Seminal Fluid Analysis Research Articles

Measurement of Seminal plasma myd88 protein and Bacterial Lipopolysaccharide in infertile male as an indicator for Leukocytospermia and bad Seminal fluid analysis

Measurement of Seminal plasma myd88 protein and Bacterial Lipopolysaccharide in infertile male as an indicator for Leukocytospermia and bad Seminal fluid analysis

High frequency of Klinefelter syndrome in a cohort of Sri Lankan males with non-obstructive azoospermia and oligozoospermia

Introduction: Klinefelter syndrome (KS) is the most common sex chromosomal aneuploidy. It affects 1:667 males. It is a major cause of male factor infertility due to the associated testicular atrophy. This study aims to describe the karyotype pattern identified in a cohort of Sri Lankan infertile males referred for cytogenetic testing prior to undergoing testicular biopsy. Materials and methods: The karyotype reports of males with severe oligozoospermia (sperm cell count<5×106 cells/ml in seminal fluid analysis) and non-obstructive azoospermia, who were referred for karyotyping between January 2010 and February 2019 were maintained prospectively in an anonymized database and analysed retrospectively. All patients were referred from a single urological practice prior to undergoing testicular biopsy. Karyotyping was performed on routinely cultured lymphocytes after GTG-banding according to the guidelines of the International System for Human Cytogenetic Nomenclature (2016). Results: A total of 69 infertile males underwent karyotyping. 40 (58.0%) had azoospermia and 29 (42.0%) had severe oligozoospermia. Abnormal karyotypes were seen in 14 (20.3%) males, comprising of 11 (78.6%) with KS (47,XXY) and 3 (21.4%) with 46,XX karyotype. Polymerase chain reaction for SRY gene was positive in one male with 46,XX karyotype. Among the KS patients, 6 (54.6%) had azoospermia and 5 (45.5%) had severe oligozoospermia. Conclusions: KS accounted for more than two-thirds of the chromosomal anomalies among the infertile males referred for karyotyping. These findings highlight the need for cytogenetic evaluation of severe oligozoospermic and azoospermic males prior to undertaking extensive invasive investigations and treatment measures in both partners.

Comparative Study between Slow Conventional Freezing and Cryoprotectant-Free Vitrification of Human Spermatozoa in Large Volume

Background: Cryopreservation is the collection, freezing, and long term storage of sperm, and is a highly effective method of protecting male fertility. Cryopreservation of semen has been widely used as a vital method for fertility preservation of male patients before undergoing chemotherapy, radiotherapy, and/or surgery that may lead to testicular failure or ejaculatory dysfunction. Objective: The aim of this study was to compare the aseptic technology of cryoprotectant-free vitrification of human spermatozoa in large volume, to conventional freezing protocol as regards post thawing motility, vitality and sperm DNA fragmentation. Patients and methods: This study included a total of 20 male patients seeking seminal fluid analysis, attending at the andrology laboratory of a specialized IVF center (ADAM International Hospital for Fertility and Sterility, Giza, Egypt. Patients were presented with the diagnoses of normozoospermia, oligozoospermia (either isolated or combined with asthenozoospermia or teratozoospermia). Results: Motility of (in a large volume (300 µl) in the absence of permeable cryoprotectants displayed significant statistically lower levels as compared to conventional Sperm Freezing. It was shown in different groups at different times (post thawing and 1-hour and 24-hour) of assessment that motility of vitrified spermatozoa decreases in comparison with slow conventional freezing as we go from the baseline. DNA fragmentation of vitrified spermatozoa showed higher levels as compared to conventional slow freezing but there is no significant statistical difference between vitrification and conventional slow freezing in DNA fragmentation. Conclusion: It could be concluded that vitrification technique was quite far away from comparison with slow conventional freezing protocol, and still need for further modifications and wide scale of study to achieve the good results.

Comparative Study between Slow Conventional Freezing and Cryoprotectant-Free Vitrification of Human Spermatozoa in Large Volume

Background: Cryopreservation is the collection, freezing, and long term storage of sperm, and is a highly effective method of protecting male fertility. Cryopreservation of semen has been widely used as a vital method for fertility preservation of male patients before undergoing chemotherapy, radiotherapy, and/or surgery that may lead to testicular failure or ejaculatory dysfunction. Objective: The aim of this study was to compare the aseptic technology of cryoprotectant-free vitrification of human spermatozoa in large volume, to conventional freezing protocol as regards post thawing motility, vitality and sperm DNA fragmentation. Patients and methods: This study included a total of 20 male patients seeking seminal fluid analysis, attending at the andrology laboratory of a specialized IVF center (ADAM International Hospital for Fertility and Sterility, Giza, Egypt. Patients were presented with the diagnoses of normozoospermia, oligozoospermia (either isolated or combined with asthenozoospermia or teratozoospermia). Results: Motility of (in a large volume (300 µl) in the absence of permeable cryoprotectants displayed significant statistically lower levels as compared to conventional Sperm Freezing. It was shown in different groups at different times (post thawing and 1-hour and 24-hour) of assessment that motility of vitrified spermatozoa decreases in comparison with slow conventional freezing as we go from the baseline. DNA fragmentation of vitrified spermatozoa showed higher levels as compared to conventional slow freezing but there is no significant statistical difference between vitrification and conventional slow freezing in DNA fragmentation. Conclusion: It could be concluded that vitrification technique was quite far away from comparison with slow conventional freezing protocol, and still need for further modifications and wide scale of study to achieve the good results.

