Lifestyle and hormonal factors affecting semen quality and sperm DNA integrity: A cross-sectional study

Male infertility is a growing public health concern, influenced by modifiable lifestyle factors and hormonal imbalances. However, limited data from India have evaluated their combined impact on semen quality and sperm DNA fragmentation (SDF).

This cross-sectional study included 278 men aged 21-50 years from a tertiary care centre. Semen analysis was performed according to the WHO's 6th edition guidelines. The SDF was evaluated using the Sperm Chromatin Dispersion (SCD) test. Lifestyle details, occupational exposures, and hormonal profiles (FSH, LH, testosterone, AMH, prolactin) were gathered through structured interviews and laboratory testing. Statistical analysis was conducted using SPSS, with p < 0.05 regarded as statistically significant.

Men aged >40 years showed a significantly elevated SDF (p = 0.038), although no significant differences were observed in conventional semen parameters. Tobacco and alcohol use were strongly associated with reduced sperm concentration, motility, and morphology (p < 0.001). Alcohol use was also associated with an increased SDF (p = 0.023). Abnormal BMI was correlated with poorer semen quality and higher SDF (p < 0.001). Occupational heat exposure significantly contributed to elevated SDF levels (p = 0.013). Hormonal analysis showed that low testosterone and elevated prolactin levels were associated with abnormal semen profiles, whereas low AMH levels were significantly correlated with increased SDF (p = 0.011).

Lifestyle habits and hormonal imbalances significantly affect the fertility of men. Clinical evaluation should be integrated into infertility assessments and counselling.