Human reproduction open · 2025
Life's Essential 8 score and its association with sperm quality parameters in reproductive-aged men: evidence from the Led-Fertyl cohort.
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Davila-Cordova Estefanía, Salas-Huetos Albert, Fernández de la Puente María, Ramos-Rodríguez Carla, Martínez María Ángeles, Canudas Silvia, Palau-Galindo Antoni, Mestres-Solà Cristina, Manzanares-Errazu José María, Sánchez-Resino Elena, Murphy Michelle M, Salas-Salvadó Jordi, Babio Nancy
Аннотация
STUDY QUESTION: Is Life's Essential 8 (LE8) score associated with sperm quality parameters in healthy reproductive-aged men?
SUMMARY ANSWER: Higher LE8 score adherence is positively associated with total sperm count, sperm concentration, total motility, and progressive motility.
WHAT IS KNOWN ALREADY: Several lifestyle and cardiovascular risk factors may affect sperm quality, but there is limited scientific evidence in men.
STUDY DESIGN SIZE DURATION: A cross-sectional analysis in the context of the Led-Fertyl (Lifestyle and Environmental Determinants of Seminogram and Other Male Fertility-Related Parameters) study was conducted.
PARTICIPANTS/MATERIALS SETTING METHODS: A total of 223 young men aged 18-40 years were recruited between February 2021 and December 2024 in Reus (Catalonia, Spain). The AHA-LE8 ideal cardiovascular health (CVH) score (ranging from 0 to 100) was calculated as the means of eight CVH metrics and was considered as exposure. This score is based on four health behaviors (healthy diet, adequate physical activity, avoidance of nicotine, and healthy sleep) and four health factors (healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure). Conventional sperm quality parameters (count, concentration, vitality, total and progressive motility, and normal sperm morphology) were considered the main outcomes. Adherence to the LE8 score was categorized into tertiles using the lowest tertile as the reference (T1). All regression models were adjusted for several potential confounders: age (years), education (high school or less, college or higher education), monthly income (<2000 euros and ≥2000 euros), and sexual abstinence (days).
MAIN RESULTS AND THE ROLE OF CHANCE: Compared with those in the lowest tertile, men in the highest tertile of the LE8 score had higher sperm concentration (β = 1.11; 95% CI: 0.12, 2.09), total motility (β = 6.05; 95% CI: 0.44, 11.65), and progressive motility (β = 5.84; 95% CI: 0.19, 11.48). In the continuous analysis, each 10-point increase in the LE8 score was positively associated with total sperm count (β = 0.88; 95% CI: 0.13, 1.63), sperm concentration (β = 0.45; 95% CI: 0.03, 0.86), total (β = 2.91; 95% CI: 0.56, 5.26), and progressive motility (β = 3.00; 95% CI: 0.63, 5.36). Compared with participants in the lowest tertile of the LE8 score, those in the highest tertile were 68% less likely to have an abnormal seminogram, according to the World Health Organization (2010) thresholds (OR: 0.32; 95% CI: 0.15, 0.67).
LIMITATIONS REASONS FOR CAUTION: Due to the cross-sectional design, a cause-effect relationship cannot be established. It is also not possible to generalize these results to other populations.
WIDER IMPLICATIONS OF THE FINDINGS: Our findings suggest a positive association between the LE8 score and total sperm count, sperm concentration, total motility, and progressive motility. In addition, a higher LE8 score is associated with lower odds of an abnormal seminogram in healthy men of reproductive age.
STUDY FUNDING/COMPETING INTERESTS: The Led-Fertyl study was supported by the Spanish government's official funding agency for biomedical research, Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), the European Union ERDF/ESF, 'A way to make Europe'/'Investing in your future' [PI21/01447], and the Diputació de Tarragona (2021/11-No.Exp. 8004330008-2021-0022642). J.S.-S. is a distinguished senior researcher supported by the ICREA Academia Program. E.D.-C. has received a Contrato Pre-doctoral de Formación en Investigación en Salud (PFIS FI22/00018) of the Acción Estratégica en Salud program (AES) from the ISCIII, Spanish Ministry of Health. All of the authors have no conflicts of interest to declare.
