Sugar-sweetened beverage intake in relation to semen quality in infertile couples − a prospective observational study

Aims: This cross-sectional study was designed to evaluate effect of sugar-sweetened beverages (SSBs) on semen parameters in infertile couples. Setting: Men attending infertility clinic. Design: prospective, observational study. Methods and material: Participants were assessed the type and frequency of SSB intake in the past month by a previously validated beverage intake questionnaire (BEVQ-15) and provided one semen sample for analysis. The primary outcome were semen parameters; namely volume (in mL), total sperm count (in millions/ejaculate), sperm concentration (in million/mL), sperm motility% (PRM+NPM+IM), progressive motility% (PRM), vitality% and sperm morphology% (per 200 spermatozoa). The main independent variable was SSB intake. Statistical analysis: Multiple linear regression models were used to predict semen parameters based on SSB intake and potential confounders, compared across quartiles using Kruskal-Wallis test. Non-linearity was examined by fitting models with linear and quadratic terms. Results: 385 men were included in the study. A significant decline in crude sperm motility% (P<0.001), progressive motility% (P<0.001), vitality% (P=0.017) and normal sperm morphology (P=0.006) with increasing SSB intake was found, along with a significant decline in volume and sperm concentration in the adjusted model (P<0.05). Significant decrease was noted in sperm motility and progressive motility percentages in both lean (BMI <25) and overweight and obese men (BMI ≥25) with increasing SSB intake. However, in presence of other potential confounders, SSBs lost its impact on semen parameters in the linear and quadratic fitted models, possibly due to interdependence of the confounders. Conclusion: Intake of SSBs negatively affect sperm parameters, except total sperm counts. But with other stronger confounders, its impact needs to further evaluated in larger populations of men.