Factors Associated With Male-Factor Infertility Risk Perceptions Among Young Adults in Ontario

Understanding male-factor infertility (MFI) risk perception among emerging adults can inform development of sexual and reproductive health (SRH) interventions. This study aimed to evaluate the influence of sociodemographic characteristics on perceptions of substance use behaviors and bioenvironmental risks to male fertility. An online survey was administered to Ontario post-secondary students from May ̶ October 25, 2022, assessing their perceptions of 15 MFI risk factors. Associations between sociodemographic characteristics and high-risk perceptions were first assessed by bivariate analyses, with significant characteristics treated as potential covariates, along with gender, for regression analysis. Multiple linear regression models evaluated perceptions for selected well-established risk factors: alcohol, obesity, recreational drug use, and cigarette smoking. Respondents rated most risk factors as no to slight MFI risks, with environmental chemical exposure, and untreated sexually transmitted infections perceived as moderate to high MFI risk. Racialized identity was the most common characteristic associated with high MFI risk perception in bivariate analyses, while age was negatively associated. In regression models, cis men perceived alcohol consumption and cigarette smoking as greater risks to male fertility compared with cis women. Given that our sample considered most substance use behaviors and bioenvironmental factors as no to slight risks to MFI, this may indicate lack of fertility awareness or sexual and reproductive health literacy. Interventions and related public health policy that focus on men's health and recognize the potential influences of sociodemographic characteristics on MFI risk perception are recommended for emerging young adults.