Prehypertension in male affects both semen quality and pregnancy outcomes in their first single blastocyst frozen-thawed embryo transfer cycles

Lina Wang; Huanhuan Li; Wenhui Zhou

doi:10.1016/j.fertnstert.2024.09.025

Prehypertension in male affects both semen quality and pregnancy outcomes in their first single blastocyst frozen-thawed embryo transfer cycles

Fertil Steril. 2024 Sep 19:S0015-0282(24)02238-6. doi: 10.1016/j.fertnstert.2024.09.025. Online ahead of print.

Authors

Lina Wang¹, Huanhuan Li¹, Wenhui Zhou²

Affiliations

¹ Reproductive Medicine Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China.
² Reproductive Medicine Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People's Republic of China. Electronic address: wenhuizhbjcy@126.com.

PMID: 39306189
DOI: 10.1016/j.fertnstert.2024.09.025

Abstract

Objective: To investigate whether prehypertension (Pre-HTN) in male affects semen quality and assisted reproductive technology (ART) outcomes.

Design: Retrospective cohort study.

Setting: University-affiliated reproductive medicine center in Beijing, China.

Patients: Clinical data were collected from 1043 couples undergoing their first single blastocyst frozen-thawed embryo transfer (FET) cycles.

Interventions: According to the blood pressure (BP, 1mmHg = 0.133 kPa) in male, including systolic blood pressure (SBP) and diastolic blood pressure (DBP), the subjects were divided into the Control group (90 ≤ SBP < 120 mmHg and 60 ≤ DBP < 80 mmHg, n = 611) and the Pre-HTN group (120 ≤ SBP < 140 mmHg and/or 80 ≤ DBP < 90 mmHg, n = 432). The association between Pre-HTN and semen quality, and ART outcomes was then evaluated.

Main outcome measures: Primary outcome: live birth rate (LBR).

Secondary outcomes: semen quality, laboratory embryo outcomes, clinical pregnancy rate (CPR), biochemical pregnancy rate, miscarriage rate, and other pregnancy outcomes.

Results: Compared with the Control group, the Pre-HTN group showed lower total sperm motility, total sperm count, sperm progressive motility, progressive sperm count (P < .05), and higher prevalence of oligozoospermia (17.6% vs. 13.1%, P = .045), and asthenozoospermia (37.7% vs. 19.8%, P < .001). Meanwhile, compared with the Control group, the Pre-HTN group had a lower CPR (42.8% vs. 57.6%, P < .001) and a lower LBR (32.9% vs. 47.3%, P < .001). There were no differences in the remaining parameters of semen quality, laboratory embryo outcomes (except for the proportion of ICSI), and pregnancy outcomes between the two groups. Additionally, regression analysis showed that Pre-HTN in male was an independent risk factor for clinical pregnancy (adjusted OR: 0.57, 95% CI: 0.44-0.74, P < .001) and live birth (adjusted OR: 0.58, 95% CI: 0.44-0.75, P < .001).

Conclusions: Pre-HTN in male not only results in lower semen quality, but also has negative consequences on the success of ART. It is an independent risk factor for clinical pregnancy and live birth in the first single blastocyst FET cycles.

Keywords: clinical pregnancy; frozen-thawed embryo transfer; live birth; prehypertension; semen quality.