title: Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data.
abstract: OBJECTIVE
  To determine the incidence of chronic medical conditions of men with infertility.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Subjects contained within the Truven Health MarketScan claims database from 2001 to 2009.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  The development of chronic medical conditions including hypertension, diabetes, hyperlipidemia, renal disease, pulmonary disease, liver disease, depression, peripheral vascular disease, cerebrovascular disease, heart disease, injury, alcohol abuse, drug abuse, anxiety disorders, and bipolar disorder.
  
  
  RESULTS
  In all, 13,027 men diagnosed with male factor infertility were identified with an additional 23,860 receiving only fertility testing. The average age was 33.1 years for men diagnosed with infertility and 32.8 years for men receiving testing alone. After adjusting for confounding factors, men diagnosed with male factor infertility had a higher risk of developing diabetes (hazard ratio [HR] 1.30, 95% confidence interval [CI] 1.10-1.53), ischemic heart disease (HR 1.48, 95% CI 1.19-1.84), alcohol abuse (HR 1.48, 95% CI 1.07-2.05), and drug abuse (1.67, 95% CI 1.06-2.63) compared with men who only received infertility testing. Similar patterns were identified when comparing those with male factor infertility to vasectomized men. The association between male factor infertility and later health outcomes were strongest for men with longer follow-up.
  
  
  CONCLUSIONS
  In this cohort of patients in a national insurance database, men diagnosed with male factor infertility had a significantly higher risk of adverse health outcomes in the years after an infertility evaluation. These findings suggest the overall importance of men's reproductive health and warrant additional investigation to understand the association and identify interventions to improve outcomes for these patients.
authors.affiliation: Departments of Urology and Obstetrics/Gynecology, Stanford University School of Medicine, Stanford, California. Electronic address: eisenberg@stanford.edu.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Eisenberg
authors.affiliation: Departments of Urology and Dermatology, Stanford University School of Medicine, Stanford, California.
authors.forename: Shufeng
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Internal Medicine, Stanford University School of Medicine, Stanford, California.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
authors.affiliation: Department of Health Research and Policy, Stanford University, Stanford, California and National Bureau of Economic Research, Cambridge, Massachusetts.
authors.forename: Laurence C
authors.initials: LC
authors.lastname: Baker
mesh_terms: D000293:Adolescent; D000328:Adult; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D016208:Databases, Factual; D006304:Health Status; D006801:Humans; D015994:Incidence; D007248:Infertility, Male / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D007348:Insurance, Health; D008297:Male; D054526:Men's Health / Q000639:trends*; D008875:Middle Aged; D011379:Prognosis; D060728:Reproductive Health / Q000639:trends*; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Male infertility; azoospermia; diabetes; fertility; ischemic heart disease; oligospermia