Semen quality in fertile men in relation to psychosocial stress

Objective: To examine the association between stressful life events and semen parameters. Design: Cross-sectional analysis in a pregnancy cohort study. Setting: Prenatal clinics in five U.S. cities. Patient(s): Fertile men (n = 744) in the Study for Future Families, a cohort study of pregnant women and their partners. Intervention(s): None. Main Outcome Measure(s): Sperm concentration, percent motile, and percent normal morphology and classification above/below World Health Organization (WHO) cutoffs for semen quality. Result(s): After adjusting for confounders, men reporting 2+ recent stressful life events had an increased risk of being classified below WHO thresholds for "normal" defined by concentration, motility, and morphology criteria compared with men reporting <2 stressful life events (odds ratio [OR] = 2.06; 95% confidence interval [CI], 1.18, 3.61; OR = 1.54; 95% CI, 1.04, 2.29; OR = 1.93; 95% CI, 1.02, 3.66 for concentration, motility and morphology, respectively). Men experiencing 2+ stressful life events had lower sperm concentration (log scale, β = -0.25; 95% CI, -0.38, -0.11) and lower percent motile sperm (β = -1.95; 95% CI, -3.98, 0.07), but percent normal morphology was less affected. Conclusion(s): These results suggest that stressful life events may be associated with decreased semen quality in fertile men. The experience of psychosocial stress may be a modifiable factor in the development of idiopathic infertility.