Subclinical Hypothyroidism and Sperm DNA Fragmentation: A Cross-sectional Study of 5401 Men Seeking Infertility Care

J Clin Endocrinol Metab. 2022 Sep 28;107(10):e4027-e4036. doi: 10.1210/clinem/dgac458.

Abstract

Context: Our previous study showed that paternal subclinical hypothyroidism (SCH) had a detrimental effect on the clinical outcomes of assisted reproductive technologies. However, it remains to be determined whether paternal SCH affects sperm DNA integrity.

Objective: To investigate the association between SCH and sperm DNA fragmentation in men seeking infertility care.

Methods: This cross-sectional study included 4983 men with euthyroidism and 418 men with SCH seeking infertility treatment in a tertiary care academic medical center between January 2017 and December 2021. The outcome measures were the absolute DNA fragmentation index (DFI) and the risk of abnormal DFI (defined as DFI ≥ 25% or ≥ 30%).

Results: The mean (SD) age of men with euthyroidism and men with SCH was 34.20 (5.97) and 35.35 (6.48) years, respectively (P < 0.001). The difference in DFI was not statistically significant (adjusted mean: 19.7% vs 18.9% in the SCH and euthyroidism groups, respectively; P = 0.07) after confounder adjustment. A DFI ≥25% was significantly more frequent in men with SCH (20.57%) than in men with euthyroidism (14.49%) after confounder adjustment [odds ratio (OR) 1.43 (95% CI 1.09-1.88)]. DFI ≥ 30% was also significantly more common in men with SCH (11.72%) than in men with euthyroidism [6.74%; OR 1.84 (95% CI 1.34-2.52)]. In addition, thyroid-stimulating hormone concentration was significantly associated with an increased risk of having a DFI ≥25% (P < 0.001) or ≥30% (P = 0.011).

Conclusion: SCH was significantly associated with an increased risk of an abnormal DFI.

Keywords: sperm DNA fragmentation; sperm parameter; subclinical hypothyroidism; thyroid function.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cross-Sectional Studies
  • DNA / therapeutic use
  • DNA Fragmentation
  • Humans
  • Hypothyroidism* / complications
  • Hypothyroidism* / epidemiology
  • Infertility, Male* / drug therapy
  • Infertility, Male* / therapy
  • Male
  • Semen
  • Spermatozoa
  • Thyrotropin / therapeutic use

Substances

  • Thyrotropin
  • DNA