Possible involvement of lifestyle factors on reproductive ability among men from an andrology clinic in northern Vietnam

Background: Current research on Vietnamese men’s reproductive health faces limitations. Therefore, this study investigates how lifestyle factors impact semen and reproductive hormones in men visiting an andrology clinic in Northern Vietnam. Methods: This cross-sectional descriptive study was conducted on men desiring children who first visited the andrology clinic, with concurrent semen and reproductive hormone tests at the Hanoi Obstetrics and Gynecology Hospital. Results: A total of 579 men aged 19–56 years were included in this study in 2022. The examined reasons were 60.6% for reproductive health checks, 36.1% for infertility and 3.3% for other reasons. Men reported using alcohol and smoking cigarettes at rates of 59.7% and 48.4%, respectively. Moreover, there are 13.3% and 16.6% of men arbitrarily used supplements and unknown-origin traditional products (UOTP) to improve reproductive and sexual health. Furthermore, semen analysis revealed that an overwhelming 67.3% of men exhibited abnormalities in at least one of the three key parameters studied: concentration, progressive motility and morphology. Interestingly, the study also demonstrated a notable inverse correlation between semen parameters and the levels of gonadotropin hormone (p < 0.05), while no significant associations were observed with prolactin and total testosterone levels. Notably, there was a statistically significant decline in sperm concentration and motility in the group that used UOTPs, accompanied by increased gonadotropin levels compared with those who did not use them (p < 0.05). We found no significant differences in semen parameters and reproductive hormone levels among other groups using tobacco, alcohol and supplements. According to our findings, there is a negative relationship between semen quality and serum gonadotropin levels. Conclusions: The indiscriminate consumption of supplements and UOTPs does not show any beneficial effects on male reproductive health. On the contrary, the utilization of UOTPs may disrupt the equilibrium between spermatogenesis and reproductive hormone concentrations.

Lifestyle habits; Semen analysis; Reproductive hormones; Unknown-origin traditional products

[1] Baker P, Dworkin SL, Tong S, Banks I, Shand T, Yamey G. The men’s health gap: men must be included in the global health equity agenda. Bulletin of the World Health Organization. 2014; 92: 618–620.

[2] Hofmann MC, Giwercman A. Andrology and humanities. Andrology. 2022; 10: 823–824.

[3] Cai J, Hu W, Yang Y, Chen S, Si A, Zhang Y, et al. Healthy life expectancy for 202 countries up to 2030: projections with a Bayesian model ensemble. Journal of Global Health. 2023; 13: 04185.

[4] Li Y, Lu T, Wu Z, Wang Z, Yu T, Wang H, et al. Trends in sperm quality by computer-assisted sperm analysis of 49,189 men during 2015–2021 in a fertility center from China. Frontiers in Endocrinology. 2023; 14: 1194455.

[5] Tong SF, Low WY, Ng CJ. Profile of men’s health in Malaysia: problems and challenges. Asian Journal of Andrology. 2011; 13: 526–533.

[6] China Kadoorie Biobank Collaborative Group. Healthy lifestyle and life expectancy free of major chronic diseases at age 40 in China. Nature Human Behaviour. 2023; 7: 1542–1550.

[7] Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, et al. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction. 2018; 113: 1905–1926.

[8] World Health Organization. Global status report on alcohol and health 2018. 2018. Available at: https://iris.who.int/handle/10665/274603 (Accessed: 03 May 2024).

[9] Tang Q, Pan F, Wu X, Nichols CE, Wang X, Xia Y, et al. Semen quality and cigarette smoking in a cohort of healthy fertile men. Environmental Epidemiology. 2019; 3: e055.

[10] Osadchuk L, Kleshchev M, Osadchuk A. Effects of cigarette smoking on semen quality, reproductive hormone levels, metabolic profile, zinc and sperm DNA fragmentation in men: results from a population-based study. Frontiers in Endocrinology. 2023; 14: 1255304.

[11] Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 world health organization laboratory methods for the examination of human semen. European Urology. 2016; 70: 635–645.

[12] 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. Human Reproduction Update. 2017; 23: 371–389.

