Comparative Evaluation of Male Subfertility and Sexual Life Quality among Individuals with Substance Use Disorders and Non-substance-using Controls: A Cross-sectional Study

Background: Male subfertility accounts for 50% of infertility cases, with lifestyle factors like substance use disorders (SUDs) playing a crucial role. This study examines the prevalence of subfertility among male substance users (alcohol, tobacco, and opioids) and its impact on quality of sexual life compared to non-users. Materials and Methods: Conducted over 6 months at a tertiary care center in Haryana, the study recruited 120 married or sexually active males aged 18–50 years, who were classified into four equal groups: controls, alcohol users, tobacco users, and opioid users based on their preexisting substance use history, using non-probability convenience sampling. Participants were evaluated using a structured sociodemographic pro forma, the Quality of Sexual Life Questionnaire, and a comprehensive evaluation of semen parameters. Results: Opioid users had the highest prevalence of subfertility (80%), followed by tobacco (70%) and alcohol users (66.7%). Prolonged alcohol use was significantly correlated with reduced motility and reduced normal morphology. Tobacco use showed a negative correlation with sperm count and morphology. Opioid use was associated with significant impairments in sperm count, motility, and morphology. The quality of sexual life subdomains – sexual life, skills, and psychosocial well-being scores – was significantly lower in substance users ( P < 0.001), with the opioid group showing the lowest scores across all domains. Conclusion: This study highlights the high prevalence of subfertility among substance users, emphasizing the need for targeted interventions and public health initiatives to mitigate its impact on male reproductive health.