The effect of serum estrogen level on male infertility & semen parameters on Sudanese males attending Khartoum Dermatology Teaching Hospital

Abstract

Background Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse. As estimated 10–15% of couples were considered infertile by W.H.O. One of the major causes of non-obstructive infertility is hormonal disturbance. Testosterone and Estrogen, traditionally, have been regarded as male and female sex hormones respectively. However, Estradiol, the predominant form of Estrogen, also plays a pivotal role in male sexual function. Estradiol in men is quintessential in many sexual physiological processes. Objectives To evaluate the effect of Estrogen levels on infertile men and their semen parameters Method In this prospective case-control hospital based study, a total number of 50 infertile men with primary and secondary infertility (case group) and 50 fertile men (control group) were included. The medical histories of all the participants were taken and physical examinations were conducted thoroughly. Serum Estradiol (E2) levels were measured for both infertile and fertile group. Seminal analysis was done for the infertile group. Serum E2 was measured by Radio-Immunosorbent Assay (RIA) using Estradiol kits for measurement. Standard semen analysis was done by computer-assisted seminal analysis (CASA) using the WHO manual 2010. The collected data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. The results were obtained and presented in tables and diagrams. The significance of testing was assessed by Chi-Square T test with P value ≤0.05 was considered statistically significant. Results A significant correlation was observed between the fertility status and serum E2 levels. 18% (n=9) of the subfertile patients were found to have serum E2 levels more than 55 pg/ml. on the other hand, only 6% (n=3) of the fertile group (control group) were above 55 pg/ml (P value less than 0.05). Azoospermia was found to be the most semen parameter among patients with elevated serum E2 level (P value less than 0.05). It is also observed that 46% of the infertile patients were found to be overweight (BMI=25–29.9) & they have significantly high serum E2 levels (P value less than 0.05). Conclusion High serum Estradiol levels were found significantly correlated with male infertility; Azoospermia was the most commonly observed abnormal semen parameter. Overweight patients have significantly elevated Serum E2 levels.