Socio-economic status and fertility of couples examined for infertility, social status and fertility.

The clinical Fertility of 1000 couples consecutively examined for infertility during 1950-52 was assessed 20 years later by means of a questionnaire, and results were compared with their socio-economic class as defined by the Svalastoga classification. Examinations had included semen analysis performed in our laboratory. 51 couples with known sterility because of azoospermia were excluded. The questionnaire was returned by 691 (72.8%). Couples of higher classes obtained more children (p less than 0.01) than those of lower classes, and they obtained, consistently, their first child in shorter time (p less than 0.01). Semen analysis showed better parameters of spermatozoa motility in higher classes, but the morphology was poorer, and there was no relation to socio-economic class when the different characteristics of semen analysis were combined according to the Hammen classification system of semen quality. It is discussed that the better fertility prognosis of couples of higher socio-economic classes not explained by a difference in semen quality of the men may indirectly indicate that females of lower classes suffered from more severe gynaecological diseases and abnormalities combined with a reduced fertility potential.