The effect of ethnicity on semen analysis and hormones in the infertile patient
Introduction: We aimed to study the association of ethnicity on semen parameters and hormones in patients presenting with infertility.
Methods: Data from men presenting for infertility assessment were prospectively collected and retrospectively reviewed. Demographic and clinical history was self-reported. Semen analysis included volume, count, motility, morphology, and vitality. The 2010 World Health Organization cutoffs were used. Baseline total testosterone and follicle-stimulating hormone (FSH) levels were recorded. Ethnicity data was classified as Caucasian, African Canadian, Asian, Indo-Canadian, Native Canadian, Hispanic, and Middle Eastern. All patients with complete data were included and statistical analysis was performed.
Results: A total of 9079 patients were reviewed, of which 3956 patients had complete data. Of these, 839 (21.2%) were azoospermic. After adjusting for age, African Canadians (odds ratio [OR] 1.70; 95% confidence interval [CI] 1.28‒2.25) and Asians (1.34; 95% CI 1.11‒1.62) were more likely to be azoospermic compared to Caucasians. Similarly, African Canadians (OR 1.75; 95% CI 1.33‒2.29) were more likely to be oligospermic and Asians (OR 0.82; 95% CI 0.70‒0.97) less likely to be oligospermic. Low volume was found in African Canadian (OR 1.42; 95% CI 1.05‒1.91), Asians (OR 1.23; 95% CI 1.01‒1.51), and Indo-Canadians (OR 1.47; 95% CI 1.01‒2.13). Furthermore, Asians (OR 0.73; 95% CI 0.57‒0.93) and Hispanics (OR 0.58; 95% CI 034‒0.99) were less likely to have asthenospermia. Asians (OR 0.73; 95% CI 0.57‒0.94) and Indo- Canadians (OR 0.58; 95% CI 0.35‒0.99) were less likely to have teratozospermia. No differences were seen for vitality. No differences were seen for FSH levels, however, Asians (p<0.01) and Indo- Canadians (p<0.01) were more likely to have lower testosterone.
Conclusions: Our study illustrates that variations in semen analyses and hormones exist in men with infertility. This may provide insight into the workup and management for infertile men from different ethnicities.
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