Challenge 4: Prevention of Infertility-related Morbidity

It is estimated that 15-20% of all couples suffer from infertility. Research indicates that men and women suffering from infertility may be at increased risk of shorter life expectancy and of medical problems when they age, such as cardiovascular and metabolic diseases, cancer and osteoporosis. ReproUnion’s Challenge 4 focuses on how fertility may represent an ideal universal marker of later health, which can be used for preventive measures. 

With increasing life expectancy, it is a growing challenge for the health care system to meet the demands of “healthy aging”. Therefore, early prevention of major morbidities of the aging population is crucial to additionally improve longevity and the quality of life of the older population and to reduce the financial burden on the society.

For over a decade a key priority of the World Health Organization has been a 25% relative reduction in risk of premature mortality from cardiovascular diseases, cancer, diabetes, or chronic respiratory diseases – as stated in the Global Action Plan for the Prevention and Control of NCDs. Part of the solution is an improved understanding of infertility as a long-term biomarker for increased morbidity and premature mortality and subsequent development of new preventive strategies.

However, only a limited number of such preventive programs have been introduced over the past years, even if they are needed. Especially for men, who usually have their first contact with the health care system after the appearance of the first signs of a disease. Both men and women seeking help for infertility problems would seem to be an ideal target group for preventive measures. They represent a relatively large and approachable part of the population and most have no apparent co-morbidities at the time they suffer from infertility. However, they could be at risk of acquiring medical problems when they age, in addition to the burden of involuntary childlessness in their youth.

Infertility may thereby represent a universal biomarker of later health and survival. As this recognition has only emerged in recent years, information is still lacking before preventive actions can be taken to reduce the increased long-term morbidity and mortality that can be associated with reduced fertility. A focused research effort is needed to provide such information and ReproUnion’s Challenge 4 has worked alongside Challenge 1 and 2 to establish the ReproUnion Biobank & Infertility Cohort (RUBIC). All the information and samples that is currently being collected will contribute to research on co-morbidities that can be linked to infertility.

End of 2020 ReproUnion received additional funding to research the impact of COVID-19 on reproductive health and Challenge 4 is also focused on researching the association between the SARS-CoV-2 virus infection and long-term morbidity. On the male side Challenge 4 is also looking at the sex-hormone profile of the men enrolled in RUBIC and coupling the profile with the risk of getting COVID-19.


Niels Jørgensen