Purpose The purpose of the study is to evaluate existing literature for possible associations between female infertility, infertility-associated diagnoses, and the following areas of disease: psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Methods The design of the study is a literature review. The patients were women included in 26 selected studies due to a diagnosis of infertility or a reproductive disorder associated with infertility. This study has no interventions, and the main outcome measure is the association between female infertility or a related diagnosis and psychiatric disorders, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Results Female infertility and related reproductive disorders may have ramifications for women beyond reproductive health. An analysis of publications shows that women with infertility had higher rates of psychiatric disorders and endometrial cancer than the general population [1][2][3][4][5][6][7][8][9][10]. Data is conflicting about whether infertile women are at increased risk for breast cancer and ovarian cancer [7,8,[10][11][12][13][14][15][16][17][18][19][20]. A generalized diagnosis of infertility was not clearly associated with an increased risk of cardiovascular disease or metabolic dysfunction, but women with infertility related to polycystic ovarian syndrome (PCOS) do appear more likely to develop cardioCapsule There is a growing body of literature addressing the impact of female infertility on long-term health. This review evaluates 26 studies, investigating possible correlations between infertility and psychiatric illness, breast cancer, ovarian cancer, endometrial cancer, cardiovascular disease, and metabolic dysfunction. Overall, higher rates of psychiatric illness and endometrial cancer were seen in infertile women. It is unclear whether infertility results in increased rates of breast cancer and ovarian cancer, and data are conflicting regarding correlations between generalized infertility and cardiovascular disease and metabolic dysfunction. This study summarizes current literature and can guide practitioners in counseling infertile patients.

Objective: To assess the effects of both male and female body mass index (BMI), individually and combined, on IVF outcomes. Design: Prospective cohort study. Setting: University fertility center. Patient(s): All couples undergoing first fresh IVF cycles, 2005–2010, for whom male and female weight and height information were available (n=721 couples). Intervention(s): None. Main Outcome Measure(s): Embryologic parameters, clinical pregnancy, and live birth incidence. Result(s): The average male BMI among the study population was 27.5±4.8 kg/m2 (range, 17.3–49.3 kg/m2), while the average female BMI (n=721) was 25.2±5.9 kg/m2 (range, 16.2–50.7 kg/m2). Neither male nor female overweight (25–29.9 kg/m2), class I obese (30–34.9 kg/m2), or class II/III obese (≥35 kg/m2) status was significantly associated with fertilization rate, embryo score, or incidence of pregnancy or live birth compared with normal weight (18.5–24.9 kg/m2) status after adjusting for male and female age, partner BMI, and parity. Similar null findings were found between combined couple BMI categories and IVF success. Conclusion(s): Our findings support the notion that weight status does not influence fecundity among couples undergoing infertility treatment. Given the limited and conflicting research on BMI and pregnancy success among IVF couples, further research augmented to include other adiposity measures is needed.

Objective To further understand the association between semen quality and cancer risk using well-defined semen parameters. Design Retrospective cohort study. Setting Subfertility Heath and Assisted Reproduction (SHARE) study in Utah from 1994 to 2011. Patients 20,433 men from that underwent semen analysis (SA) and a sample of 20,433 fertile controls matched on age and birth year Interventions none. Main Outcome Measures Risk of all cancers, as well as site-specific results for prostate, testicular, and melanoma. Results Relative to fertile men, men with SA have an increased risk of testicular cancer (Hazard Rate Ratio (HR) =3.3). When the characterization of infertility is refined using individual semen parameters, we find that oligozoospermic men have an increased risk of cancer relative to fertile controls. This association is particularly strong for testicular cancer, with increased risk in men with oligozoospermia based on concentration (HR=11.9) and sperm count (HR=10.3). Men in the in the lowest quartile of motility (HR=4.1), viability (HR=6.6), morphology (HR=4.2) or total motile count (HR=6.9) have higher risk of testicular compared to fertile men. Men with sperm concentration and count in the 90th percentile of the distribution (≥178 M/ml and ≥579, respectively) and total motile count (TMC) have an increased risk of melanoma (HRConcentration=2.1; HRCount=2.7; HRTMC=2.0). We find no differences in cancer risk between azoospermic and fertile men. Conclusions Men with SA have an increased risk of testicular cancer that varies by semen quality. Unlike prior work, we did not find an association between azoospermia and increased cancer or testicular cancer risk. Capsule Subfertile men have an increased risk of testicular cancer that varies by semen quality. We did not find an association between azoospermia and increased cancer or testicular cancer risk.

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