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Какие мужчины рискуют не дожить до 50 лет

Датские ученые из Копенгагенского университета обнаружили связь между ранней смертностью и азооспермией - отсутствием сперматозоидов в семенной жидкости у мужчин. Средняя продолжительность жизни у мужчин с азооспермией составляет всего 48,8 лет, установили исследователи.

Влияние бесплодия на продолжительность жизни у представителей сильного пола специалисты обнаружили, проанализировав данные 50 тысяч мужчин, лечившихся в клиниках Дании с 2006 по 2015 годы. В результате ученые заключили, что «фертильность является показателем мужского здоровья в целом». Наиболее тревожным маркером плохого состояния организма и низкой продолжительности жизни является азооспермия, убеждены исследователи. По их мнению, мужчины с таким диагнозом должны проходить полное обследование состояния здоровья.

Мужчины, чье здоровье отслеживалось в рамках проекта, были поделены на несколько групп. В первую вошли мужчины с азооспермией,  во вторую - мужчины с олигоспермией (сниженная концентрация сперматозоидов) в третью - мужчины с нормальным количеством сперматозоидов в эякуляте, в четвертую - мужчины после, вазэктомии, в пятую - мужчины с другими проблемами фертильности. Выяснилось, что мужчины из первой группы больше остальных склонны к раннему уходу из жизни - они часто умирают, не дожив до 50 лет.

«Риск умереть, не дожив до старости, у мужчин с азооспермией вдвое выше, чем у остальных. Чаще всего мужчины с азооспермией умирают от рака или сердечно-сосудистых заболеваний», - констатировали авторы работы.

Ученые полагают, что бесплодие связано с высоким риском смертности в силу генетических факторов. Эта проблема требует дальнейших исследований, пояснили они.


Good Semen Quality and Life Expectancy: A Cohort Study of 43,277 Men


Fertility status may predict later mortality, but no studies have examined the effect of semen quality on subsequent mortality. Men referred to the Copenhagen Sperm Analysis Laboratory by general practitioners and urologists from 1963 to 2001 were, through a unique personal identification number, linked to the Danish central registers that hold information on all cases of cancer, causes of death, and number of children in the Danish population. The men were followed until December 31, 2001, death, or censoring, whichever occurred first, and the total mortality and cause-specific mortality of the cohort were compared with those of all age-standardized Danish men or according to semen characteristics. Among 43,277 men without azospermia referred for infertility problems, mortality decreased as the sperm concentration increased up to a threshold of 40 million/mL. As the percentages of motile and morphologically normal spermatozoa and semen volume increased, mortality decreased in a dose-response manner ( P trend < 0.05). The decrease in mortality among men with good semen quality was due to a decrease in a wide range of diseases and was found among men both with and without children; therefore, the decrease in mortality could not be attributed solely to lifestyle and/or social factors. Semen quality may therefore be a fundamental biomarker of overall male health.



Infertile men may have a higher risk of early death

Infertile men may have a higher risk of early death

Men with a certain type of infertility have a much higher risk of premature death, a sobering new study reveals. 

Those who have no sperm in their semen - about 15 percent of male infertility cases - have an average life expectancy of 48.8 years old, according to data on more than 50,000 Danish men from 2006 to 2015.

Up until a few years ago, male fertility issues were lumped into one category, until research showed that there are three broad categories.

Lead researcher Dr Clara Helene Glazer said her team was stunned that this one category, known as azoospermia, carried such high mortality risks while the other categories didn't. 

While there is nothing to show why this is the case, Dr Glazer said it may be due to underlying genetic factors. 

Men with no sperm in their semen (a condition called azoospermia) have a two times greater risk of dying than men with other fertility issues, and fertile men

'I was quite surprised that the azoospermic men had such a high risk,' Dr Glazer told DailyMail.com. 

'The strongest hypothesis that the association between male infertility and mortality could be due to common underlying genetic factors.

'Certainly, more research is needed to identify interventions that could ultimately improve the health outcomes of these men.' 

Dr Glazer, a medical doctor based in Copenhagen, started a PhD two years ago to find some answers about how male infertility influences, or is influenced by, general health.

Her first work showed male infertility was linked to higher risks of certain diseases, including heart disease and diabetes. 

This study was to look further: what were the mortal impacts of that connection?  

About one percent of men in the world are azoospermic, but among men with fertility issues it's not so uncommon - accounting for about one in six. 

Azoospermia is characterized by a total lack of sperm in the man's semen. 

The most common reason for this is a blockage in their anatomy that prevents sperm from entering the semen, known as obstructive azoospermia. Fewer have non-obstructive azoospermia, which is usually explained by genetic abnormalities with the testicles. 

Oligospermia is a low sperm count which can be linked to various factors including restricted veins, sexually-transmitted infections, drug use, hormone imbalances, high BMI, exposure to chemicals - the list goes on. 

Though the conditions are distinct, Dr Glazer said she presumed there would be a mortality risk for both men and women. 

Infertility is linked to all manner of life-threatening conditions in women, and is usually caused by factors that would likely be affecting the rest of the body.  

The data, being presented this week at the American Society for Reproductive Medicine (ASRM) conference in Denver, categorized men into groups of azoospermic, oligospermic, normal, vasectomized, or those with other fertility issues. 

They only included men from 2006 onwards, which was when fertility clinics started categorizing men into groups of azoospermia, oligospermia, or other. Prior to that, oligospermia and azoospermia were lumped together, or azoospermia was not included because they could be azoospermic due to vasectomy.

They found men with azoospermia had a two times greater risk of dying than the rest, mostly to cancer or cardiovascular disease.

To their surprise, men with oligospermia or other types of infertility had the same life expectancies as fertile or vasectomized men. 

'Based on our previous studies, and other studies in the field, we were expecting also to find a higher risk among men that had oligospermia. We found a slightly increased risk, but not like we had expected.' 

Dr Glazer believes there may be an early death risk for men with oligospermia, too, but their data does not extend long enough to determine that.  

These findings are part of a small but growing movement to research sperm more closely. 

'The risks of female infertility and general health has been studied quite a lot,' Dr Glazer explains. 'But the association between male infertility and general health is sort of new.' 

Plenty of that has to do with the industry's laser focus on females.  

Women are the headline act when it comes to fertility, since the vast majority of the reproduction process happens in their body, and all of that is monitored and documented, making it easier to study.  

Once ICSI was invented in the 1990s - a procedure that allows practitioners to literally inject the sperm into the egg - that seemed to solve any issues of slow swimming sperm or low sperm count, kicking the can of male fertility further down the road of research. 

Increasingly, though, it's becoming clear that there are many male-specific factors that need to be parsed out to improve fertility for all - a question becoming ever more pertinent as sperm quality and count declines globally and more men require fertility treatment to conceive. 

'A man's infertility status is a component of his whole health status,' said Peter Schlegel MD, ASRM president-elect. 

'Semen analysis results exist on a continuum, but a diagnosis of azoospermia may be a call to take a closer look at a man's overall health in addition to his reproductive function.' 

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  Дата публикации: 08.09.2018  

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