Presentation Authors: Jonathan Beilan*, Alexander Tatem, Jabez Jabez Gondokusumo, Houston, TX, Alexander Pastuszak, Salt Lake City, UT, Dolores Lamb, New York, NY, Larry Lipshultz, Houston, TX
Introduction: Increased evidence suggests that genetics involved in male infertility is important to neural development and cognitive function. However, whether male infertility and lower cognitive function is due to shared genetic abnormalities remains unknown. Further understanding this potential link could aid in counseling couples and direct future treatment plans for affected men. This study serves to update our previous series to explore the association between male infertility and cognitive function, anxiety, and depressive symptoms.
Methods: A total of 70 men presenting to a single academic andrology practice were prospectively identified and enrolled in the study. Of these, 42 men presented with nonobstructive azoospermia (NOA) or severe oligospermia ( < 5 million sperm/mL) and 28 with proven fertility (control group). All patients completed the validated Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and Test of Nonverbal Intelligence, 4th edition (TONI-4) IQ evaluation under the supervision of a technician trained to administer the tests. Patients were asked to provide their occupation, and U.S. Census Bureau statistics were used to estimate incomes by occupation. TONI-4 results were analyzed by a psychologist in blinded fashion to determine final IQ scores. Test and questionnaire results were compared between groups.
Results: MeanÂ±SD age in the entire cohort was 38.5Â±7.9 years, and in the infertile and control subgroups was 36.1Â±7.3 and 42.0Â±7.5 years, respectively. Mean estimated income in the infertile and control groups was $76,474Â±$46,195 and $97,340Â±54,836, respectively (p=0.14). A small majority (22/41, 53.7%) of the infertile group had at least a bachelor's degree while 14/28 (50.0%) of the control group had the same (p=0.77). The mean IQ for the infertile cohort was 99.2Â±8.2 points, whereas the mean IQ for the control group was 106.3Â±9.1 points (mean diff: 7.1 points; p=0.001). The mean PHQ-9 score within the infertile group was 3.9Â±4.1 points and in the control group 3.8Â±4.9 points (p=0.89). Mean GAD-7 scores were 3.7Â±3.3 points in the infertile group and 3.8Â±4.3 points in the control group (p=0.98). These latter test results ensured that other psychological factors did not impact the IQ findings.
Conclusions: Our extended data confirms that severe male factor infertility may predispose to lower cognitive function. Additional work examining this relationship is essential to better establish the link between infertility and cognitive function, and to determine whether affected men demonstrate specific genetic defects.
Source of Funding: A.W.P. is a National Institutes of Health K08 Scholar supported by a Mentored Career Development Award (K08DK115835-01) from the National Institute of Diabetes and Digestive and Kidney Diseases. This work is also supported in part through a Urology Care F