Association of Anxiety With Sperm Quality: a Multicentre Cross-sectional Study in China During the COVID-19 Outbreak

Objectives: There is no report about association of anxiety on sperm quality during the COVID-19 epidemic. Purpose of this study was to investigate the relationship between anxiety and sperm quality during the COVID-19 outbreak in China.Methods: 896 sperm donors from 7 sperm banks in China were investigated, and passed the screening for sperm donation between 23 January 2020 and 8 June 2020. Semen quality analysis follows the standards of the WHO Fifth Edition Human Semen Examination and Processing Manual. Anxiety symptoms were assessed by the Generalized Anxiety Disorder Scal-7(GAD-7). Logistic regression and linear regression were used to identify the association between anxiety level and sperm quality.Results: Participants with anxiety status (N = 155; 17.3%) had lower sperm concentration (56.81 ± 32.70 vs. 47.21 ± 30.76 [106/mL]), sperm volume (3.58 ± 1.65 vs. 3.04 ± 1.69 [mL], P < 0.001), total sperm count (7.29 ± 1.23 vs. 6.56 ± 1.63 [106], P < 0.001), and progressive motility (50.86 ± 12.45 vs. 38.50 ± 17.00 [%], P < 0.001) than those without anxiety. Linear regression showed that anxiety symptoms was significantly associated with 8.13 (95% confidence interval [CI]: 2.51, 13.75), 0.49 (0.20, 0.79) ,51.05 (23.43, 78.68) and 12.15 (95% CI: 23.43, 78.68), reduction in sperm concentration, semen volume, and total sperm count and progressive motility respectively.Conclusions: This study revealed that anxiety symptoms were negatively associated with semen quality, and interaction was discovered between debt stress and anxiety.