The Association between HDL Cholesterol and Semen Parameters

It is well known that obesity, metabolic syndrome and hyperlipidemia are associated with higher prevalence of male infertility. In addition, abnormal lipid metabolism is associated with altered spermatogenesis, sperm maturation and capacitation.

This study is aimed to investigate the relationship between levels of High density lipoprotein (HDL) in the plasma and semen parameters.

A retrospective case-control study including data of 6,554 semen analyses collected between 2009 and 2017 as part of the basic fertility evaluation of 2,830 patients. . Twenty two hundred and twenty fourof the patients had a valid HDL test taken within ± 90daysof the semen analysis.

Patients were divided into two groups; above and below the cut-off value of 40 mg/dL HDL.

HDL ≥ 40 (high HDL) was found in 1,327 blood samples while HDL < 40 (low HDL) was found in 897 samples. Patients with low HDL levels had significantly higher BMI compared to those with high HDL levels (26.2±5.5, 27.7±5.3, respectively, p<0.001) and had significantly higher rates of diabetes mellitus (DM) and impaired fasting glucose (IFG) (DM - 7.8%, 10.8%, IFG – 5.4%, 5.9%, respectively, p=0.045).

The high HDL group had higher semen volume compared to the low HDL group (2.9±1.6, 2.7±1.6 respectively, p=0.003), and had a higher total motile count (80.5±104, 126.8±145.3 respectively, p=0.010).

Asthenozoospermia was more common in the low HDL group when compared with the high HDL group (34.5%, 39.0%, respectively, p=0.030). Using multiple logistic regression models, controlling for confounders, low HDL was found as independent risk factor for low seminal volume (OR 1.44, CI 1.14-1.82, p=0.002) and for asthenozoospermia (OR 1.22, CI 1.02-1.46, p=0.001 p=0.031).

Conclusion:

Low HDL levels are related to abnormal semen parameters, hence, increasing the HDL levels may improve male fertility.