Osteopenia is not uncommon in infertile men

While it does not affect the vast majority of male infertility patients, there is a subgroup of men with disrupted hormonal axes and/or hypogonadism whom urologists should work up for the presence of osteopenia, according to the results of a study from Brown University in Providence, RI, reported here yesterday.

In what appears to be the first study of its kind involving infertile patients, investigators found that the incidence of osteopenia among infertile men is 9%. Significantly, that figure rises to 21% in severely oligospermic men.The 46 patients in the study ranged in age from 18 to 60 years, but the majority were in their 30s and 40s. In that age range among the general population, one would expect to see an incidence of osteopenia of only about 5%, said first author Daniel Kaplon, MD.

"This reaffirms that there is certainly a correlation between hormone and gonadotropin levels and osteopenia," said Dr. Kaplon, who worked on the study with Mark Sigman, MD.

"There's an important group of patients we're teasing out here who are going to be evaluated for infertility and who have been found to have some degree of hypogonadism causing their infertility. It's those patients who should be worked up and suspected to have osteopenia, even at young ages," he said.

Four patients (9%) presented with bone mineral density scores indicative of osteopenia. The prevalence of the condition in men with sperm counts p=.035).

Total sperm count correlated positively with BMD (p=.01) and average testicular volume (p=.031), and negatively with follicle-stimulating hormone levels (p=.003). Age, BMI, and total testosterone did not correlate significantly with BMD.

Tune into www.urologytimes.com/radio for an interview with Dr. Kaplon.