Sociodemographic and lifestyle factors associated with semen status among men undergoing infertility evaluation
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20264005Keywords:
Azoospermia, Education, Lifestyle factors, Male infertility, Normozoospermia, Semen analysisAbstract
Background: Male infertility is multifactorial, and semen abnormalities may be associated with sociodemographic and lifestyle factors. This study evaluated associations between demographic, behavioural, lifestyle, and socioeconomic factors and distinct semen-status categories among men undergoing infertility evaluation.
Methods: An observational study was conducted among 501 men undergoing infertility evaluation at an infertility care centre, Raipur, from 2023 to 2026. Participants were classified as having normozoospermia, non-azoospermic abnormal semen parameters, or azoospermia. Sociodemographic, lifestyle, behavioural, and socioeconomic factors were assessed. Pearson’s chi-square test was used for unadjusted associations, followed by multinomial logistic regression with normozoospermia as the reference outcome. The model was adjusted for age, BMI, smoking, alcohol, smokeless tobacco, education, computer use, fast-food consumption, mobile-phone use, sleep duration, physical activity, and annual family income.
Results: Among 501 men, unadjusted analyses showed significant associations with smoking (p=0.002), alcohol consumption (p=0.007), educational attainment (p<0.001), and computer use (p=0.029). The multinomial regression model was significant (χ2=71.8, df=46, p=0.009; McFadden pseudo-R2=0.084). Educational attainment remained significantly associated with semen status (LR χ2=13.555, df=6, p=0.035). Low educational attainment was associated with higher adjusted odds of azoospermia compared with graduation-level education (AOR=3.617, 95% CI 1.098-11.920; p=0.035). No other individual adjusted comparison was statistically significant.
Conclusions: Smoking and alcohol consumption were significantly associated with semen status in unadjusted analyses. After adjustment, educational attainment remained significantly associated with semen status, with low education associated with higher odds of azoospermia. These findings highlight the relevance of lifestyle and sociodemographic factors in male infertility.
References
World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021.
Agarwal A, Baskaran S, Parekh N, Cho CL, Henkel R, Vij S, et al. Male infertility. Lancet. 2021;397:319-33.
Sharma R, Biedenharn KR, Fedor JM, Agarwal A. Lifestyle factors and reproductive health: taking control of your fertility. Reprod Biol Endocrinol. 2013;11:66.
Agarwal A, Gupta S, Du Plessis SS, Sharma R, Esteves SC, Cirenza C, et al. Lifestyle factors and male infertility: role of oxidative stress. Reprod Biol Endocrinol. 2016;14:70.
Durairajanayagam D. Lifestyle causes of male infertility. Arab J Urol. 2018;16:10-20.
Tesarik J. Lifestyle and environmental factors affecting male fertility, individual predisposition, prevention, and intervention. Int J Mol Sci. 2025;26(6):2797.
Szabó A, Váncsa S, Hegyi P, Váradi A, Forintos A, Filipov T, et al. Lifestyle-, environmental-, and additional health factors associated with an increased sperm DNA fragmentation: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2023;21:5.
Agarwal A, Deepinder F, Sharma RK, Ranga G, Li J. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008;89:124-8.
Adams JA, Galloway TS, Mondal D, Esteves SC, Mathews F. Effect of mobile telephones on sperm quality: a systematic review and meta-analysis. Environ Int. 2014;70:106-12.
Verma S, Rahangdale S, Saraf A, Madhariya N. Impact of lifestyle factors and digital device exposure on semen quality and sperm DNA fragmentation in infertile men. Int J Reprod Contracept Obstet Gynecol. 2026;15(7):2672-80.
Stavros S, Potiris A, Molopodi E, Mavrogianni D, Zikopoulos A, Louis K, et al. Sperm DNA fragmentation: unraveling its imperative impact on male infertility based on recent evidence. Int J Mol Sci. 2024;25(18):10167.
Agarwal A, Virk G, Ong C, du Plessis SS. Effect of oxidative stress on male reproduction. World J Mens Health. 2014;32:1-17.
The Jamovi project. Jamovi Version 2.7 (computer software). 2025. Available from: https://www.jamovi.org/index.html. Accessed on 11 July 2026.
Gaskins AJ, Afeiche MC, Hauser R, Williams PL, Gillman MW, Tanrikut C, et al. Physical activity and television watching in relation to semen quality in young men. Hum Reprod. 2015;30:1114-22.
Jurewicz J, Radwan M, Sobala W, Ligocka D, Radwan P, Bochenek M, et al. Lifestyle and semen quality: role of diet and physical activity. Hum Reprod. 2014;29:2180-9.
Salas-Huetos A, Bulló M, Salas-Salvadó J. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Hum Reprod Update. 2017;23:371-89.
Nassan FL, Chiu YH, Vanegas JC, Gaskins AJ, Williams PL, Ford JB, et al. Diet and men’s fertility: association between dietary patterns and semen quality. Hum Reprod. 2018;33:1149-57.
Attaman JA, Toth TL, Furtado J, Campos H, Hauser R, Chavarro JE. Dietary fat and semen quality among men attending a fertility clinic. Hum Reprod. 2012;27:1466-74.
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Copyright (c) 2026 Ratna Matawale, Manoj Singh, Sandeep Rahangdale, Manoj Chellani

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