Male physicians as patients: is fertility an issue?

Abstract Introduction Physicians may be subjected to grueling work hours, sleep deprivation, and a stressful work environment during their prime reproductive years. While attention to fertility among female physicians has garnered interest in recent years, little is known about the fertility of their male colleagues. Objective In this study we sought to compare semen parameters of male physicians presenting for a fertility evaluation compared to their non-physician counterparts. Methods Upon IRB approval, a retrospective review of all hospital employed individuals (or their partners) who underwent a semen analysis between 2013-2019 was performed. Post-vasectomy semen analysis patients were excluded. Baseline patient demographics including age, comorbidities, occupation, and BMI were recorded. Normal semen parameters were defined by the World Health Organization 2010 criteria. A comparison analysis of semen analysis parameters, baseline characteristics, and comorbidities was conducted with a significant p-value defined as <0.05. Results Of the 169 physicians and 438 non-physicians identified, physicians were more likely to have a lower BMI (median 25.8 vs. 28.0, p<0.0001) when compared to their non-physician counterparts. Physicians were less likely to have ADHD, depression, obstructive sleep apnea, malignancy, alcohol abuse, and history of smoking (p<0.05). Physicians had better semen parameters including pH, concentration, motility, volume, and morphology (p<0.05), with a greater sperm concentration (68.4 vs. 52.2 million/mL, p<0.0001) and higher total motile sperm count (125 vs. 86.4 million, p<0.0001) compared to non-physicians. However, male physicians were more likely to be older at time of semen analysis (33.8 versus 32.7 years, p<0.05), more likely to utilize assisted reproductive technology (IVF and IUI, p=0.0277), have older female partners (p=0.0053), and have older female partners at time of delivery (p=0.0124). Conclusions In this study we report, for the first time, semen parameters of physicians compared to non-physicians. Physicians had a significantly higher total motile sperm count and sperm concentration; however, they were older at time of semen analysis, more likely to utilize ART, and more likely to have older female partners. While physicians may be healthier, this may indicate increased difficulty achieving pregnancy. Patient care is directly impacted by the health and safety provided to their physicians. As the paradigm in the medical field shifts from caring only for our patients to caring for ourselves, fertility amongst male physicians warrants further investigation. Disclosure No