[13] Amor H, Hammadeh ME, Mohd I, Jankowski PM. Impact of heavy alcohol consumption and cigarette smoking on sperm DNA integrity. Andrologia. 2022; 54: e14434.

[14] Rao W, Li Y, Li N, Yao Q, Li Y. The association between caffeine and alcohol consumption and IVF/ICSI outcomes: a systematic review and dose-response meta-analysis. Acta Obstetricia et Gynecologica Scandinavica. 2022; 101: 1351–1363.

[15] de Jong AME, Menkveld R, Lens JW, Nienhuis SE, Rhemrev JPT. Effect of alcohol intake and cigarette smoking on sperm parameters and pregnancy. Andrologia. 2014; 46: 112–117.

[16] Fan S, Zhang Z, Wang H, Luo L, Xu B. Associations between tobacco inhalation and semen parameters in men with primary and secondary infertility: a cross-sectional study. Frontiers in Endocrinology. 2024; 15: 1396793.

[17] Ramaswamy S, Weinbauer GF. Endocrine control of spermatogenesis: role of FSH and LH/testosterone. Spermatogenesis. 2015; 4: e996025.

[18] Dzialach L, Sobolewska J, Zak Z, Respondek W, Witek P. Prolactin-secreting pituitary adenomas: male-specific differences in pathogenesis, clinical presentation and treatment. Frontiers in Endocrinology. 2024; 15: 1338345.

[19] Bac NH, Cuong HH. Survey of Andrological diseases model at Ha Noi University Hospital. Vietnam Medical Journal. 2020; 490: 224–228.

[20] Quang N, Hong NP. Situation of patients coming for medical examination at the Andrology Center of Viet Duc Hospital in the first 6 months of 2012. Vietnam Medical Journal. 2013; 403: 544–549.

[21] Robertson S. Men’s health: body, identity and social context. Sociology of Health & Illness. 2009; 31: 1116–1117.

[22] WHO. SDG Target 3.a Tobacco control. 2024. Available at: https://www.who.int/data/gho/data/themes/topics/sdg-target-3_a-tobacco-control (Accessed: 14 May 2024).

[23] O’Donnell L, Stanton P, de Kretser DM. Endocrinology of the male reproductive system and spermatogenesis (Last Update: 11 January 2017). MDText.com, Inc.: South Dartmouth (MA). 2000.

[24] Babu SR, Sadhnani MD, Swarna M, Padmavathi P, Reddy PP. Evaluation of FSH, LH and testosterone levels in different subgroups of infertile males. Indian Journal of Clinical Biochemistry. 2004; 19: 45–49.

[25] Gangwar PK, Sankhwar SN, Pant S, Krishna A, Singh BP, Mahdi AA, et al. Increased gonadotropins and prolactin are linked to infertility in males. Bioinformation. 2020; 16: 176–182.

[26] Spaggiari G, Costantino F, Dalla Valentina L, Romeo M, Furini C, Roli L, et al. Are they functional hypogonadal men? Testosterone serum levels unravel male idiopathic infertility subgroups. Endocrine. 2024; 84: 757–767.

[27] Su L, Qu H, Cao Y, Zhu J, Zhang SZ, Wu J, et al. Effect of antioxidants on sperm quality parameters in subfertile men: a systematic review and network meta-analysis of randomized controlled trials. Advances in Nutrition. 2022; 13: 586–594.

[28] Elnashar A, Farag MAEF, GamalEl Din SF, AbdElSalam MA, Elseginy A, Mohamed AOS, et al. Evaluation of daily supplementation of fertitonex on different semen parameters in idiopathic male infertility: a randomized double blind placebo controlled cross over study. International Urology and Nephrology. 2025; 57: 135-142.

[29] Pan X, Zhou J, Chen Y, Xie X, Rao C, Liang J, et al. Classification, hepatotoxic mechanisms, and targets of the risk ingredients in traditional Chinese medicine-induced liver injury. Toxicology Letters. 2020; 323: 48–56.

[30] Li Q, Yan X, Zhang Y, Zhou J, Yang L, Wu S, et al. Risk compounds, potential mechanisms and biomarkers of traditional Chinese medicine-induced reproductive toxicity. Journal of Applied Toxicology. 2022; 42: 1734–1756.