Presentation Authors: Michael Eisenberg, Alex Kasman*, Shufeng Li, Palo Alto, CA
Introduction: Infertility may be a harbinger of future health. Data has demonstrated a higher risk of cardiometabolic disease in the years following an evaluation. However, the etiology remains uncertain and whether such an association persists across sociodemographic strata. The objective of this study was to determine whether men with male factor infertility have a higher incidence of adverse future health outcomes regardless of socioeconomic class or race.
Methods: We utilized the OptumÂ® de-identified Clinformatics&[copy] Datamart (2003-2016) which is a de-identified database from a large national insurance provider that stores data from adjudicated and paid insurance claims from 2003 to 2016. For the purpose of our study, we focused on men with an infertility diagnosis code, those undergoing fertility evaluation based on either diagnosis or procedural code, and those with a diagnosis of vasectomy counseling or procedure code for vasectomy. We performed Cox proportional hazard regression models to adjust for the possible confounding factors.
Results: Our study population consisted of 76,343 males identified with male factor infertility, 60,072 males who underwent fertility testing, and 183, 742 males that underwent vasectomy (control population). Overall, we showed that those with male factor infertility have a higher risk of developing hypertension (HR 1.15, CI 1.13-1.18), diabetes (HR 1.5, CI 1.44-1.57), hyperlipidemia (HR 1.18, CI 1.16-1.21), and heart disease (HR 1.34, CI 1.25-1.45) when compared to those undergoing vasectomy. Race (white, black, Asian, or Hispanic) was overall shown to have no influence on the development of any cardiometabolic outcome (Figure 1). Similar findings were true when controlling for education (100K dollars per year)
Conclusions: Men with infertility have a higher risk of cardiometabolic disease in the years following a fertility evaluation which is not altered by race or socioeconomic status. This implies a biologic etiology to explain the relationship between fertility and future health.
Source of Funding: Precision Health and Integrated Diagnostics Center (PHIND) at Stanford