Download PDF
Semin Reprod Med 2019; 37(01): 005-011
DOI: 10.1055/s-0039-1694027
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Infertility and the Military Male

Amanda B. Reed-Maldonado
1   Department of Surgery, Urology Service, Madigan Army Medical Center, Tacoma, Washington
,
Kristin C. Madden
2   Audie L Murphy South Texas VA Hospital, San Antonio, Texas
3   University of Texas Health Science Center at San Antonio, San Antonio, Texas
4   College of Pharmacy, University of Texas, Austin, Texas
› Author Affiliations
Further Information

Publication History

Publication Date:
16 August 2019 (online)

    Permissions and Reprints

Abstract

Male infertility is a condition that affects approximately 50% of infertile couples and about 30% of those couples have only male factor infertility identified. There has been speculation that male military service members may have an even greater lifetime prevalence of infertility as compared to the general population, but very few scientific publications focus on male factor infertility in the military population specifically. This review will discuss many of the unique considerations regarding male infertility in the military and highlight future opportunities for research. The military/federal health system has the potential to serve as a leader in both the delivery of health care for male factor infertility and in the clinical investigation into the etiologies of and treatments for male factor infertility.

Keywords

Male infertility - military - active duty - service members - veterans

Disclaimer

The content presented herein is the responsibility of the authors alone and does not reflect the views or policies of the Department of Defense, the Department of Veterans Affairs, or the United States Government.


 

