What Your Sperm May Reveal About Your Overall Health

From electrolytes and enzymes to cholesterol and glucose, your blood offers a snapshot into many aspects of your health, which is often why providers request it as part of your annual exam.

However, a growing body of evidence suggests another bodily fluid also may be an effective screening tool for the early detection of broader health issues in men: semen.

That's according to Dr. Akhil Muthigi, a urologist and male infertility specialist at Houston Methodist who is currently studying the connection between male infertility and the presence or increased risk of chronic medical conditions.

"Like a blood or urine test, a semen analysis is a test using a naturally produced bodily fluid that can relay important information about a man's health," says Dr. Muthigi. "Conventionally, semen analysis has only been employed as a tool in the diagnosis of male factor infertility or for men who are family planning and interested in knowing their sperm count."

"However, I see a potentially expanded role for semen analysis to become a health screening for young men that may allow for an earlier diagnosis and intervention for certain chronic conditions," he adds.

So what might your semen say about your health? Dr. Muthigi discusses the research behind this concept, what abnormalities in sperm quality could indicate and how to get involved in this study.

What does a sperm analysis typically look for and measure?

The quality of semen is measured not so much by visual markers (although volume is important) but more so through microscopic metrics: concentration, motility, vitality, morphology.

Concentration refers to the number of sperm per milliliter of semen, whereas motility refers to the ability and rate at which the sperm move or swim. As far as vitality goes, the meaning is in the name —it refers to the percentage of alive sperm. And finally, there's morphology, which refers to the size, shape and appearance of the sperm — whether they look normal or not.

According to Dr. Muthigi, if any of these metrics fail to meet the generally accepted percentile ranges set by the World Health Organization, the sample is considered "abnormal" and the patient follows up with a fertility specialist for further discussion and testing as needed. Research shows that most men with male factor infertility will have abnormalities in sperm concentration, morphology and motility.

In any case, Dr. Muthigi recommends at least two semen analysis tests before making any clinical decisions, in accordance with guidelines set by the American Urological Association.

Besides fertility, what might an abnormal semen analysis indicate about your health?

"At this point, we cannot state that the presence of male factor infertility or an abnormality on a semen analysis indicates the presence or absolute development of other chronic medical conditions," says Dr. Muthigi. "However, we can definitively state that male infertility is associated with a higher risk of developing other chronic medical conditions over time, including cancers such as prostate and testicular cancer, diabetes, cardiovascular disease, metabolic disorders and even depression."

One large-scale study involving more than 22,000 men revealed those with male factor infertility were twice as likely to be diagnosed with high-grade prostate cancer compared to the general population. Another study found that men seeking fertility treatment with male factor infertility had an increased risk of subsequently developing testicular cancer.

One study published in the journal Fertility and Sterility involving more than 36,000 men revealed that those diagnosed with male factor infertility had a higher risk of developing not only diabetes and ischemic heart disease, but also alcohol and drug abuse disorders.

"With respect to the [Fertility and Sterility] study and how it was designed, male factor fertility was found to be a predictor of future development of diabetes, ischemic heart disease and alcohol abuse," Dr. Muthigi says. "Therefore, a diagnosis of infertility preceded the development of these other conditions."

There is also evidence to suggest that male factor infertility may be a risk factor for poorer health overall and a higher likelihood of developing comorbidities — the presence of two or more diseases — over time, according to a study published in the journal European Urology. A significantly larger study, published in the journal Human Reproduction this month, concluded that men with higher counts of motile sperm could expect to live 2.7 years longer than men with low motile counts, further suggesting there may be a possible link between sperm abnormalities and overall health.

"It is likely that there are underlying genetic and environmental risk factors that lead to the development of male infertility and other chronic conditions over time," he continues. "Therefore, a semen analysis and detection of male factor fertility can potentially be utilized as a 'window' into the body to prompt further investigation of other underlying medical conditions or initiate preventative measures early on."

What happens if my sperm analysis results are abnormal?

Male infertility, meaning an abnormality detected on a semen analysis, is quite common, according to the World Health Organization. It states that roughly 1 in 6 people worldwide, almost equally male and female, will experience infertility at some point in their lives.

The causes of male infertility are vast, ranging from congenital disorders present at birth such as genetic abnormalities to acquired disorders, such as infections, trauma and erectile dysfunction.

But as far as future disease development goes, Dr. Muthigi says male factor infertility detected through a semen analysis may prompt an individual to establish care with a primary care physician; seek further screening tools for conditions such as prostate cancer, diabetes, heart disease or sexual dysfunction; employ more routine self-check exams for testicular cancer; and incorporate health lifestyle changes through diet, exercise, sleep and stress reduction.

Should you get your sperm tested?

Research has shown that overtesting and screening can lead to unnecessary anxiety and costs. However, Dr. Muthigi says that semen analysis "at face value" meets the criteria of a "good screening test" — one that's accurate, safe, cost-effective and has the potential to improve health outcomes "when employed in the proper patient population."

Dr. Muthigi says his research has yet to determine which groups constitute that proper patient population. He says that will only be determined through further study.

"With the idea of utilizing semen analysis as a potential screening tool to predict future development of certain diseases or conditions, it naturally follows that this should be employed in a younger patient population, approximately ages 18 to 45, prior to development or advancement of these conditions," says Dr. Muthigi. "However, we as a field have yet to determine the age group or groups that would benefit the most from this initial screening."

So could sperm quality really prove to be a "canary in the coalmine" for future disease risk?

"That is our goal," says Dr. Muthigi, "For Houston Methodist to be the first center to introduce semen analysis as a screening diagnostic test for overall health in men."

Dr. Muthigi says a semen analysis could be employed every few years — similar to a pap smear, but with more frequent assessment if any abnormalities are detected.

"This is a novel concept with high potential, and participation in the research is currently open to all men who establish care within the Houston Methodist Men's Health Center and are interested," he says.