The relationship between post-earthquake trauma levels and semen quality in adult men: a cross-sectional study from Turkey

Background: The study aimed to evaluate the semen quality of male patients who received infertility treatment after the earthquakes using the Post-Earthquake Trauma Level Determination Scale. Methods: The Post-Earthquake Trauma Level Determination Scale (PETLDS) was applied to 148 male patients who presented to the Assisted Reproductive Technologies (ART) Center in the 6 months after 06 February 2023, to evaluate the semen parameters. Results: The city where the study was conducted had relatively less destruction compared to other cities in the earthquake area, and the average score obtained from the PETLDS among our patients was 39.52 ± 15.75. It was found that, with high post-earthquake trauma levels, behavioral problems (r = 0.738, p < 0.001), emotional limitation level (r = 0.842, p < 0.001) and sleep problems (r = 0.816, p < 0.001) increased, and forward progressive sperm counts decreased (r = −0.162, p < 0.05), while other semen parameters were not affected. Conclusions: It was understood that emotional limitations and sleep problems were more common in individuals with high Post-Earthquake Trauma Levels, the psychological impact was greater, and the physical reflection of stress was also high in these individuals, and this effect could cause a decrease in the number of progressively motile sperm in the male reproductive system.

Earthquake; Post-psychological trauma; Semen analysis

[1] Ankara, Türkiye: Disaster and Emergency Management Authority (AFAD). February 6, 2023 Pazarcık–Elbistan (Kahramanmaraş) Earthquakes Report (Mw: 7.7–Mw: 7.6). 2023. Available at: https://deprem.afad.gov.tr/earthquake-reports (Accessed: 13 October 2025).

[2] Vigil JM, Geary DC. A preliminary investigation of family coping styles and psychological well-being among adolescent survivors of Hurricane Katrina. Journal of Family Psychology. 2008; 22: 176–180.

[3] Rowe O, Nadkarni A. Barriers and facilitators to the implementation of mental health and psychosocial support programmes following natural disasters in developing countries: a systematic review. Global Mental Health. 2024; 11: e5.

[4] Skirbekk V. Fertility in the aftermath of disaster. In Skirbekk V (ed). Decline and prosper!: Changing global birth rates and the advantages of fewer children (pp. 265–284). Palgrave Macmillan: Cham. 2022.

[5] Lee DS, Batyra E, Castro A, Wilde J. Human fertility after a disaster: a systematic literature review. Proceedings of the Royal Society B: Biological Sciences. 2023; 290: 20230211.

[6] Jung Y. Natural disaster and fertility preference: evidence from the tsunami in Indonesia. Biodemography and Social Biology. 2024; 69: 110–116.

[7] Raker EJ. Natural hazards, disasters, and demographic change: the case of severe tornadoes in the United States, 1980–2010. Demography. 2020; 57: 653–674.

[8] Yabe T, Tsubouchi K, Fujiwara N, Sekimoto Y, Ukkusuri SV. Understanding post-disaster population recovery patterns. Journal of the Royal Society Interface. 2020; 17: 20190532.

[9] Ahmed KJ, Tan Y, Rudd D. Exploring the relationship between changes in fertility and disasters: a review of the literature. Journal of Population Research. 2024; 41: 1.

[10] WHO. WHO laboratory manual for the examination and processing of human semen, 6th ed. 2021. Available at: https://www.who.int/publications/i/item/9789240030787 (Accessed: 25 July 2025).

[11] Rochdi C, Ouadrhiri M, Allai L, Bellajdel I, Mamri S, Taheri H, et al. Beneficial effects of oral antioxidant supplementation on semen quality parameters, reproductive hormones, and sperm DNA integrity in men with idiopathic oligoasthenoteratozoospermia. Clinical and Experimental Reproductive Medicine. 2025; 51: 135–141.

[12] Castellini C, Cordeschi G, Tienforti D, Barbonetti A. Relationship between male aging and semen quality: a retrospective study on over 2500 men. Archives of Gynecology and Obstetrics. 2024; 309: 2843–2852.

[13] Lyons HE, Gyawali P, Mathews N, Castleton P, Mutuku SM, McPherson NO. The influence of lifestyle and biological factors on semen variability. Journal of Assisted Reproduction and Genetics. 2024; 41: 1097–1109.

[14] Sichani HP, Alavi SM, Mahmoodi M, Meybodi JE, Amiri SM, Mahmoudi-Zadeh M, et al. The association of global and prime diet quality scores with sperm quality parameters: a cross-sectional study. Journal of Health, Population and Nutrition. 2025; 44: 197.