  • References

  • 1 Hanson BM, Eisenberg ML, Hotaling JM. Male infertility: a biomarker of individual and familial cancer risk. Fertil Steril 2018; 109 (01) 6-19
    CrossrefPubMedGoogle Scholar
  • 2 Costabile RA, Spevak M. Characterization of patients presenting with male factor infertility in an equal access, no cost medical system. Urology 2001; 58 (06) 1021-1024
    CrossrefPubMedGoogle Scholar
  • 3 Gudeman SR, Townsend B, Fischer K, Walters RC, Crain D. Etiology of azoospermia in a military population. J Urol 2015; 193 (04) 1318-1321
    CrossrefPubMedGoogle Scholar
  • 4 Fedder J, Crüger D, Oestergaard B, Petersen GB. Etiology of azoospermia in 100 consecutive nonvasectomized men. Fertil Steril 2004; 82 (05) 1463-1465
    CrossrefPubMedGoogle Scholar
  • 5 Masterson J, Avalos E, Santomauro M. , et al. A retrospective review of factors associated with vasovasostomies in United States military members. Curr Urol 2013; 6 (03) 150-155
    PubMedGoogle Scholar
  • 6 Bernie AM, Osterberg EC, Stahl PJ, Ramasamy R, Goldstein M. Vasectomy reversal in humans. Spermatogenesis 2012; 2 (04) 273-278
    CrossrefPubMedGoogle Scholar
  • 7 Howard G. Who asks for vasectomy reversal and why?. Br Med J (Clin Res Ed) 1982; 285 (6340): 490-492
    CrossrefPubMedGoogle Scholar
  • 8 Alexandria Hertz, Mark I Anderson, Karen Baker. Society of Government Service Urologists Kimbrough Seminar. Abstract 72. Vasectomy Reversal in an Open Access System: A 14-year Experience. 19 Jan 2019. Kona, HI
    PubMed
  • 9 Sharma V, Zargaroff S, Sheth KR. , et al. Relating economic conditions to vasectomy and vasectomy reversal frequencies: a multi-institutional study. J Urol 2014; 191 (06) 1835-1840
    CrossrefPubMedGoogle Scholar
  • 10 Potts JM, Pasqualotto FF, Nelson D, Thomas Jr AJ, Agarwal A. Patient characteristics associated with vasectomy reversal. J Urol 1999; 161 (06) 1835-1839
    CrossrefPubMedGoogle Scholar
  • 11 Morris R. Divorce Rates by Job Industry: Military Vets and Baby Boomers. 2017 . Available at: https://www.zippia.com/advice/divorce-rates-job-industry/ . Accessed July 27, 2018
    PubMedGoogle Scholar
  • 12 Jacobson IG, Gumbs GR, Sevick CJ, Smith TC, Ryan MA. Smallpox vaccination is not associated with infertility in a healthy young adult population. Hum Vaccin 2008; 4 (03) 224-228
    CrossrefPubMedGoogle Scholar
  • 13 De Pijper CA, Koen G, Schinkel J, Grobusch MP, Goorhuis A, Stijnis C. No detection of Zika virus infection in asymptomatic Dutch military personnel after deployment in high endemic areas (Belize, Curacao, Saint Martin) from December 2016 to December 2017. Travel Med Infect Dis 2019; 27: 119-120
    CrossrefPubMedGoogle Scholar
  • 14 Writer JV, Poss DE, Harris S. Surveillance snapshot: Zika virus infection among Military Health System beneficiaries following introduction of the virus into the Western Hemisphere, 20 May 2016. MSMR 2016; 23 (05) 19
    PubMedGoogle Scholar
  • 15 Poss DE, Writer JV, Harris S. Zika virus infections in Military Health System beneficiaries since the introduction of the virus in the Western Hemisphere, 1 January 2016 through 30 November 2016. MSMR 2016; 23 (12) 7-11
    PubMedGoogle Scholar
  • 16 Michaelson SM. Effects of exposure to microwaves: problems and perspectives. Environ Health Perspect 1974; 8: 133-155
    CrossrefPubMedGoogle Scholar
  • 17 Mitchell A, Bakshi K, Kimmel C. , et al. Evaluating chemical and other agent exposures for reproductive and developmental toxicity. J Toxicol Environ Health A 2004; 67 (15-16): 1159-1314
    CrossrefPubMedGoogle Scholar
  • 18 Salamon R, Verret C, Jutand MA. , et al. Health consequences of the first Persian Gulf War on French troops. Int J Epidemiol 2006; 35 (02) 479-487
    CrossrefPubMedGoogle Scholar
  • 19 Møllerløkken OJ, Moen BE. Is fertility reduced among men exposed to radiofrequency fields in the Norwegian Navy?. Bioelectromagnetics 2008; 29 (05) 345-352
    CrossrefPubMedGoogle Scholar
  • 20 Baste V, Riise T, Moen BE. Radiofrequency electromagnetic fields; male infertility and sex ratio of offspring. Eur J Epidemiol 2008; 23 (05) 369-377
    CrossrefPubMedGoogle Scholar
  • 21 Kesari KK, Agarwal A, Henkel R. Radiations and male fertility. Reprod Biol Endocrinol 2018; 16 (01) 118
    CrossrefPubMedGoogle Scholar
  • 22 Kuebker J, Celan A, Baughman S. Moderated Poster 64: 2016 association of occupation and idiopathic male factor infertility diagnoses in the Air Force population. J Urol 2011; 185 (4, Suppl): e806
    PubMedGoogle Scholar
  • 23 Velez de la Calle JF, Rachou E, le Martelot MT, Ducot B, Multigner L, Thonneau PF. Male infertility risk factors in a French military population. Hum Reprod 2001; 16 (03) 481-486
    CrossrefPubMedGoogle Scholar
  • 24 Maconochie N, Doyle P, Carson C. Infertility among male UK veterans of the 1990-1 Gulf war: reproductive cohort study. BMJ 2004; 329 (7459): 196-201
    CrossrefPubMedGoogle Scholar
  • 25 Ishøy T, Andersson AM, Suadicani P. , et al; Danish Gulf War Study. Major reproductive health characteristics in male Gulf War Veterans. The Danish Gulf War Study. Dan Med Bull 2001; 48 (01) 29-32
    PubMedGoogle Scholar
  • 26 Maconochie N, Doyle P, Davies G. , et al. The study of reproductive outcome and the health of offspring of UK veterans of the Gulf war: methods and description of the study population. BMC Public Health 2003; 3: 4
    CrossrefPubMedGoogle Scholar
  • 27 Abu-Musa AA, Kobeissi L, Hannoun AB, Inhorn MC. Effect of war on fertility: a review of the literature. Reprod Biomed Online 2008; 17 (Suppl. 01) 43-53
    CrossrefPubMedGoogle Scholar
