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2026-01-20
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Copyright (c) 2026 Zhi-Da Shi, Ye Zhao*

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Analysis of semen quality, sperm DNA fragmentation and heavy metals in urine in 1202 males of premarital medical examination
Zhi-Da Shi
Department of Public Health, International College, Krirk University, Bangkok 10220, Thailand.
Ye Zhao
Department of Public Health, International College, Krirk University, Bangkok 10220, Thailand.
DOI: https://doi.org/10.59429/ace.v9i1.5859
Keywords: Semen quality; Sperm DNA integrity; Urine heavy metals; Male fertility
Abstract
Background: Studies have shown that trace elements may adversely affect male reproduction, even at low levels. The toxic effects of heavy metals on the reproductive system have been mainly studied in animal experiments, and epidemiological evidence for populations exposed to the general environment is limited and inconsistent.
Objectives: Our aim in this study was to analyze the relationship between semen quality and multiple metals or metalloids (Al, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Cd, Pb, As and Se) in men undergoing premarital medical examinations (PME) and living in the same city.
Methods: Among 1202 PME men, semen quality and sperm DNA integrity were measured by using flow cytometry. Urine heavy metals were tested using a mass spectrometer at our infertility clinic. The urinary levels of various metals and the sperm DNA fragmentation rate of men with normal sperm parameters (NSP) and abnormal sperm parameters (ASP) were compared.
Results: Among1202 males, 42.0% (505/1202) were smokers, and 42.9% (516/1202) were alcohol users. A total of 594 men (594/1202, 49.4%) had NSP such as sperm concentration, total sperm, sperm motility and sperm morphology, whereas 608 men (608/1202, 50.6%) had some type of sperm-pathology (ASP); 600 had oligo- or astheno- or terato- or oligoasthenoteratozoospermia (OAT), 8 azoospermia 8/1202, 0.7%). The males of long-term outdoor work, smoking and drinking alcohol in ASP group were 252 (41.4%) , 308 (50.7%) and 283 (46.5%), respectively, and more than NSP group [(180, 30.3%), (33.1%) and (39.2%)] (P<0.05). There were no significant differences between ASP and NSP in semen volume, liquefaction time, pH, and round cells. The DNA fragmentation index shouwed a statistically significant difference between the two groups (13.3% ± 5.9%, 585 NSPs; vs 16.6% ± 14.1%, 585 ASPs, P<0.001). The mean concentrations of vanadium (V), chromium (Cr), cobalt (Co) and lead (Pb) and metalloid arsenic (As) were statistically significant between the two groups [(0.58 ± 0.42 µg, 483 NSPs; vs 0.65 ± 0.62 µg, 483 ASPs, P=0.043), (5.86 ± 15.14 µg, 483 NSPs; vs 11.94 ± 46.76 µg, 483 ASPs, P=0.007), (0.29 ± 0.26 µg, 483 NSPs; vs 038 ± 0.66 µg, 483 ASPs, P=0.008), (4.26 ± 1.90 µg, 483 NSPs; vs 6.47 ± 18.00 µg, 483 ASPs, P=0.008) and (39.69 ± 59.92 µg 592 NSPs; vs 51.85 ± 78.58 µg 598 ASPs)].
Conclusion: Our study suggests that high levels of vanadium, chromium, cobalt, lead and arsenic in urine may adversely affect sperm count, motility, morphology and sperm DNA integrity. Long time of outdoor work, smoking and alcohol consumption are more strongly associated with poorer sperm quality.
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