Low Birth Weight Is Associated with a Decreased Overall Adult Health Status and Reproductive Capability – Results of a Cross-Sectional Study in Primary Infertile Patients

Abstract

Individuals born with low birth weight (LBW) risk cardiometabolic complications later in life. However the impact of LBW on general health status and male reproductive function has been scantly analysed. We investigated the clinical and seminal impact of different birth weights (BW) in white-European men presenting for primary couple’s infertility. Demographic, clinical, and laboratory data from 827 primary infertile men were compared with those of 373 consecutive fertile men. Patients with BW ≤2500, 2500–4200, and ≥4200gr were classified as having LBW, normal (NBW), and high BW (HBW), respectively. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Testicular volume was assessed with a Prader orchidometer. Semen analysis values were assessed based on 2010 WHO reference criteria. Descriptive statistics and regression models tested associations between semen parameters, clinical characteristics and BW categories. LBW, NBW and HBW were found in 71 (8.6%), 651 (78.7%) and 105 (12.7%) infertile men, respectively. LBW was more frequent in infertile patients than fertile men (p = 0.002). Infertile patients with LBW had a higher rate of comorbidities (p = 0.003), lower mean testicular volume (p = 0.007), higher FSH (p = 0.02) and lower tT levels (p = 0.04) compared to other BW groups. Higher rates of asthenozoospermia (p = 0.02) and teratozoospermia (p = 0.03) were also found in LBW men. At logistic regression models, LBW was univariably associated with pathologic progressive motility (p≤0.02) and pathologic sperm morphology (p<0.005). At multivariable logistic regression analysis, LBW achieved independent predictor status for both lower sperm motility and pathologic sperm morphology (all p≤0.04). Only LBW independently predicted higher CCI values (p<0.001). In conclusion, we found that LBW was more frequent in infertile than in fertile men. Infertile individuals with LBW showed a higher rate of comorbidities and significantly worse clinical, endocrine and semen parameters compared to other BW groups.

Fertility in adult men born with hypospadias: A nationwide register‐based cohort study on birthrates, the use of assisted reproductive technologies and infertility

“…[6][7][8][9][10][11] Being born small for gestational age and having low birth weight are common features among patients with hypospadias [12][13][14] and have also been suggested to increase the risk of subsequent male infertility and need of assisted reproductive technologies (ART). 15,16 Paternal subfertility and the use of ART are suggested risk factors for hypospadias, and it is plausible that subfertility traits in the father may be transferred to the son. 17,18,19,20 As previously mentioned, few previous studies have investigated the paternity rate in men with hypospadias.…”

Nutritional adversity, sex and reproduction: 30 years of DOHaD and what have we learned?

“…These infertile LBW men had reduced sperm motility and abnormal sperm morphology, lower total testosterone levels but higher FSH values, compared with average or high birth weight men. Interestingly, these LBW male patients reported a higher rate of significant comorbidities and reduced left testicular volume and also presented with higher BMI (Boeri et al 2016). It may be that part of association between reproductive deficits and LBW could be accounted for by an increased prevalence of obesity, which occurs concomitantly with metabolic dysfunction, since LBW increases obesity risk, and obesity in men is known to impair reproductive capacity (Palmer et al 2012).…”

Maternal protein malnutrition: effects on prostate development and adult disease

“…86 Recently, a cross-sectional study observed reduced sperm motility and higher rates of abnormal sperm morphology, including asthenozoospermia and teratozoospermia in adult infertile individuals born with low birth weight. 11 Other findings were higher follicle stimulating hormone (FSH) values, lower mean testicular volume, as well as lower testosterone levels in adulthood. 87 Although there are controversies regarding the relationship between the developmental environment and postnatal reproductive function in men, this evidence suggests that early life events may contribute to male infertility.…”

“…5,8,10 For example, a cross-sectional study has shown that low birth weight is associated with decreased overall adult health status as well as reduced reproductive capability. 11 Although birth weight is a poor proxy for nutritional events during gestation, the Barker hypothesis has been confirmed in many independent cohorts across the developed and developing world. [12][13][14] Similarly, the 'thrifty phenotype' hypothesis proposes that poor fetal nutrition imposes mechanisms of nutritional economy upon the growing individual.…”