JBRA Assisted Reproduction 2025;29(Suppl.2 SBRA 2025):40
Poster Presentation
29^th Annual Congress of the SBRA. São Paulo/SP - Brazil, 2025
doi: 10.5935/1518-0557.20263568

P-28. Associations Between Sperm Quality Parameters and Lifestyle and Health-Related Factors in Men Undergoing Fertility Evaluation

Andrea Belo¹, Thiago Augusto C. L. Lofti¹, Martina C Stapenhorst¹, Isabela Mantelato¹, Leticia Tamashiro¹, Ana Carolina C Fernandes¹, Sabrina M Melo¹, Maria Eduarda R L Silva¹, Dóris Spinosa Chéles¹, Mauricio Barbour Chehin¹, Guilherme J A Wood¹, Thiago F Nunes¹, José Roberto Alegretti¹, Aline Rodrigues Lorenzon¹

¹Huntington Medicina Reprodutiva - Eugin Group - São Paulo - SP - Brasil

Objective: Sperm analysis is the standard test for male fertility assessment. A growing body of evidence highlights the influence of modifiable lifestyle, environmental, and health-related factors on male reproductive function. Behaviors such as smoking, alcohol consumption, physical activity levels, sleep quality and the use of medications or recreational drugs have been associated with alterations in semen parameters. Despite these associations, comprehensive clinical evaluations integrating these diverse factors remain limited. This study aims to investigate the relationship between sperm quality and a broad range of lifestyle, health, and environmental exposures in men undergoing fertility assessment.
Methods: This retrospective study included 2,004 semen analyses from 1,478 patients between September/2024 and July/2025 at two Brazilian ART centers. Seminal parameters — sperm concentration, progressive motility, morphology — and abstinence time were evaluated according to WHO 2021 guidelines. Concentration was categorized as severe (0–5 million/mL), moderate oligozoospermia (5–15 million/mL), or normal (≥16 million/mL); progressive motility <30% defined asthenozoospermia; morphology <4% (Kruger criteria) defined teratozoospermia. Clinical and lifestyle data were obtained from standardized patient intake forms, including age, body weight, varicocele diagnosis, previous urological surgery, tobacco and electronic cigarette use, alcohol consumption, physical activity, medication or drug use, and exposure to contact substances. Sleep variables included average sleep duration (hours/night), snoring, and presence or suspicion of sleep apnea. Associations between sperm quality and these variables were assessed using correlation analysis and multivariate logistic regression. Statistical significance was set at p<0.05.
Results: The mean patient age was 40.6±6.6 years, with 9% reporting tobacco use (7.4% conventional, 2.1% electronic), 3.7% reporting moderate or high alcohol consumption, and 62.4% engaging in regular physical activity. Sleep-related complaints were reported by 50.1% of patients, with a mean sleep duration <6 hours per night in 6.5% of cases; snoring and suspected sleep apnea were reported in 39.1% and 8.9% of cases, respectively. Exposure to contact substances and continuous medication use other than vitamins or food supplement use were reported in 4.0% and 34.0% of patients. Varicocele diagnosis and previous urological surgery were reported in 16.5% and 13.3% respectively. Mean time of abstinence was 2.0±2.8 days. Severe oligozoospermia, moderate oligozoospermia, and normal sperm count were observed in 15.4%, 12.9%, and 71.7% of cases, respectively. Asthenozoospermia was present in 18.1% of samples, and teratozoospermia in 93.3%, with 46.0% classified as severe (≤1% morphology). Logistic regression showed that varicocele (OR: 2.93, 95% CI [2.30–3.74], p<0.0001), previous history of surgery (OR: 2.09, 95% CI [1.60–2.72], p<0.0001), and medication use (OR: 1.30, 95% CI [1.06–1.59], p=0.012) were independently associated with increased odds of oligozoospermia. The presence of varicocele (OR: 0.36, 95% CI [0.28–0.48], p<0.001), history of surgery (OR: 0.49, 95% CI: 0.36–0.67, p<0.001), and medication use (OR: 0.76, 95% CI: 0.60–0.97, p=0.028) were significantly associated with lower odds of normal sperm motility. Class III obesity was also associated with reduced odds of normal motility (OR: 0.30, 95% CI: 0.12–0.72, p=0.006). In morphology parameters, being a smoker significantly higher the odds of abnormal sperm morphology (OR: 5.10 (95% CI: 1.23–21.18, p=0.025).
Conclusion: This study highlights the significant impact of clinical and lifestyle factors on sperm quality. Varicocele, prior urological surgery, and medication use were independently associated with reduced sperm concentration and motility, while class III obesity further impaired motility. Additionally, smoking markedly increased the likelihood of abnormal sperm morphology. These findings reinforce the importance of comprehensive reproductive assessments that include lifestyle, medical, and environmental exposures, and support the need for targeted counseling and preventive strategies to optimize male fertility outcomes.