Telomere Length, a New Biomarker of Male (in)Fertility? A Systematic Review of the Literature

Male factors are suspected in around half cases of infertility, of which up to 40% are diagnosed as idiopathic. In the context of a continuously increased resort to ART and increased decline of semen parameters, it is of greatest interest to evaluate an additional potential biomarker of sperm quality. According to PRISMA guidelines, this systematic review of the literature selected studies evaluating telomere length in sperm and/or in leukocytes as a potential male fertility biomarker. Twenty-two publications (3168 participants) were included in this review of experimental evidence. For each study, authors determined if there was a correlation between telomere length and semen parameters or fertility outcomes. Of the 13 studies concerning sperm telomere length (STL) and semen parameters, ten found an association between short STL and altered parameters. Concerning the impact of STL on ART results, the data are conflicting. However, eight of the 13 included studies about fertility found significantly longer sperm telomeres in fertile men than in infertile men. In leukocytes, the seven studies reported conflicting findings. Shorter sperm telomeres appear to be associated with altered semen parameters or male infertility. Telomere length may be considered as a new molecular marker of spermatogenesis and sperm quality, and thus is related to male fertility potential. However, additional studies are needed to define the place of the STL in the assessment of individual fertility.

Automated summary

Male factors are involved in around 50% of infertility cases, with up to 40% being diagnosed as idiopathic. It is important to evaluate additional biomarkers for sperm quality, especially considering the increasing use of ART and declining semen parameters. This systematic review selected studies on telomere length as a potential male fertility biomarker. The results suggest that shorter sperm telomeres may be associated with altered semen parameters or male infertility, but further studies are needed to determine its role in assessing individual fertility.