  • 28 Katon J, Cypel Y, Raza M. , et al. Self-reported infertility among male and female veterans serving during Operation Enduring Freedom/Operation Iraqi Freedom. J Womens Health (Larchmt) 2014; 23 (02) 175-183
    CrossrefPubMedGoogle Scholar
  • 29 Li Y, Lin H, Li Y, Cao J. Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses. Fertil Steril 2011; 95 (01) 116-123
    CrossrefPubMedGoogle Scholar
  • 30 Nordkap L, Jensen TK, Hansen AM. , et al. Psychological stress and testicular function: a cross-sectional study of 1,215 Danish men. Fertil Steril 2016; 105 (01) 174-187 e171–172
    CrossrefPubMedGoogle Scholar
  • 31 Li Y, Li Y, Zhou N. , et al. Socio-psycho-behavioural factors associated with male semen quality in China: results from 1346 healthy men in Chongqing. J Fam Plann Reprod Health Care 2013; 39 (02) 102-110
    CrossrefPubMedGoogle Scholar
  • 32 Giblin PT, Poland ML, Moghissi KS, Ager JW, Olson JM. Effects of stress and characteristic adaptability on semen quality in healthy men. Fertil Steril 1988; 49 (01) 127-132
    CrossrefPubMedGoogle Scholar
  • 33 Poland ML, Giblin PT, Ager JW, Moghissi KS. Effect of stress on semen quality in semen donors. Int J Fertil 1986; 31 (03) 229-231
    PubMedGoogle Scholar
  • 34 Janak JC, Orman JA, Soderdahl DW, Hudak SJ. Epidemiology of genitourinary injuries among male U.S. service members deployed to Iraq and Afghanistan: early findings from the Trauma Outcomes and Urogenital Health (TOUGH) Project. J Urol 2017; 197 (02) 414-419
    CrossrefPubMedGoogle Scholar
  • 35 Balzano FL, Hudak SJ. Military genitourinary injuries: past, present, and future. Transl Androl Urol 2018; 7 (04) 646-652
    CrossrefPubMedGoogle Scholar
  • 36 Cannon JW, Hofmann LJ, Glasgow SC. , et al. Dismounted complex blast injuries: a comprehensive review of the modern combat experience. J Am Coll Surg 2016; 223 (04) 652-664 e658
    CrossrefPubMedGoogle Scholar
  • 37 Morey AF, Metro MJ, Carney KJ, Miller KS, McAninch JW. Consensus on genitourinary trauma: external genitalia. BJU Int 2004; 94 (04) 507-515
    CrossrefPubMedGoogle Scholar
  • 38 Panara K, Masterson JM, Savio LF, Ramasamy R. Adverse effects of common sports and recreational activities on male reproduction. Eur Urol Focus 2018; DOI: 10.1016/j.euf.2018.04.013. [Epub ahead of print]
    PubMedGoogle Scholar
  • 39 Agha A, Thompson CJ. High risk of hypogonadism after traumatic brain injury: clinical implications. Pituitary 2005; 8 (3-4): 245-249
    CrossrefPubMedGoogle Scholar
  • 40 Hohl A, Mazzuco TL, Coral MH, Schwarzbold M, Walz R. Hypogonadism after traumatic brain injury. Arq Bras Endocrinol Metabol 2009; 53 (08) 908-914
    CrossrefPubMedGoogle Scholar
  • 41 Barton DJ, Kumar RG, McCullough EH. , et al. Persistent hypogonadotropic hypogonadism in men after severe traumatic brain injury: temporal hormone profiles and outcome prediction. J Head Trauma Rehabil 2016; 31 (04) 277-287
    CrossrefPubMedGoogle Scholar
  • 42 Eastridge BJ, Mabry RL, Seguin P. , et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg 2012; 73 (06) (Suppl. 05) S431-S437
    CrossrefPubMedGoogle Scholar
  • 43 Holcomb JB, Stansbury LG, Champion HR, Wade C, Bellamy RF. Understanding combat casualty care statistics. J Trauma 2006; 60 (02) 397-401
    CrossrefPubMedGoogle Scholar
  • 44 Frappell-Cooke W, Wink P, Wood A. The psychological challenge of genital injury. J R Army Med Corps 2013; 159 (Suppl. 01) i52-i56
    CrossrefPubMedGoogle Scholar
  • 45 Lucas PA, Page PR, Phillip RD, Bennett AN. The impact of genital trauma on wounded servicemen: qualitative study. Injury 2014; 45 (05) 825-829
    CrossrefPubMedGoogle Scholar
  • 46 ARMY UDOT. REG. 600–8-101, Personnel Readiness Procedures. In: Army Dot, ed. Washington, DC:
    Google Scholar
  • 47 Sharma DM, Bowley DM. Immediate surgical management of combat-related injury to the external genitalia. J R Army Med Corps 2013; 159 (Suppl. 01) i18-i20
    CrossrefPubMedGoogle Scholar
  • 48 Shefi S, Raviv G, Eisenberg ML. , et al. Posthumous sperm retrieval: analysis of time interval to harvest sperm. Hum Reprod 2006; 21 (11) 2890-2893
    CrossrefPubMedGoogle Scholar
  • 49 Kaabi M, Paz P, Alvarez M. , et al. Effect of epididymis handling conditions on the quality of ram spermatozoa recovered post-mortem. Theriogenology 2003; 60 (07) 1249-1259
    CrossrefPubMedGoogle Scholar
  • 50 Healy MW, Yauger BJ, James AN, Jezior JR, Parker P, Dean RC. Seminal vesicle sperm aspiration from wounded warriors. Fertil Steril 2016; 106 (03) 579-583
    CrossrefPubMedGoogle Scholar
  • 51 Lindgren MC, Ross LS. Reproductive health care delivery. Urol Clin North Am 2014; 41 (01) 205-211
    CrossrefPubMedGoogle Scholar
  • 52 Leung AK, Henry MA, Mehta A. Gaps in male infertility health services research. Transl Androl Urol 2018; 7 (Suppl. 03) S303-S309
    CrossrefPubMedGoogle Scholar
  • 53 Chambers GM, Sullivan EA, Ishihara O, Chapman MG, Adamson GD. The economic impact of assisted reproductive technology: a review of selected developed countries. Fertil Steril 2009; 91 (06) 2281-2294
    CrossrefPubMedGoogle Scholar
  • 54 Wu AK, Odisho AY, Washington III SL, Katz PP, Smith JF. Out-of-pocket fertility patient expense: data from a multicenter prospective infertility cohort. J Urol 2014; 191 (02) 427-432
    CrossrefPubMedGoogle Scholar
  • 55 Gröne O, Garcia-Barbero M. ; WHO European Office for Integrated Health Care Services. Integrated care: a position paper of the WHO European Office for Integrated Health Care Services. Int J Integr Care 2001; 1: e21
    PubMedGoogle Scholar