Male Fertility Under Fire- the Association between Semen Parameters and Armed Conflict Related Stress: A Population-Based Study
AWARD NOMINEE

Introduction: Psychological stress has been established as having a negative impact on fertility. However, the association between psychological stress and semen quality has not been studied extensively. In recent years the civilian population of Southern Israel experienced multiple alert sirens and rocket fire on a daily basis creating a stressogenic environment.

Aim: To investigate whether the population exposure to stress, peaking during two large military operations (MO), was associated with poor semen quality.

Materials & Methods: Data of 11,195 consecutive semen analyses taken between 2009-2017 were analyzed. MO-adjacent samples were defined as those obtained during the MO and the two subsequent months following cease-fire. Multivariate analysis was performed using Logistic Regression models.

Results: Comparison of 659 MO-adjacent semen samples with 10,536 samples obtained during the rest of the period showed similarity in mean patient age (31.8±7.8 vs. 32.1±8.1 years, respectively, p=0.246), BMI (26.1±4.7 vs. 26.1±8.1, p=0.813) and smoking (44.2% vs. 43.5%, p=0.320). In the MO-adjacent group, mean total motility was lower (47.4%±22.9% vs. 49.5%±22.0%, p=0.019), as well as mean progressive motility (39.7%±21.5% vs. 43.3%±21.5%, p<0.001) and mean normal sperm forms (3.4%±1.9% vs. 3.7%±2.3%, p=0.010). Prevalence of low progressive motility was higher in the MO-adjacent group (37.5% vs. 30.8%, p<0.001). In multivariate analysis, MO adjacency adjusted for age, BMI and smoking was associated with low progressive motility (adjusted O.R=1.47 C.I 95% 1.16-1.61).

Conclusion The results of this ecological study show that acute psychological stress can potentially impact sperm quality, resulting in decreased sperm motility and reduced normal sperm forms.