmol/L, pâ‰¤0.001) decreased for increasing TGL values. Rates of SDF were not associated with circulating lipids. At Spearman&[prime]s correlation, HDL was positively correlated with tT (p≤0.001), SHBG (pâ‰¤0.001) and AMH (pâ‰¤0.01) levels while TGL were negatively correlated with tT (pâ‰¤0.001) and SHBG (pâ‰¤0.001) values.
Conclusions: Our results corroborate previous findings showing the association between high Chol and TGL levels with better sperm concentration rates. HDL values were positively correlated with tT and SHBG, while higher TGL levels were significantly associated with an impaired hormonal milieu in primary infertile men.