Is male factor infertility rising? Another side of the equation from an in vitro fertilization clinic in southwestern Nigeria

Abstract

Background: Male factors account for about half of the causes of infertility and a high premium is placed on childbirth and rearing in developing countries. With the introduction of assisted conception, the burden of care for managing male infertility has shifted to the female partner. Male infertility is generally evaluated via seminal fluid analysis which includes parameters such as concentration, motility, and morphology. The etiology of male infertility is multifactorial, and majority of cases are known to be idiopathic. Materials and Methods: A descriptive cross-sectional study of 77 male partners of infertile couples presenting to an in vitro fertilization clinic in Ibadan, Nigeria, between January 1 and June 30, 2019. Participants were selected consecutively at their first consultation visit. A self-administered questionnaire was completed by each participant comprising socio-demographic information, results of laboratory screening, and seminal fluid analysis. Data was analyzed using the Statistical Package for Social Sciences (SPSS, IBM, NY), version 22. Descriptive statistics were generated, and presented with the aid of a bar chart, pie chart, and frequency tables. Results: The average age of the participants was 43.64 ± 3.1 years and 97.4% (75) were in a stable relationship. Duration of infertility ranged between 3 and 17 years with an average of 7.6 ± 1.8 years. Human immunodeficiency virus, syphilis, hepatitis B, and hepatitis C were diagnosed in 3%, 4%, 5%, and 1%, respectively. Over half of the participants had semen volume and liquefaction time of 1-2 mL and 15-30 min, respectively. 34 men (44.1%) had normal semen parameters while the remaining 43 (55.9%) had various forms of abnormalities. Mid-piece defects were the most prevalent morphological defects and were found in 70 men (90.9%) while immature spermatozoa were found in 38 men (49.4%). Only one participant had azoospermia (1.3%). Conclusion: The impact of male factor infertility cannot be over-emphasized. Male contribution to infertility is thought to be rising and this study from male partners of infertile couples revealed semen abnormalities in over 50% of the participants. Addressing preventable causes of male infertility through health awareness and lifestyle modifications are important steps towards engendering optimal reproductive health.