A Systematic Review and Meta-analysis on the Impact of Infertility on Men’s General Health

There is evidence of increased risks of death and comorbidities, such as cancer or cardiometabolic diseases, in infertile men compared with fertile ones. Male infertility assessment should be seen as an opportunity to improve secondary preventive strategies for overall men's health beyond the immediate reproductive goals. Male infertility has been associated with increased morbidity and mortality. To perform a systematic review and meta-analysis to provide the most critical evidence on the association between infertility and the risk of incident comorbidities in males. A systematic review and meta-analysis was performed according to the Meta-analysis of Observational Studies in Epidemiology and Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, and registered on PROSPERO. All published studies on infertile versus fertile men regarding overall mortality and risks of cancer, diabetes, and cardiovascular events were selected from a database search on PubMed, EMBASE, Google Scholar, and Cochrane. Forest plot and quasi-individual patient data meta-analysis were used for pooled analyses. A risk of bias was assessed using the ROBINS-E tool. Overall, an increased risk of death from any cause was found for infertile men (hazard risk [HR] 1.37, [95% confidence interval {CI} 1.04–1.81], p = 0.027), and a 30-yr survival probability of 91.0% (95% CI 89.6–92.4%) was found for infertile versus 95.9% (95% CI 95.3–96.4%) for fertile men (p