[15] Yang W, Duan Z, Li G, Geng H, Gao Y, Shen Q, et al. Association of lifestyle and occupational exposure factors with human semen quality: a cross-sectional study of 1060 participants. Systems Biology in Reproductive Medicine. 2024; 70: 150–163.

[16] Nakhaee Moghadam M, Ghaemi M, Eskandari Delfan S, Afshari M, Kaveh M, Eshraghi N, et al. Mood disorders and sexual function in infertile men: exploring the relationship with semen analysis results. Andrologia. 2024; 2024: 1–6.

[17] Zhang Y, Chen B, Wang Y, Liu C, Sun J, Zhang Z, et al. Association between mental health and male fertility: depression, rather than anxiety, is linked to decreased semen quality. Frontiers in Endocrinology. 2024; 15: 1478848.

[18] Simbar M, Ghasemi V, Taherian R, Kalhor M, Mohammadian F, Kiani Z. Prevalence of anxiety symptoms in infertile men: a systematic review and meta-analysis. BMC Public Health. 2024; 24: 1805.

[19] Moon N, Morgan CP, Marx-Rattner R, Jeng A, Johnson RL, Chikezie I, et al. Stress increases sperm respiration and motility in mice and men. Nature Communications. 2024; 15: 7900.

[20] Abu-Musa AA, Nassar AH, Hannoun AB, Usta IM. Effect of the Lebanese civil war on sperm parameters. Fertility and Sterility. 2007; 88: 1579–1582.

[21] Abu-Musa AA, Kobeissi L, Hannoun AB, Inhorn MC. Effect of war on fertility: a review of the literature. Reproductive BioMedicine Online. 2008; 17: 43–53.

[22] Chen X, Chen S, Yue H, Lin L, Wu Y, Liu B, et al. Semen quality in adult male survivors 5 years after the 2008 Wenchuan earthquake. Andrologia. 2016; 48: 1274–1280.

[23] Yanardağ R, Toper F, Yağar F. A qualitative study on the exploration of the psycho-social and economic impacts of the Kahramanmaraş-centered earthquakes on February 6, 2023. Sosyoekonomi. 2025; 33: 551–573. (In Turkish)

[24] Fenster L, Katz DF, Wyrobek AJ, Pieper C, Rempel DM, Oman D, et al. Effects of psychological stress on human semen quality. Journal of Andrology. 1997; 18: 194–202.

[25] Tanhan F, Kayri M. Validity and reliability study of the post-earthquake trauma level determination scale. Educational Sciences: Theory and Practice. 2013; 13: 1013–1025. (In Turkish)

[26] Baran C, Hellstrom WJ, Sikka SC. A comparative evaluation of semen parameters in pre-and post-Hurricane Katrina human population. Asian Journal of Andrology. 2015; 17: 676–680.

[27] Satar DA, Bağcı R, Demirdelen U. The effect of war conditions and social stress on semen parameters in Syrian refugees. Phoenix Medical Journal. 2022; 6: 6–10.

[28] Amin YK. The effect of chemical weapon exposure on semen fluid analysis and the determination of SOD and MDA levels in peshmerga against ISIS war. Indian Journal of Forensic Medicine & Toxicology. 2021; 15: 2885–2892.

[29] Fukuda M, Fukuda K, Shimizu T, Yomura W, Shimizu S. Kobe earthquake and reduced sperm motility. Human Reproduction. 1996; 11: 1244–1246.

[30] Lindaman LA, Pilsner JR, Kroll-Desrosiers AR, Haskell S, Brandt CA, Mattocks KM. Semen quality parameters among US veterans of operation enduring freedom, operation Iraqi freedom, and operation new dawn. Military Medicine. 2017; 182: e1775–e1781.

[31] Medina H, Flores A, Juárez-Rojas L, Casillas F, Ommati MM, Heidari R, et al. Chronic stress disturbs neuroendocrine control of reproduction and fertility in male rats. Reproductive Biology. 2025; 25: 101027.

[32] Song J, Xiao L, Zhang Z, Wang Y, Kouis P, Rasmussen LJ, et al. Effects of reactive oxygen species and mitochondrial dysfunction on reproductive aging. Frontiers in Cell and Developmental Biology. 2024; 12: 1347286.

[33] Odetayo AF, Akhigbe RE, Bassey GE, Hamed MA, Olayaki LA. Impact of stress on male fertility: role of gonadotropin inhibitory hormone. Frontiers in Endocrinology. 2024; 14: 1329564.

[34] Moustakli E, Zikopoulos A, Skentou C, Katopodis P, Domali E, Potiris A, et al. Impact of reductive stress on human infertility: underlying mechanisms and perspectives. International Journal of Molecular Sciences. 2024; 25: 11802.