Relationships between income levels, lifestyles, occupational factors, and male fertility in peninsular Malaysia

Abstract

Objective: To explore the associations between income levels, employment risk, lifestyles, occupational stress, and male fertility.

Methods: This cross-sectional study analyzed 294 men seeking fertility treatment at fertility clinics in Terengganu, Pahang, and Kuala Lumpur from November 2021 to June 2023. Data were collected through structured questionnaires covering income levels, lifestyles, employment risks, occupational stress, and semen quality. Multinomial logistic regression was employed to assess predictors of semen quality, with crude and adjusted odds ratios (OR) reported.

Results: The lower-income group exhibited higher odds of having abnormal semen quality compared to normal semen quality. Specifically, these participants were more likely to experience azoospermia [crude OR 6.68, 95% confidence interval (CI) 1.84- 52.63; adjusted OR 6.26, 95% CI 1.76-51.38], indicating a link between low income and infertility issues. Lifestyle factors did not show significant associations with semen abnormalities after adjustment. High employment risks had significant associations with oligozoospermia after adjustment (crude OR 5.50, 95% CI 2.14-14.11; adjusted OR 5.15, 95% CI 1.93-13.71), while high occupational stress was linked to asthenozoospermia (crude OR 2.26, 95% CI 1.09-4.68; adjusted OR 2.25, 95% CI 1.07-4.69).

Conclusions: The findings underscore the influence of socioeconomic and occupational factors on male fertility, showing associations between lower income levels, high-risk occupations, and semen abnormalities. In contrast, lifestyle factors did not show significant associations with semen abnormalities after adjustment. Nevertheless, the current findings should be further confirmed through more extensive studies focusing on abnormal semen and lifestyle factors.

Keywords

Male infertility / Income levels / Employment risks / Occupational stress / Lifestyles

Conflict of interest statement

The authors confirm that they have no conflict of interests that could have influenced the work presented in this paper.

Funding

This study was supported by Malaysia's Ministry of Higher Education through the Fundamental Research Grant Scheme (FRGS) under the reference code FRGS/1/2020/SS0/UMT/02/3 and vote number 59637.

Authors’ contributions

Nur Fatma Hasni Majid conducted the data analysis and drafted the manuscript. Suriyani Muhamad was responsible for developing the concepts and study design. Suhal Kusairi contributed to the conceptual framework and manuscript drafting. Mohd Nasir Nawawi managed data acquisition and performed the statistical analysis. Noor Salihah Zakaria conducted the literature search and edited the manuscript. Roszaman Ramli provided critical manuscript editing and comprehensive review.

Publisher’s Note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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