The impact of neighborhood socioeconomic status and racial composition on semen quality

Background: Socioeconomic and racial disparities are well-established determinants of health outcomes, yet their influence on male reproductive health remains underexplored. Semen quality, particularly total motile sperm count (TMSC), is increasingly recognized not only as a marker of fertility but also as a proxy for overall health. This study investigates the relationship between neighborhood-level socioeconomic deprivation and racial composition with semen quality among men undergoing fertility evaluation. Objective: To assess the association between neighborhood deprivation, measured by the Area Deprivation Index (ADI), and TMSC, and to evaluate racial disparities in these associations. Study Design: A retrospective cohort study was conducted involving 2198 men evaluated at a single academic fertility clinic in Georgia between 2015 and 2024. ADI scores were calculated using geocoded residential addresses and matched to census block data. Participants were stratified into quartiles based on ADI scores. Semen samples were analyzed for TMSC and other parameters. Regression analyses were performed to assess associations between ADI, race, and semen quality. Results: