Work

Mp91-03 Increased Risk of Autoimmune Disorders in Infertile Men: Analysis of U.s. Claims Data

Year: 2016

Type: article

Abstract: You have accessJournal of UrologyInfertility: Epidemiology & Evaluation1 Apr 2016MP91-03 INCREASED RISK OF AUTOIMMUNE DISORDERS IN INFERTILE MEN: ANALYSIS OF U.S. CLAIMS DATA William D. Brubaker, Shufeng Li, Laurence C. Baker, and Michael L. Eisenberg William D. BrubakerWilliam D. Brubaker More articles by this author , Shufeng LiShufeng Li More articles by this author , Laurence C. BakerLaurence C. Baker More articles by this author , and Michael L. EisenbergMichael L. Eisenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2590AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Aberrations in reproductive fitness may be a harbinger of medical diseases in men. Existing data suggests that female infertility is associated with autoimmune disorders; however, this has not been examined in men. As immune surveillance and hormonal factors can impact male fertility and autoimmunity, we sought to determine the association between male infertility and incident autoimmune disorders. METHODS We analyzed subjects from the Truven Health MarketScan claims database from 2001 to 2008. Infertile men were identified through diagnosis and treatment codes. We examined the most common immune disorders, which were identified by ICD9 diagnosis codes. Men diagnosed with an immune disorder at baseline or within 1 year of follow-up were excluded. Infertile men were compared to vasectomized men (i.e. men who are likely fertile) and to and age-matched control (10:1) group using Cox regression analysis. RESULTS A total of 33,077 infertile men (mean age of 33 yrs), 77,693 vasectomized men (mean age 35), and 330,770 matched control men (mean age 33) were assembled with a total follow up of 1.49 M person years. Overall, immune disorders were rare in the group with the individual conditions occurring in <0.1% of men. However, infertile men displayed the highest risk of many conditions. Infertile men had a higher risk of developing rheumatoid arthritis compared to both vasectomized men (HR 1.56, 95% CI 1.19 - 2.05) and age-matched men (HR 1.29, 95% CI 1.02 - 1.62). Additionally this higher risk was seen in general immune disorders (under which systemic lupus erythematosus is categorized) compared to vasectomized men (HR 3.11, 95% CI 2.00 - 4.86) and age-matched men (HR 2.12, 95% CI 1.52 - 2.96). This same risk trend was seen in psoriasis, when compared to vasectomized men (HR 1.28, 95% CI 1.09 - 1.50) and age-matched group (HR 1.20, 95% CI 1.04 - 1.37). A similar trend was seen in the analysis comparing infertile men and vasectomized men in developing multiple sclerosis (HR 1.91, 95% CI 1.10 - 3.31) and Grave′s disease (HR 1.46, 95% CI 1.10 - 1.92); as well as the higher risk of infertile men compared to the age-matched group at developing thyroiditis (HR 1.60, 95% CI 1.02 - 2.52). CONCLUSIONS The current analysis shows that infertile men have a higher risk of developing certain autoimmune disorders in the years following an infertility evaluation. Specifically infertile men had higher rates of developing rheumatoid arthritis, multiple sclerosis, psoriasis, thyroiditis, and Grave′s disease. Given these findings, further research should focus on confirmation of these associations and elucidation of the pathways between fertility and immunity. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1153-e1154 Advertisement Copyright & Permissions© 2016MetricsAuthor Information William D. Brubaker More articles by this author Shufeng Li More articles by this author Laurence C. Baker More articles by this author Michael L. Eisenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Source: The Journal of Urology

DOI: 10.1016/j.juro.2016.02.2590

Authors: William D. Brubaker, Shufeng Li, Laurence C. Baker, Michael L. Eisenberg

Language: English

Topic: Sperm and Testicular Function

Subfield: Reproductive Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: bronze

Funders: National Institutes of Health, National Institute of Child Health and Human Development, Eunice Kennedy Shriver National Institute of Child Health and Human Development

Awards: G4741041465, K-12: Male Reproductive Health Research (MRHR) Career Development Program at BCM