The Association Between Calcium, Magnesium, and Ratio of Calcium/Magnesium in Seminal Plasma and Sperm Quality

The study aimed to examine the relationships between calcium, magnesium, and calcium/magnesium ratio in semen plasma and sperm quality. It was a cross-sectional study based on a program aiming at promoting the reproductive health in less-developed areas. A total of 515 men aged between 18 and 55 years provided semen specimens at family planning clinics in Sandu County, Guizhou Province, China. Total calcium and magnesium concentrations in semen plasma were measured with flame atomic absorption spectrometry. Sperm quality, including sperm motility and concentration, was evaluated by using a computer-assisted sperm analysis method. The medians of seminal plasma calcium, magnesium, and zinc concentrations were 9.61, 4.41, and 2.23 mmol/l, respectively. Calcium concentration and calcium/magnesium ratio were negatively associated with sperm concentrations (β = -0.47, P = 0.0123 for calcium; β = -0.25, P = 0.0393 for calcium/magnesium ratio) after adjusting for zinc and other covariates. In stratified analyses, the association between calcium and sperm concentrations only persisted among subjects with a calcium/magnesium ratio of ≤2.5 (β = -0.71, P = 0.0268). In the same stratum, magnesium was associated with increased sperm concentration (β = 0.73, P = 0.0386). Among subjects with a calcium/magnesium ratio of >2.5, neither calcium nor magnesium was associated with sperm concentration. In conclusion, total calcium and magnesium concentrations were associated with sperm concentration among subjects with a lower calcium/magnesium ratio. The calcium and magnesium ratio had a modifying effect on the associations of calcium and magnesium with sperm concentration.