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Racial/Ethnic differences in male reproductive health: a systematic review and meta-analysis of semen parameters and hormonal profiles in the United States

International Journal of Impotence Research (2025)Cite this article

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Abstract

We conducted systematic review and meta-analysis of differences in semen parameters and reproductive hormones between White, Black, Asian, Hispanic, and non-Hispanic men in the United States. We systematically searched PubMed, Scopus, and Web of Science. Of 2624 studies identified, 25 studies were included for meta-analysis. The pooled analysis revealed that White men compared to Black men had higher sperm concentration of +26.43 million/ml (95%CI = 7.81, 45.05; I2 = 98.98%), higher total sperm count of +128.35 million (95%CI = 82.10, 174.60; I2 = 98.46%), lower age-adjusted free testosterone of −15.12 pmol/L (95%CI = −29.89, −0.35; I2 = 99.55%), lower age-adjusted estradiol of −15.23 pmol/L (95%CI = −27.61, −2.85; I2 = 99.96%), and lower age-adjusted SHBG of −1.52 nmol/L (95%CI = −2.60, −0.44; I2 = 95.65%). Compared to Asian men, White men had higher age-adjusted estradiol of +0.97 pmol/L (95%CI = 0.81, 1.14; I2 = 0%) and Black men had higher SHBG of +2.93 nmol/L (95%CI = 2.63, 3.23; I2 = 0%). Hispanic compared to non-Hispanic men had higher sperm concentration of +5.12 million/ml (95%CI = 4.17, 6.06; I2 = 60.67%) and higher total motility of +5.28% (95%CI = 0.49, 10.07; I2 = 93.11%), lower age-adjusted total testosterone of −0.77 nmol/L (95%CI = −1.22, −0.33; I2 = 98.51%), lower age-adjusted estradiol of −12.54 pmol/L (95%CI = −23.26, −1.81; I2 = 99.82%), and lower age-adjusted SHBG of −2.08 nmol/L (95%CI = −4.13, −0.02; I2 = 99.57%). In conclusion, this meta-analysis found ethnic variations in male reproductive parameters in the United States.

Highlights

  • White men demonstrated higher sperm concentration (+26.43 million/ml), higher total sperm count (+128.35 million), and lower free testosterone (−15.12 pmol/L) than Black men.

  • Asian men exhibited lower free testosterone (−10.98 pmol/L) than White men after adjusting for publication bias.

  • Hispanic men had higher sperm concentration (+5.12 million/ml), higher total motility (+5.28%), and lower estradiol (−12.54 pmol/L) than non-Hispanic men.

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Fig. 1
Fig. 2: Weighted mean differences in reproductive hormones between White and Black men in the United States.
Fig. 3: Weighted mean differences in reproductive hormones between White and Asian men in the United States.
Fig. 4: Weighted mean differences in reproductive hormones between Black and Asian men in the United States.
Fig. 5: Weighted mean differences in reproductive hormones between Hispanic and non-Hispanic men in the United States.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of Utah Health, Salt Lake City, UT, USA

    Hojat Dehghanbanadaki, Kiarad Fendereski, Joshua J. Horns, Joemy M. Ramsay, Masaya Jimbo, Kelli X. Gross, Alexander W. Pastuszak & James M. Hotaling

  2. Texas A&M University School of Medicine, Bryan, TX, 77807, USA

    Bryan Kim

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Contributions

Conceptualization, HD and JMH; Methodology, HD; Screening, data extraction, and risk of bias assessment, HD and BK; Validation, formal analysis and visualization, HD; Manuscript drafting, HD, BK, and KF; Writing—review and editing, HD, BK, KF, JJH, JMR, MJ, KXG, AWP, and JMH; Supervision, JMH; Project administration, HD; All authors have read and agreed to the final version of the manuscript.

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Correspondence to Hojat Dehghanbanadaki or James M. Hotaling.

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Dehghanbanadaki, H., Kim, B., Fendereski, K. et al. Racial/Ethnic differences in male reproductive health: a systematic review and meta-analysis of semen parameters and hormonal profiles in the United States. Int J Impot Res (2025). https://doi.org/10.1038/s41443-025-01084-9

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