A new retrospective cohort study shows that men with infertility are at higher risk for various chronic diseases such as diabetes, heart disease, alcohol and drug abuse, suggesting that male infertility affects more than just the reproductive system. Researchers Michael Eisenberg of Stanford University School of Medicine and colleagues used insurance claims data from Truven Health MarketScan between 2001 and 2008, from which 115,000 patients were enrolled, to examine the outcomes of 13,027 men with infertility, 23,860 men who underwent semen or infertility screening, and 79,099 men who underwent vasectomy. A comparative analysis of the outcomes of men who underwent vasectomy was performed. The results found that men diagnosed with infertility had a higher prevalence of obesity and smoking than men with vasectomies and men who were screened for infertility only, and were at higher risk for multiple diseases even after correcting for age and follow-up time. Specifically, men with infertility had a 30%, 48%, 48%, 67%, and 19% increased risk of diabetes, ischemic heart disease, alcohol abuse, substance abuse, and depression, respectively, compared to men who were screened for infertility. Compared to vasectomized men, infertile men had a 9%, 14%, 41% and 16% increased risk of hypertension, hyperlipidemia, ischemic heart disease and other heart diseases, respectively; and 81%, 60%, 53% and 52% increased risk of diabetes, kidney disease, liver disease and peripheral vascular disease, respectively. Further analysis showed that among men with infertility, the risk of kidney disease was highest in men with azoospermia, and could be more than twice as high as in men who had only been tested for infertility. In addition, azoospermic men also had a significantly increased risk of alcohol abuse compared to men who had only been tested for infertility (HR=1.94, 95% CI: 1.11 to 3.39). The researchers’ analysis suggests two possible reasons for the correlation between infertility and adverse health outcomes. One, fetal exposure affects reproductive and physical health in adulthood; and two, infertile men have lower testosterone levels. Given that hypogonadism is a risk factor for cardiovascular disease and death, this may help explain the correlation between infertility and cardiovascular disease.