Impact of semen-derived amyloid (SEVI) on sperm viability and motility: its implication in male reproductive fitness.

Human semen contains a large number of macromolecules, including proteins/enzymes and carbohydrates, regulating and protecting sperm cells. Proteomic analysis of human seminal fluid led to the discovery of semen amyloids derived from short peptide fragments of the proteins prostatic acid phosphatase (PAP) and semenogelin (SG) which are known to play a crucial role in enhancing HIV infection. However, the relevance of their existence in human semen and role in maintaining sperm behavior remains unclear. Distinct physiological, biochemical, and biophysical attributes might cause these amyloids to influence sperm behavior positively or negatively, affecting fertilization or other reproductive processes. We assessed the direct effect of amyloids derived from a PAP248-286 fragment, on sperm motility and viability, which are crucial parameters for assessment of sperm quality in semen. Co-incubation of human sperm with PAP248-286 amyloids at normal physiological concentrations formed in buffer led to significant reduction in sperm viability, though approximatelya 10× higher concentration was needed to show a similar effect with amyloid formed in seminal fluid. Both forms of PAP248-286 amyloid also had a significant impact on sperm motility at physiological levels, in agreement with a previous report. Our study suggests that PAP248-286 amyloids can directly influence sperm motility and viability in a concentration-dependent manner. We hypothesise that the direct toxic effect of PAP248-286 amyloid is normally mitigated by other seminal fluid ingredients, but that in pathological conditions, where PAP248-286 concentrations are elevated and it plays a role in determining sperm health and viability, with relevance for male fertility as well as sterility.

Sociodemographic factors associated with semen quality among Malaysian men attending fertility clinic.

The worldwide declining trend in male fertility has been a steady concern since the past few decades. Male infertility reportedly accounts for half of the overall infertility cases in the world. Despite the evidences of reduced fertility rates in Malaysia in the recent years, there is lack of interventions regarding the reproductive parameters in Malaysian men. Complexity in determining the underlying causatives in most of the male subfertility and infertility cases limits the scope of management. The sociodemographic impacts upon overall health as well as on reproductive health of men are undeniable. The present study has analysed the data collected from patients' records in the Fertility Clinic, International Islamic University Malaysia (IIUM), from the January 2009 until December 2018. A total of 300 male patients were included in the study and were categorised according to their seminal fluid analysis (SFA) records. The sociodemographic characteristics for each subject were analysed. The results presented significant correlations among essential sociodemographic factors, such as educational attainment, marital duration as well as the age of wife, with the levels of semen abnormalities in the subjects. The study thereby unleashes scope for further investigations focusing upon the demographic factors for better insights to ameliorate male reproductive health in the Malaysian population.

Effects of Low Seminal Plasma Antioxidant Potential on Semen Quality and Male Fertility

It is very important to identify the factors which affect normal sperm functions. New Bio-chemical parameters in seminal plasma were analyzed to determine the biochemical factors that affect normal sperm function. The research groups consists of infertile groups Asthenozoospermia (n=31) and Normozoospermia (n=27) with a healthy men as a control (n=24). The patients have been selected and examined according to the World Health Organization (2010). In addition the seminal fluid analysis the biochemical parameters were analyzed in the seminal plasma of each sample including; Total antioxidant capacity, Catalase, Glutathione Reductase , glutathione and Malondialdehyde.Results showed a decrease in seminal plasma total antioxidant capacity of Astheno-zoospermia and Normozoospermia , and a significance decrease in catalase level for both infertile groups, Malondialdehyde level significantly increased in both infertile groups and Glutathione level significantly decreased in Asthenozoospermia group as compared to control group. Antioxidants have an important role in sperm protection via disturbing the balance in ROS production which destroys sperm plasma membrane causing loss sperm activity and it's ability to fertilize the egg.

