Respiratory tract disease and obstructive azoospermia

Abstract

Male infertility may be linked to respiratory tract disease in conditions such as cystic fibrosis and Kartagener's syndrome. Young's syndrome constitutes another such link, in which bronchiectasis is found in association with obstructive azoospermia and normal testicular function. We have studied 34 infertile men with mechanical azoospermia and appropriate control subjects to assess the number of patients with respiratory tract disease and the type and frequency of such disorders. Nineteen patients (59%) had grossly abnormal sinus radiographs compared with six controls (18%) (p less than 0.01) and 19 (56%--NS) gave a history of sinusitis; of these, six (18%) had had sinus operations (p less than 0.01). Eleven patients (32%) had histories of repeated otitis media, of whom two had had mastoid operations. Twelve (35%) had chronic bronchitis, of whom three were non-smokers. Ten other patients had bronchiectasis (p less than 0.001) and three of these had had a lobectomy. The chest radiograph was abnormal in 18 patients (p less than 0.001), including all 10 with bronchiectasis. Two patients had severe airflow obstruction and 13 others had a mildly obstructive pattern. This controlled study confirms that a significant excess of sinorespiratory disease can be identified in young men with obstructive azoospermia. We have found no features in the history or in the results of examination or investigations to explain why some of these patients have respiratory tract disease while others do not.