Civil war and male infertility in Lebanon

Objective To investigate the long-term impacts of the 15-year Lebanese civil war on male infertility. Design Clinic-based, case–control study, using reproductive history and risk factor interview data and laboratory-based semen analysis. Setting Two IVF clinics in Beirut, Lebanon, during an 8-month period (January–August 2003). Patient(s) One hundred twenty infertile male cases and 100 fertile male controls, distinguished by semen analysis and reproductive history. Intervention(s) None. Main Outcome Measure(s) Standard clinical semen analysis. Result(s) Infertile male cases were more likely than fertile controls to have lived through the Lebanese civil war and to have experienced war-related trauma (residence in bombing areas, participation in combat, injuries, kidnapping, and displacement from home). Cases had a 57% increase in their odds of exposure to civil war–related trauma. Conclusion(s) This case–control study demonstrates an association between the Lebanese civil war and male infertility. Wartime and postwar exposure to a number of potential reproductive risk factors—including toxins, injuries, and stress—is believed to be the main factor leading to this finding.