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Effect of obstructive sleep apnea on semen quality

  • Sleep Breathing Physiology and Disorders • Original Article
  • Published:
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Abstract

Background

Obstructive sleep apnea (OSA) has several notable complications such as hypertension and diabetes. Studies have also shown that OSA is associated with erectile dysfunction and reduced androgen levels. However, the effect of OSA on semen quality remains poorly studied.

Methods

Men attending a tertiary reproductive center for semen analysis were tested with a portable sleep breathing monitor. Patients were divided into four groups based on their apnea hypopnea index: none, mild, moderate, and severe obstructive sleep apnea. Differences between groups were assessed using χ2, and associations were tested with multiple regression analysis.

Results

We included a total of 175 male subjects with a mean age of 32.2 ± 3.6 years. There were significant differences between groups in progressive sperm motility (%) (43 ± 16, 42 ± 17, 36 ± 18, 29 ± 18, respectively; p = 0.002), total motility (%) (59 ± 19, 59 ± 20, 49 ± 21, 42 ± 20, respectively; p = 0.010), and vitality (%) (80 ± 10, 81 ± 11, 79 ± 8, 72 ± 19, respectively; p = 0.039). Asthenospermia (progressive motility < 35%) was significantly more common in subjects with OSA (χ2 = 5.195, p = 0.023). In multiple regression models, after adjusting for age and body mass index, apnea hypopnea index remained negatively and significantly associated with progressive motility, total motility, and vitality.

Conclusions

OSA is an independent risk factor for sperm motility and vitality, and further investigation is now needed to determine if continuous positive pressure ventilation or other therapies can improve semen quality in these patients.

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Data availability

The datasets generated during and analysed during the current study are not publicly available due individual privacy but are available from the corresponding author on reasonable request.

Abbreviations

AHI:

Apnea-hypopnea index

BMI:

Body mass index

CPAP:

Continuous positive airway pressure

DFI:

DNA fragmentation index

ODI:

Oxygen desaturation index

OSA:

Obstructive sleep apnea

PR:

Progressive motility

SDB:

Sleep-disordered breathing

T90:

Percentage of sleep time with SpO2 < 90%

WHO:

World Health Organization

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Acknowledgements

The authors would like to thank all the patients for participating in this study. The authors would also like to thank all the research assistants at the Reproductive Medicine Center and Department of Respiratory and Critical Care Medicine for their assistance in data collection. This study was funded by the National Natural Science Foundation of China (Nos. 81970082, 82270101).

Funding

This research was supported by grants from the National Natural Science Foundation of China (Nos. 81970082, 82270101).

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Author notes

  1. Zehao Wang and Qingfeng Zhang are co-first authors and contributed equally.

Authors and Affiliations

  1. Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, 430060, China

    Zehao Wang, Jinli Ding, Sisi Yan, Wenyi Jin, Lingbo Luo, Qing Liu & Jing Yang

  2. Hubei Clinic Research Center for Assisted Reproductive Technology and Embryonic Development, Wuhan, 430060, China

    Zehao Wang, Jinli Ding, Sisi Yan, Wenyi Jin, Lingbo Luo, Qing Liu & Jing Yang

  3. Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China

    Qingfeng Zhang, Shiqian Zha, Zongyue Zhang, Hao Chen & Ke Hu

Authors
  1. Zehao Wang
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Contributions

ZW and QZ contributed to study design, data collection, data analysis and drafting the manuscript. JY and KH contributed to correcting the manuscript, final approval, and obtaining funding. JD, SY, WJ, SZ, LL, QL, ZZ and HC contributed to data collection and cleaning.

Corresponding authors

Correspondence to Jing Yang or Ke Hu.

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Ethical approval

The research protocol was approved by the Ethics Committee of Renmin Hospital of Wuhan University and has been performed in accordance with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare that they have no conflict of interest.

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Wang, Z., Zhang, Q., Ding, J. et al. Effect of obstructive sleep apnea on semen quality. Sleep Breath 27, 2341–2349 (2023). https://doi.org/10.1007/s11325-023-02847-8

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