Occupational Heat Exposure and Fertility Stress as Independent Factors of Low Semen Quality: A Multidimensional Analysis.

Semen quality is a key factor in male reproductive health. The multifactorial etiology of male infertility involves complex interactions between environmental exposures and psychological states. The "mind-body" interaction, specifically the synergistic impact of lifestyle, social support, and fertility stress on semen quality, remains underexplored. This cross-sectional study recruited 485 men from our hospital between May 2021 and April 2023. Participants were categorized into normal (n = 256) and low semen quality (n = 229) groups based on WHO Laboratory Manual for the Examination and Processing of Human Semen (6th Edition). Participants completed the Social Support Rating Scale (SSRS), Fertility-related Quality of Life (FertiQoL), and Fertility Problem Inventory (FPI). Backward stepwise logistic regression was employed to identify independent predictors. Occupational heat exposure was the strongest risk factor (adjusted odds ratio [OR] = 4.188, 95% confidence interval [CI]: [1.527, 11.484], p = .005). Higher fertility-related stress showed a trend toward an independent association with low semen quality (adjusted OR = 1.005 per point, 95% CI: [1.000, 1.011], p = .068). Higher education level was a protective factor of semen quality (adjusted OR = .624, 95% CI: [0.415, 0.937], p = .023). Clinical management of male infertility should integrate psychological screening with occupational health guidance to optimize reproductive outcomes.