Andrology. 2022 Sep 18. doi: 10.1111/andr.13297. Online ahead of print.
ABSTRACT
BACKGROUND: Alfa-fetoprotein (AFP) is a serum glycoprotein highly produced during fetal development. While AFP synthesis drops dramatically after birth, AFP production only persists or returns under specific pathological condition OBJECTIVE: : We sought to investigate the rate of and the potential meaning of high AFP serum levels in men seeking first medical attention for couple’s primary infertility.
MATERIALS AND METHODS: Socio-demographic and clinical data from 1803 non-Finnish, white-European primary infertile men were retrospectively analysed. AFP was routinely measured in each patient (high AFP was defined as > 7 ng/mL). Men with history of liver diseases, testicular cancer or other known causes of increased AFP levels were excluded from the final analysis. Semen analyses were based on the 2010 WHO reference criteria. Descriptive statistics and logistic regression models tested the association between serum AFP and clinical variables. Possible non-linear relationships were graphically explored with LOESS method.
RESULTS: Overall, high serum AFP level was found in 29 (1,7%) patients. Normal vs. high AFP levels patients were comparable in terms of BMI, CCI, waist circumference, smoking habits, history of cryptorchidism, testicular volume and serum hormones (i.e., FSH, LH and tT). Conversely, men with higher AFP levels were older (p = 0.02), had lower sperm concentration (p = 0,003), and were more frequently oligozoospermic and azoospermic (all p≤0.03). At multivariate analysis, high AFP levels were independently associated with oligozoospermia (OR 3.79; p = 0.033) and azoospermia (OR 3.29; p = 0.006). Likewise, if AFP levels increase, patients were found to be older, with higher BMI and to have more comorbidities (all p<0.05).
DISCUSSION: Unexplained high AFP levels account for almost 2% of cases in primary infertile patients without a previous history of associated disorders. Higher serum AFP levels are linked with aberrant sperm counts, older age, obesity and a greater amount of comorbid conditions.
CONCLUSION: Despite the need for additional validation, these data suggest that serum AFP measurement might have a multifaceted role over the diagnostic work-up of males presenting for couple’s infertility. This article is protected by copyright. All rights reserved.
PMID:36116018 | DOI:10.1111/andr.13297
