Male infertility : immunological and clinical aspects at the University Health Center of Brazzaville

Abstract

Summary : The objective of this study is to contribute to the knowledge of the immunological and clinical aspects of the male infertility at the University Health Center of Brazzaville. Patients and methods : it was a descriptive, transversal and analytical study over a period ranging from the 1st november 2015 to the 31st october 2016. All patients with infertlity were concerned among them we distinguished between those having agglutinates of sperm in the semen on the one hand (G1) from those who did not have any (G2). So we looked for the presence of the antisperm antibodies in the two groups. Results : During the period of study, 1889 spermograms had been realised, and 67 among them were pathological approximately 3,5 % and among them there were 18% with the ASA. The patients were on average 37,4 +/- 5,8 years old, extreme (27-56 years old). They consulted after a delay of 5,3 +/3,7 years on average, extremes (1-16 years). The infertlity was primary in 50,7% and secondary in 49,3%. As far as the scrotum is concerned, the varicocele was more found in 34,3%. In the spermogram, 18 % had agglutinates of sperm against 82 %. The. oligoasthenozoospermias represented 41,8% followed by azoospermia, 20 %. The stigmata of infection have been noticed, they are alkaline PH (9,9%),many leukocytes (10%) and hyperspermia (0,9%). For the 9 patients who had sperm with antispermatozoid antibodies, 1 patient had IgA, 2 patients had IgG and 6 patients had both IgA and IgG. The age of those having agglutinates ranged between 50 and 56 years (58,%) versus 30 and 39 years at 60 % (p˂0,05). The story of uro genital infecion was more present. The ASA were more identified in those having agglutinates in 58,33% of cases (p=0,0001). The average of the percentages of the anti-sperm auto-antibodies of the G1 was of 26,4 ± 7,01% with extrems between 18% and 85%. The average of percentages of anti-sperm auto-antibodies of G2 was 1,4 ± 1,02 % with extrems between 38% and 40% (p˂0,05). The two types of antibodies were identified in an associative way in the majority of serums. Conclusion : the unvailability of the research of the ASA in our context make difficult the diagnosis of male infertility from immunological origine. The presence of the sperm agglutinates remains the only diagnosis element. Once the diagnosis is established, the management must be done through the Medically Assisted Reproduction (IVF).