Health issues in the Arab American community. Male infertility in Lebanon: a case-controlled study.
OBJECTIVE
The impact of risk factors, such as consanguinity and familial clustering, reproductive infections, traumas, and diseases, lifestyle factors and occupational and war exposures on male infertility, was investigated in a case-controlled study conducted in Lebanon.


METHODS
One-hundred-twenty males and 100 controls of Lebanese, Syrian or Lebanese-Palestinian descents were selected from two in-vitro fertilization (IVF) clinics located in Beirut, Lebanon. All cases suffered from impaired sperm count and function, according to World Health Organization guidelines for semen analysis. Controls were the fertile husbands of infertile women. Data were collected using a semi-structured interview, laboratory blood testing and the results of the most recent semen analysis. Univariate, bivariate and multivariate logistic regression analyses were used for data analysis, along with checks for effect modification and control of confounders.


RESULTS
Consanguinity and the familial clustering of male infertility cases, as well as reproductive illnesses and war exposures were independently significant risk factors for male infertility. The odds of having infertility problems in the immediate family were 2.6 times higher in cases than controls. The odds of reproductive illness were 2 times higher in cases than controls. The odds of war exposures were 1.57 times higher in cases than controls. Occupational exposures, such as smoking and caffeine intake, were not shown to be important risk factors.


CONCLUSIONS
This case-controlled study highlights the importance of investigating the etiology of male infertility in Middle Eastern communities. It suggests the need to expand research on male reproductive health in the Middle East in order to improve the prevention and management of male infertility and other male reproductive health problems.
Kobeissi
Loulou
L
Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
Inhorn
Marcia C
MC
D000328:Adult; D018912:Arabs; D016022:Case-Control Studies; D006801:Humans; D007248:Infertility, Male / Q000097:blood / Q000453:epidemiology / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D018456:Reproductive Medicine; D012307:Risk Factors; D012661:Semen / Q000378:metabolism