Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population

Reproductive Medicine Network

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. Design: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). Setting: Infertility clinics. Patient(s): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. Intervention(s): None. Main Outcome Measure(s): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. Result(s): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318–520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12). Conclusion(s): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. Clinical Trial Registration Number: NCT01044862.

Original languageEnglish (US)
Pages (from-to)1129-1134
Number of pages6
JournalFertility and sterility
Volume111
Issue number6
DOIs
StatePublished - Jun 1 2019

Fingerprint

Insemination
Live Birth
Semen
Infertility
Testosterone
Ovulation Induction
Population
Spermatozoa
Pregnancy
Semen Analysis
Birth Rate
Spermatogenesis
Multicenter Studies
Fertility
Fasting
Body Mass Index
Randomized Controlled Trials
Logistic Models
Outcome Assessment (Health Care)
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

@article{c21f0e1ba5ea4a8cb758e6b7aa1a77c2,
title = "Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population",
abstract = "Objective: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. Design: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). Setting: Infertility clinics. Patient(s): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. Intervention(s): None. Main Outcome Measure(s): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. Result(s): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318–520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4{\%} strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95{\%} confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95{\%} CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40{\%}. Among couples whose male partner had low TT, 21 (18.8{\%}) had a live birth, compared with 184 (27.5{\%}) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40{\%} in couples whose male partner had low TT (unadjusted OR, 0.60; 95{\%} CI, 0.36, 1.00; adjusted OR, 0.65; 95{\%} CI, 0.38, 1.12). Conclusion(s): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. Clinical Trial Registration Number: NCT01044862.",
author = "{Reproductive Medicine Network} and Trussell, {J. C.} and Coward, {R. Matthew} and Nanette Santoro and Christy Stetter and Allen Kunselman and Diamond, {Michael P.} and Hansen, {Karl R.} and Krawetz, {Stephen A.} and Richard Legro and Dan Heisenleder and James Smith and Anne Steiner and Robert Wild and Peter Casson and Cristos Coutifaris and Alvero, {Reuben R.} and Robinson, {R. B.} and Greg Christman and Pasquale Patrizio and Heping Zhang and Lindgren, {Mark C.}",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.fertnstert.2019.01.034",
language = "English (US)",
volume = "111",
pages = "1129--1134",
journal = "Fertility and Sterility",
issn = "0015-0282",
publisher = "Elsevier Inc.",
number = "6",

}

Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population. / Reproductive Medicine Network.

In: Fertility and sterility, Vol. 111, No. 6, 01.06.2019, p. 1129-1134.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Association between testosterone, semen parameters, and live birth in men with unexplained infertility in an intrauterine insemination population

AU - Reproductive Medicine Network

AU - Trussell, J. C.

AU - Coward, R. Matthew

AU - Santoro, Nanette

AU - Stetter, Christy

AU - Kunselman, Allen

AU - Diamond, Michael P.

AU - Hansen, Karl R.

AU - Krawetz, Stephen A.

AU - Legro, Richard

AU - Heisenleder, Dan

AU - Smith, James

AU - Steiner, Anne

AU - Wild, Robert

AU - Casson, Peter

AU - Coutifaris, Cristos

AU - Alvero, Reuben R.

AU - Robinson, R. B.

AU - Christman, Greg

AU - Patrizio, Pasquale

AU - Zhang, Heping

AU - Lindgren, Mark C.

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Objective: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. Design: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). Setting: Infertility clinics. Patient(s): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. Intervention(s): None. Main Outcome Measure(s): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. Result(s): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318–520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12). Conclusion(s): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. Clinical Trial Registration Number: NCT01044862.

AB - Objective: To determine whether men with unexplained infertility and low total T (TT) have abnormal spermatogenesis and lower fecundity. Design: Secondary analysis of the prospective, randomized, multicenter clinical trial, Assessment of Multiple Intrauterine Gestations from Ovarian Stimulation (AMIGOS). Setting: Infertility clinics. Patient(s): Nine hundred couples with unexplained infertility enrolled in AMIGOS. Semen analysis with an ejaculate of at least 5 million total motile sperm was required for enrollment. For inclusion in this secondary analysis, a fasting TT was required. Intervention(s): None. Main Outcome Measure(s): Logistic regression, adjusted for age and body mass index, assessed the association between low TT (defined as <264 ng/dL), semen parameters, and pregnancy outcome. Result(s): Seven hundred eighty-one men (mean age, 34.2 ± 5.7 years) with a median (interquartile range) TT of 411 (318–520) ng/dL were included. Men with TT <264 ng/dL were less likely to have normal (≥4% strict Kruger) morphology (unadjusted odds ratio [OR], 0.56; 95% confidence interval [CI], 0.34, 0.92; adjusted OR, 0.59; 95% CI, 0.35, 0.99). There was no association between low TT and semen volume < 1.5 mL, sperm concentration < 15 × 106/mL, or motility < 40%. Among couples whose male partner had low TT, 21 (18.8%) had a live birth, compared with 184 (27.5%) live births in couples with a male partner having TT > 264 ng/dL. The odds of live birth decreased by 40% in couples whose male partner had low TT (unadjusted OR, 0.60; 95% CI, 0.36, 1.00; adjusted OR, 0.65; 95% CI, 0.38, 1.12). Conclusion(s): In couples with unexplained infertility, low TT in the male partner was associated with abnormal sperm morphology and lower live birth rates. Clinical Trial Registration Number: NCT01044862.

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