A MAJOR population-level study from Utah has found that family members of men with subfertility, particularly those related to men with azoospermia or oligozoospermia, experience modest but statistically significant increases in mortality risk. The findings support the emerging view that semen quality reflects broader familial patterns of health shaped by shared genetics and environmental exposures.
Expanded Mortality Patterns Across Families
The research drew on the Utah Population Database, integrating genealogic, demographic and medical records to examine 666,437 first- through third-degree relatives of men who underwent semen analysis between 1996 and 2017. Families were grouped by the proband’s total sperm count: azoospermic (0 million), oligozoospermic (<39 million), or normozoospermic (≥39 million).
Overall, relatives in oligozoospermia families showed a small but significant rise in all-cause mortality (HR 1.03), with the strongest effects seen in first- and second-degree relatives. Relatives in azoospermia families displayed similar trends, though estimates for all relatives combined narrowly missed statistical significance. However, close relatives of azoospermic men showed clear increases in disease-specific mortality, particularly from cardiovascular disease, chronic respiratory disease, digestive disease, and mental health disorders.
Age- and Cause-Specific Mortality Risks
Childhood mortality risk was elevated in families of both azoospermic and oligozoospermic men, driven by neurologic disorders, cardiovascular disease and congenital conditions. Among adults, mortality differences became more pronounced after age 40, including higher rates from noncommunicable diseases, injuries, and metabolic conditions such as diabetes.
Emerging Evidence of Familial Health Signatures
The authors suggest that these patterns reflect complex heritable factors that influence both reproductive and somatic health, ranging from genetic variants involved in meiotic repair to shared lifestyle and environmental exposures. They argue that male fertility assessments may offer a window into broader familial health trajectories, potentially informing preventive strategies.
Reference
Ramsay JM et al. Risk of mortality in family members of men seeking fertility assessment. Fertil Steril. 2025;124(6):1235-44.
