Associations between testosterone, bone mineral density, vitamin D and semen quality in fertile and infertile Chinese men

Abstract

Testosterone (T) and vitamin D (VD) interact in androgen deficient men, however, this interaction and subsequent semen quality and bone mineral density (BMD) status is not clear in infertile men. Our objective was to investigate T, VD, semen quality, BMD and their relationships in Chinese infertile men. We conducted a cross-sectional study of 559 men aged 20-40 years, including 195 fertile men, 9 infertile men with known risk factors for osteoporosis (WR) and 355 infertile men without known risk factors for osteoporosis (WOR). WOR infertile men constituted 314 oligo-, astheno-, teratospermic or normospermic infertile men (OATN men) and 41 non-obstructive azoospermic men (NOA men). Differences of parameters were assessed, and the relationships were adjusted by multiple linear regression. WOR infertile men had significantly lower T, lumbar spine and total hip BMD than fertile men (all p < 0.05). Bioavailable T (Bio-T) and 25-hydroxyvitamin D [25(OH)D] were independent determinants of BMD in WOR infertile men (all p < 0.01) but not in fertile men. After stratifying Bio-T, WOR infertile men had lower BMD than fertile men (all p < 0.05) in low Bio-T subgroups (Bio-T ≤ 11.6 nmol/L), but not high Bio-T subgroups (Bio-T > 11.6 nmol/L). 25(OH)D was an independent determinant of sperm motility and morphology in WOR OATN men (all p < 0.05), with only borderline significance in fertile men(motility: p = 0.047; morphology: p = 0.056). T determined sperm concentration (square root) and morphology in WOR OATN men (all p < 0.001). No correlations between T and 25(OH)D were found in all groups. We suggest that infertile men have lower T and BMD than fertile men. 25(OH)D and T were associated with low BMD and poor semen quality in infertile men.

Association of vitamin D status with semen quality and reproductive hormones in Iranian subfertile men

“…Most reports consisted of cross-sectional studies in healthy men and the general population with discordant results (Blomberg Jensen et al, 2011;Ramlau-Hansen et al, 2011;Hammoud et al, 2012). Recent studies reported a relationship between vitamin D and poor semen quality in infertile men (Yang et al, 2012;Tak et al, 2015). In addition, an association between vitamin D and serum androgen has been reported (Wehr et al, 2010).…”

Vitamin D and assisted reproduction technologies: current concepts

“…The results, however, were quite discordant (Table 1). A single cross-sectional study [31] has also investigated the relationship between vitamin D status and semen parameters in a population of n = 364 infertile men as compared to n = 195 age-matched fertile controls. Interestingly, after adjustment for some relevant confounders, statistically significant associations were observed between 25(OH)D levels and sperm motility (Spearman’s coefficient = 0.12, p = 0.03) and morphology (Spearman’s coefficient = 0.12, p = 0.03) in infertile men (Table 1).…”

Vitamin D and gonadal function in men: a potential inverse U‐shaped association?

“…In a Danish study (n = 300), men with vitamin D deficiency [25(OH)D < 25 nM] had a lower proportion of motile, progressive motile and morphologically normal spermatozoa compared with those with 25 (OH)D concentrations >75 nM (Blomberg Jensen et al, 2011). In a Chinese study (n = 559), 25(OH)D concentrations were independently associated with sperm motility and morphology, only in infertile men (Yang et al, 2012).…”

“…Gonadal function Ramlau-Hansen, 2011 Hammoud, 2012 studies have reported no association between bioavailable testosterone and 25(OH)D concentrations in both fertile and infertile men (Yang et al, 2012). Moreover, no difference in vitamin D status was found in men with congenital hypogonadotropic hypogonadism compared with healthy controls (Meric et al, 2014).…”