Male Factor Infertility and Risk of Multiple Sclerosis (MS): A Systematic Review and Meta-Analysis
Abstract
Objective: Multiple sclerosis is an autoimmune disease of central nervous system (CNS). There are a few articles studying the risk factors of developing MS in men. Male infertility can stem from a range of etiological factors such as genetics or environment. In the context of MS, research suggests a potential link, possibly due to shared immunological and inflammatory mechanisms. Therefore, we designed this study to evaluate the relationship between male infertility and MS development.
Materials and methods: We systematically searched PubMed, Embase, Scopus, web of science, Google scholar and gray literature including references of the references as well as conference papers which were published up to June 2021. The search strategy in PubMed was ("Infertility, Male"[Mesh] OR [Male Infertility] OR [Sterility, Male] OR [Male Sterility] OR [Subfertility, Male] OR [Male Subfertility] OR [Sub-Fertility, Male] OR [Male Sub-Fertility] OR [Sub Fertility, Male]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [MS] OR [Multiple Sclerosis, Acute Fulminating]) AND ("Testicular Diseases"[Mesh] OR [Disease, Testicular] OR [Diseases, Testicular] OR [Testicular Disease]) AND ("Multiple Sclerosis"[Mesh] OR [Sclerosis, Multiple] OR [Sclerosis, disseminated] OR [Disseminated Sclerosis] OR [Multiple Sclerosis, Acute Fulminating] OR [MS]).
Results: The literature search revealed 197 articles, after deleting duplicates 109 remained. For the meta-analysis, 3 studies were included. Totally, 2090 MS cases as well as 3895562 healthy subjects were enrolled. One hundred and fourteen infertile men were in MS group and 139716 infertile men were in controls. The pooled OR for male factor infertility and odds of developing MS was1.87 (95%
CI: 0.89-3.94) (I2=86.1%, P=0.001).
Conclusion: The results of this systematic review and meta-analysis show that there is no relationship between male factor infertility and risk of MS.
2. Azimi A, Ghajarzadeh M, Sahraian MA, Mohammadifar M, Roostaei B, Samani SMV, Shabestari HRF, Hanaei S. Effects of Vitamin D Supplements on IL-10 and INFγ Levels in Patients with Multiple Sclerosis: a Systematic Review and Meta-Analysis. Maedica (Bucur). 2019;14(4):413-417.
3. Kingwell E, Marriott JJ, Jetté N, Pringsheim T, Makhani N, Morrow SA, et al. Incidence and prevalence of multiple sclerosis in Europe: a systematic review. BMC Neurol. 2013 26;13:128.
4. Glazer CH, Tøttenborg SS, Giwercman A, Bräuner EV, Eisenberg ML, Vassard D, Magyari M, Pinborg A, Schmidt L, Bonde JP. Male factor infertility and risk of multiple sclerosis: A register-based cohort study. Mult Scler. 2018;24(14):1835-1842.
5. Salehi F, Abdollahpour I, Nedjat S, Sahraian MA, Memari AH, Rahnama M, Mansournia MA. Uncovering the link between reproductive factors and multiple sclerosis: A case-control study on Iranian females. Mult Scler Relat Disord. 2018 Feb;20:164-168.
6. Goodin DS. The epidemiology of multiple sclerosis: insights to a causal cascade. Handb Clin Neurol. 2016;138:173-206.
7. Ribbons KA, McElduff P, Boz C, Trojano M, Izquierdo G, Duquette P, et al. Male Sex Is Independently Associated with Faster Disability Accumulation in Relapse-Onset MS but Not in Primary Progressive MS. PLoS One. 2015;10(6):e0122686.
8. Bove R, Chitnis T. Sexual disparities in the incidence and course of MS. Clin Immunol. 2013;149(2):201-10.
9. Massarotti C, Sbragia E, Gazzo I, Stigliani S, Inglese M, Anserini P. Effect of Multiple Sclerosis and Its Treatments on Male Fertility: Cues for Future Research. J Clin Med. 2021;10(22):5401.
10. Wells G A, Shea B , O’Connell D , Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality if Nonrandomized Studies in Meta-Analyses. 2015. Available online: http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm. [accessed on November 2023].
11. Jacobsen R, Bostofte E, Engholm G, Hansen J, Olsen JH, Skakkebaek NE, Moller H. Risk of testicular cancer in men with abnormal semen characteristics: cohort study. BMJ. 2000;321(7264):789-92.
12. Eisenberg ML, Li S, Brooks JD, Cullen MR, Baker LC. Increased risk of cancer in infertile men: analysis of U.S. claims data. J Urol. 2015;193(5):1596-601.
13. Eisenberg ML, Li S, Cullen MR, Baker LC. Increased risk of incident chronic medical conditions in infertile men: analysis of United States claims data. Fertil Steril. 2016;105(3):629-636.
14. Jensen TK, Jacobsen R, Christensen K, Nielsen NC, Bostofte E. Good semen quality and life expectancy: a cohort study of 43,277 men. Am J Epidemiol. 2009;170(5):559-65.
15. Walsh TJ, Schembri M, Turek PJ, Chan JM, Carroll PR, Smith JF, Eisenberg ML, Van Den Eeden SK, Croughan MS. Increased risk of high-grade prostate cancer among infertile men. Cancer. 2010;116(9):2140-7.
16. Pakpoor J, Goldacre R, Schmierer K, Giovannoni G, Goldacre MJ. Testicular hypofunction and multiple sclerosis risk: a record-linkage study. Ann Neurol. 2014;76(4):625-8.
17. Brubaker WD, Li S, Baker LC, Eisenberg ML. Increased risk of autoimmune disorders in infertile men: analysis of US claims data. Andrology. 2018 Jan;6(1):94-98.
18. Ortona E, Pierdominici M, Maselli A, Veroni C, Aloisi F, Shoenfeld Y. Sex-based differences in autoimmune diseases. Ann Ist Super Sanita. 2016;52(2):205-12.
19. Sicotte NL, Giesser BS, Tandon V, Klutch R, Steiner B, Drain AE, et al. Testosterone treatment in multiple sclerosis: a pilot study. Arch Neurol. 2007;64(5):683-8
20. Bove R, Musallam A, Healy B, Raghavan K, Glanz B, Bakshi R, et al. Low testosterone is associated with disability in men with multiple sclerosis. Multiple Sclerosis Journal. 2014;20(12):1584-92.
21. Hussain R, Ghoumari AM, Bielecki B, Steibel J, Boehm N, Liere P, et al. The neural androgen receptor: a therapeutic target for myelin repair in chronic demyelination. Brain. 2013;136(Pt 1):132-46.
22. Palaszynski KM, Loo KK, Ashouri JF, Liu HB, Voskuhl RR. Androgens are protective in experimental autoimmune encephalomyelitis: implications for multiple sclerosis. J Neuroimmunol. 2004;146(1-2):144-52.
23. Bobjer J, Katrinaki M, Tsatsanis C, Lundberg Giwercman Y, Giwercman A. Negative association between testosterone concentration and inflammatory markers in young men: a nested cross-sectional study. PLoS One. 2013;8(4):e61466.
24. Montgomery SM, Lambe M, Olsson T, Ekbom A. Parental age, family size, and risk of multiple sclerosis. Epidemiology. 2004;15(6):717-23.
| Files | ||
| Issue | Vol 17, No 4 (December 2023) | |
| Section | Review Articles | |
| DOI | https://doi.org/10.18502/jfrh.v17i4.14590 | |
| Keywords | ||
| Multiple Sclerosis Infertility Risk | ||
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