OSA may increase male infertility risk

New data suggest that obstructive sleep apnea may be a risk factor for infertility in men, researchers reported in JAMA Network Open.

Further, length of exposure to OSA is associated with infertility risk.

“The association between OSA and testosterone has been studied previously. The association of OSA therapy with reproductive hormones has also been investigated, but conflicting results were found,” Yi-Han Jhuang, MD, from the department of surgery at Tri-Service General Hospital at the National Defense Medical Center in Taipei, Taiwan, and colleagues wrote. “However, to date, the association between OSA and male infertility has not been examined in a population-based study.”

The case-control, population-based study included 4,607 men (mean age, 34.2 years) from the Longitudinal Health Insurance Database. All had a diagnosis of infertility and at least three outpatient visits or a hospitalization from 2000 to 2013. Patients were matched by age, sex and date of infertility diagnosis with 18,428 controls.

The researchers reported that OSA was a independent risk factor associated with infertility in the male cohort following the multivariate conditional logistic regression analysis (adjusted OR = 1.24; 95% CI, 1.1-1.64; absolute risk = 0.204; P = .003). Risk for infertility was significantly higher among men with OSA who did not receive treatment, including continuous positive airway pressure and/or uvulopalatopharyngoplasty compared with patients without OSA (aOR = 1.8; 95% CI, 1.56-2.07; P < .001).

Researchers observed a pattern of increasing risk for infertility that was associated with the increasing OSA exposure time interval. For exposure time intervals over 5 years, infertility risk was higher among those with OSA compared with those without OSA (aOR = 1.86; 95% CI, 1.23-2.21; P < .001).

“Findings from this study appear to support the hypothesis that OSA increases the risk of infertility in male patients and the risk is associated with the OSA exposure time interval,” the researchers wrote. “Early recognition of OSA and its interventions may decrease the risk of subsequent complications, including infertility.”