A cohort study of 2,238 men who were evaluated for infertility at a clinic in Texas from 1989 to 2009 found that those men who had azoospermia, a condition in which no measurable sperm is present, had a 2.2-fold higher cancer risk compared with those who were nonazoospermic. The study was published online in the journal Fertility and Sterility.1
In all, 451 men had azoospermia and 1,787 were not azoospermic (mean age at evaluation = 35.7 years). The researchers found 29 cases of cancer, including testicular, prostate, and intestinal cancers, as well as lymphoma and melanoma, during an average follow-up of nearly 7 years.
The standardized incidence rate of cancer among infertile men was 1.7 times that of the general population, and when stratified by azoospermic status, men with azoospermia had substantially elevated risk of cancer (standardized incidence rate = 2.9). In contrast, men without azoospermia had an increased risk of 1.4 times that of men in the overall population.
“There are some data [showing] that the defects in sperm production are also seen in cancer syndromes, and based on that hypothesis, we linked the men in the cohort to the Texas Cancer Registry to see if the cancer incidence was higher in these azoospermic men than in nonazoospermic infertile men,” said Michael Eisenberg, MD, Assistant Professor of Urology at the Stanford School of Medicine and lead author of the study. According to Dr. Eisenberg, between 10% and 15% of infertile men will have azoospermia.
Infertility May Signal Other Health Problems
Infertility may signal other health problems. Infertile men should be vigilant about maintaining healthy lifestyles and be monitored and possibly screened for diseases like cancer, said Dr. Eisenberg.
“As our understanding of azoospermia and cancer increases, we can target some of these men to undergo genetic screenings and, hopefully, identify the ones at greatest risk [for developing cancer]. Unfortunately, this [understanding] is just in its infancy,” said Dr. Eisenberg. ■
Disclosure: Dr. Eisenberg reported no potential conflicts of interest. For full disclosures of all study authors, visit www.fertstert.org.
1. Eisenberg ML, Betts P, Herder D, et al: Increased risk of cancer among azoospermic men. Fertil Steril. June 24, 2013 (early release online).