TRIAL REGISTRATION NUMBER: N/A.
SUMMARY ANSWER: Higher LE8 score adherence is positively associated with total sperm count, sperm concentration, total motility, and progressive motility.
WHAT IS KNOWN ALREADY: Several lifestyle and cardiovascular risk factors may affect sperm quality, but there is limited scientific evidence in men.
STUDY DESIGN SIZE DURATION: A cross-sectional analysis in the context of the Led-Fertyl (Lifestyle and Environmental Determinants of Seminogram and Other Male Fertility-Related Parameters) study was conducted.
PARTICIPANTS/MATERIALS SETTING METHODS: A total of 223 young men aged 18-40 years were recruited between February 2021 and December 2024 in Reus (Catalonia, Spain). The AHA-LE8 ideal cardiovascular health (CVH) score (ranging from 0 to 100) was calculated as the means of eight CVH metrics and was considered as exposure. This score is based on four health behaviors (healthy diet, adequate physical activity, avoidance of nicotine, and healthy sleep) and four health factors (healthy weight, and healthy levels of blood lipids, blood glucose, and blood pressure). Conventional sperm quality parameters (count, concentration, vitality, total and progressive motility, and normal sperm morphology) were considered the main outcomes. Adherence to the LE8 score was categorized into tertiles using the lowest tertile as the reference (T1). All regression models were adjusted for several potential confounders: age (years), education (high school or less, college or higher education), monthly income (<2000 euros and ≥2000 euros), and sexual abstinence (days).
MAIN RESULTS AND THE ROLE OF CHANCE: Compared with those in the lowest tertile, men in the highest tertile of the LE8 score had higher sperm concentration (β = 1.11; 95% CI: 0.12, 2.09), total motility (β = 6.05; 95% CI: 0.44, 11.65), and progressive motility (β = 5.84; 95% CI: 0.19, 11.48). In the continuous analysis, each 10-point increase in the LE8 score was positively associated with total sperm count (β = 0.88; 95% CI: 0.13, 1.63), sperm concentration (β = 0.45; 95% CI: 0.03, 0.86), total (β = 2.91; 95% CI: 0.56, 5.26), and progressive motility (β = 3.00; 95% CI: 0.63, 5.36). Compared with participants in the lowest tertile of the LE8 score, those in the highest tertile were 68% less likely to have an abnormal seminogram, according to the World Health Organization (2010) thresholds (OR: 0.32; 95% CI: 0.15, 0.67).
LIMITATIONS REASONS FOR CAUTION: Due to the cross-sectional design, a cause-effect relationship cannot be established. It is also not possible to generalize these results to other populations.
WIDER IMPLICATIONS OF THE FINDINGS: Our findings suggest a positive association between the LE8 score and total sperm count, sperm concentration, total motility, and progressive motility. In addition, a higher LE8 score is associated with lower odds of an abnormal seminogram in healthy men of reproductive age.
STUDY FUNDING/COMPETING INTERESTS: The Led-Fertyl study was supported by the Spanish government's official funding agency for biomedical research, Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS), the European Union ERDF/ESF, 'A way to make Europe'/'Investing in your future' [PI21/01447], and the Diputació de Tarragona (2021/11-No.Exp. 8004330008-2021-0022642). J.S.-S. is a distinguished senior researcher supported by the ICREA Academia Program. E.D.-C. has received a Contrato Pre-doctoral de Formación en Investigación en Salud (PFIS FI22/00018) of the Acción Estratégica en Salud program (AES) from the ISCIII, Spanish Ministry of Health. All of the authors have no conflicts of interest to declare.
TRIAL REGISTRATION NUMBER: N/A.