The Relationship between Anogenital Distance, Fatherhood, and Fertility in Adult Men

Abstract

BackgroundAnogenital distance (AGD), a sexually dimorphic measure of genital development, is a marker for endocrine disruption in animal studies and may be shorter in infant males with genital anomalies. Given the correlation between anogenital distance and genital development, we sought to determine if anogenital distance varied in fertile compared to infertile adult men.MethodsA cross sectional study of consecutive men being evaluated for infertility and men with proven fertility was recruited from an andrology clinic. Anogenital distance (the distance from the posterior aspect of the scrotum to the anal verge) and penile length (PL) were measured using digital calipers. ANOVA and linear regression were used to determine correlations between AGD, fatherhood status, and semen analysis parameters (sperm density, motility, and total motile sperm count).FindingsA total of 117 infertile men (mean age: 35.3±17.4) and 56 fertile men (mean age: 44.8±9.7) were recruited. The infertile men possessed significantly shorter mean AGD and PL compared to the fertile controls (AGD: 31.8 vs 44.6 mm, PL: 107.1 vs 119.5 mm, p<0.01). The difference in AGD persisted even after accounting for ethnic and anthropomorphic differences. In addition to fatherhood, on both unadjusted and adjusted linear regression, AGD was significantly correlated with sperm density and total motile sperm count. After adjusting for demographic and reproductive variables, for each 1 cm increase in a man's AGD, the sperm density increases by 4.3 million sperm per mL (95% CI 0.53, 8.09, p = 0.03) and the total motile sperm count increases by 6.0 million sperm (95% CI 1.34, 10.58, p = 0.01). On adjusted analyses, no correlation was seen between penile length and semen parameters.ConclusionA longer anogenital distance is associated with fatherhood and may predict normal male reproductive potential. Thus, AGD may provide a novel metric to assess reproductive potential in men.

Fetal programming of adult Leydig cell function by androgenic effects on stem/progenitor cells

“…This data fits with growing evidence that subtle deficiency in fetal androgens is a major determinant of adult male reproductive disorders, such as low sperm production (16,17), and might explain why low sperm counts are often associated with compensated Leydig cell failure in men (18). However, the mechanisms through which fetal events could influence adult testosterone levels are unknown.…”

Growth and reproductive development of male piglets are more vulnerable to midgestation maternal stress than that of female piglets12

“…In human men, reduced anogenital distance is associated with reduced fertility and may be associated with cryptorchidism (Hsieh et al, 2008;Eisenberg et al, 2011) and reduced semen quality (Mendiola et al, 2011). In this study, ANO was longer in the males from Companion sows than males from Mixed sows and tended to be longer in the males from Companion sows than males from Stable sows.…”

Genetic and Anthropometrical Evidences in Infertile Male

“…This study is supported by a study done by Deborah Zabarenko et al, in 2011 published in EHP Environmental health perspectives) in which they found that men having AGD less than 2 inches 52mm) have seven times more chances of being sub-fertile as those with longer AGD. In other research work published in the same year by Michael Eisenberg et al, revealed that fatherhood is associated with the longer AGD and may predict the normal male potential and AGD was significantly correlated with total motile sperm count and with sperm density (Michael et al, 2011). Hsieh et al, (2008) revealed that boys having less anogenital distance have genital anomalies (i.e.…”