Associations between urinary antibiotics exposure and semen parameters among adult men: A biomonitoring-based...

Exposure to multiple antibiotics is inevitable among adult men. Nevertheless, biomonitoring-based epidemiological studies on urinary antibiotics exposure and semen quality are lacking. The current cross-sectional study aimed to examine the associations between urinary multiple antibiotic exposure and semen parameters in reproductive-age men. The present study included 986 participants in Hefei, China. Forty-two urinary antibiotics (including two metabolites) and four semen parameters were measured. The generalized linear models were applied to explore the associations between antibiotics exposure and semen parameters, and these associations were stratified by age and body mass index of participants. The quantile-based g-computation (QGComp) approach was used to explore the joint effects of antibiotic mixtures on semen parameters. In the current study, selected antibiotics were detected in 98.9 % of urine samples from subjects, with predominantly doxycycline (80.1 %), erythromycin (74.5 %), ciprofloxacin (67.1 %), and florfenicol (65.6 %). After adjusting potential confounders, generalized linear models found that urinary erythromycin and doxycycline exposure were inversely associated with sperm concentration, sperm total motility, and sperm progressive motility. Stratified analyses revealed that the inverse effect of erythromycin and doxycycline with sperm concentration appeared to be stronger in younger men. QGComp indicated that urinary antibiotic mixtures were negatively associated with sperm concentration, sperm total motility, and sperm progressive motility. Our study provides epidemiological evidence that both individual and mixture of urinary antibiotics exposure were related to lower semen parameters. More well-designed studies are needed in the future to validate and expand our findings.