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Health\u2010significant comorbidities were scored with the Charlson Comorbidity Index. Patients were followed up yearly recording any worsening in their health status until 2019. Cox regression models were used to estimate hazard ratios and 95% confidence intervals of Charlson Comorbidity Index score increase.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At a median follow\u2010up of 136 months (Interquartile range: 121, 156), 85 men (9.5%) depicted an increase of their baseline Charlson Comorbidity Index score of at least one point. The most frequent reason for Charlson Comorbidity Index upgrade was cancer (34%), cardiovascular diseases (29%) and diabetes mellitus (22%). Compared to patients without a Charlson Comorbidity Index increase, patients with a Charlson Comorbidity Index increase presented with higher body mass index and follicle\u2010stimulating hormone values, a higher rate of baseline Charlson Comorbidity Index \u2265 1 (all <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and a greater proportion of non\u2010obstructive azoospermia (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In the Cox regression model, the patient's BMI (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001), baseline Charlson Comorbidity Index \u2265 1 (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01) and azoospermia status (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001) were found to be independently associated with Charlson Comorbidity Index increases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Almost 10% of men presenting for primary infertility had a decrease of the overall health status already in the relatively short 10\u2010year time frame after the first presentation. Non\u2010obstructive azoospermic men showed the worst health status impairment and should be strictly followed\u2010up regardless of their fertility status.<\/jats:p><\/jats:sec>","DOI":"10.1111\/andr.13090","type":"journal-article","created":{"date-parts":[[2021,8,9]],"date-time":"2021-08-09T09:06:28Z","timestamp":1628499988000},"page":"128-136","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Risk of health status worsening in primary infertile men: A prospective 10\u2010year follow\u2010up study"],"prefix":"10.1111","volume":"10","author":[{"given":"Luca","family":"Boeri","sequence":"first","affiliation":[{"name":"Division of Experimental Oncology\/Unit of Urology Urological Research Institute, IRCCS Ospedale San Raffaele  Milan Italy"},{"name":"Department of Urology, Foundation IRCCS Ca\u2019 Granda \u2013 Ospedale Maggiore Policlinico University of Milan  Milan 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