Infertile Men Have Higher Prostate-specific Antigen Values than Fertile Individuals of Comparable Age. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Infertile men are at greater risk for oncological and nononcological chronic disease than fertile individuals. OBJECTIVE: To investigate prostate-specific antigen (PSA) values in men presenting for primary couple's infertility compared with a cohort of fertile individuals, according to the recommendation of the European Association of Urology guidelines that a first PSA assessment should be done at 40-45 yr of age. DESIGN, SETTING, AND PARTICIPANTS: This is a cross-sectional study. Data from 956 (90%) infertile men and 102 (9.6%) fertile participants were analysed. Circulating hormones, total PSA, and semen parameters were investigated in every man. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Descriptive statistics, local polynomial smoothing, and linear regression models were used to test potential associations with PSA levels. RESULTS AND LIMITATIONS: Overall, PSA >1 ng/ml was found in 318 (30%) men. Serum PSA was higher (p = 0.02), while serum testosterone (p < 0.01) was lower in infertile than in fertile men. In participants younger than 40 yr, 176 (27%) men had PSA >1 ng/ml; of them, a greater proportion were infertile (28% infertile vs 17% fertile, p = 0.03). At multivariable linear regression analysis, infertile status (coefficient 0.21; 95% confidence interval 0.02-0.39) was associated with higher PSA values, after adjusting for age and serum testosterone level. This was a single-centre study, raising the possibility of selection biases. CONCLUSIONS: Infertile men have higher PSA values than fertile individuals. Of all, almost one out of three primary infertile men younger than 40 yr has a first total PSA value of >1 ng/ml. PATIENT SUMMARY: In this study, we observed that (1) infertile men have higher prostate-specific antigen (PSA) values than fertile individuals and (2) a greater proportion of infertile men younger than 40 yr had total PSA >1 ng/ml at the first assessment. These data might be relevant to study the potential clinical impact of more rigorous screening in primary infertile men.

publication date

  • August 17, 2020

Research

keywords

  • Infertility, Male
  • Prostate-Specific Antigen

Identity

Scopus Document Identifier

  • 85089446110

Digital Object Identifier (DOI)

  • 10.1016/j.eururo.2020.08.001

PubMed ID

  • 32814638

Additional Document Info

volume

  • 79

issue

  • 2