The association between sperm quality and asymptomatic chlamydial infection in infertile men at a private fertility clinic in Nigeria

Background: Association between chlamydia trachomatis infection and male infertility is debated in literature. There is little or no information from Nigeria. The study aimed to determine the prevalence of chlamydial infection and its association with sperm quality parameters among asymptomatic men that present for infertility treatment in a Nigeria facility. Methods: A cross-sectional study conducted at a private assisted conception clinic in Lagos, Nigeria among 138 men seeking infertility care. Seminal fluid analysis and IgG Chlamydial serology were performed for each participant. Data obtained were analysed using SPSS; p was significant at <0.05. Results: Of the 138 men screened, 13.9% were Chlamydia-positive. Twenty-one per cent of clients who tested positive to Chlamydia had predominantly immotile sperm, compared with 10.2% without the infection; 26.3% with non-progressive motility had Chlamydia, compared with 2.8% men who were not infected. These differences were statistically significant (p = 0.001). More of those (57.9%) with Chlamydia (compared to 33.1% without) had significant leukocyte counts (p = 0.037). There were no statistically significant differences in sperm count and percent motility between serologically positive and negative men. Conclusion: Positive Chlamydia serology is associated with non-progressive motility and leukocytospermia in infertile Nigerian men. Keywords: Chlamydia, semen analysis, infertility

Sonography of scrotal abnormality among subfertile and fertile males in Abuja, Nigeria

Background Male factor infertility in Nigeria accounts for up to 50% of all infertility cases, most of which happen as a result of abnormalities of testicular function and infection. Male factor can be assessed by seminal fluid analysis; however scrotal ultrasound is now increasingly being used to evaluate males with infertility. Objectives The objective of this study is to determine the spectrum of scrotal abnormalities on ultrasound in sub-fertile and fertile men. Patients and method This was a prospective study which spanned for a period of eight months (January–August 2016). A total of 270 patients were included in the study comprising of 180 consecutive males who were being evaluated for sub-fertility and 90 apparently normal fertile adults who underwent a scrotal scan at the radiology department of University of Abuja Teaching Hospital using 7.5 MHz of EMP G70, China scan machine with Doppler facility. All patients were scanned in supine and upright position in both B and Doppler modes and any scrotal abnormalities were recorded. Result The mean age of sub-fertile and fertile subjects studied was 29 ± 11.4 years and 34 ± 16.3 years, respectively. Scrotal abnormalities were commoner in the sub-fertile group compared to the fertile group with a prevalence rate of 45.0% and 32.2%, respectively. Varicocele was the most common finding in both groups with a higher prevalence rate of 50.6% in the sub-fertile group compared to 48.3% in fertile group. This distribution was statistically significant (P = 0.000). Varicocele was observed more on the left. Hydrocele was the second most common finding in both groups. Conclusion The role of scrotal scan in evaluating infertility cannot be overemphasized. In this study, ultrasound scan was used to evaluate 45.0% of sub-fertile subjects with scrotal abnormalities. Ultrasound being non-invasive and readily available should be considered as an important investigation in accessing cases of infertility.

Tracing of Antibiotic-Resistant Bacteria Isolated from Semen of Iraqi Males with Primary Infertility

Objectives: The main objective of this study was to investigate the bacterial infections of seminal fluid in males with primary infertility. The patients were referred to and/or visiting the Urology Department in Salah Al-Deen Teaching Hospital. Methods: The present study was carried out from May 2017 to June 2018 and the number of the patients group was 60. The patients aged between 20 to 50 years. Semen was collected from infertile men of a couple that female failed to become pregnant after one year of regular and unprotected intercourse of marriage and submitted for seminal fluid analysis for the bacteriological analyses. The control group consisted of 50 fertile male who were selected randomly from Tikrit City during the period of this study. Semen culture was done for all the patients and the control group. Results: There were 30 patients who suffered from bacteriospermia and 16 of them (53.3%) were infected with gram positive organisms, while only 14 (46.7%) patients were infected with gram negative organisms. The most common organism was Staphylococcus aureus which was isolated from bacteriospermia. Escherichia coli, Enterococcus faecalis, Klebsiella pneumoniae, S. saprophyticus, Proteus mirabilis and Niesseria gonorrhoae were also isolated and the frequencies of isolation were 23.3% (7), 13.3% (4), 10.0% (3), 10.0% (3), 6.6% (2), and 6.6% (2) respectively. The present study showed many antibiotics were not active against gram positive bacteria isolated e.g. the resistance frequenciy to rifampcin, vancomycin and clindamycin was 48%, 44% and 40% respectively. Conclusions: The gram positive organisms were more prevalent than gram negative organisms in patients with bacteriospermia and the isolationfrequencies of two groups were 16 (53.3%) and 14 (46.7%) respectively. The most effective antimicrobial agents were amikacin, ciprofloxacin and levofloxacin and the least effective one was ceftazidime, whereas moxifloxacin, norfloxacin, gentamicin, azithromycin, moxifloxacin, norfloxacin, cefotaxime, and ceftriaxone were effective at different levels.

Sperm DNA Fragmentation Among Smokers and Non-Smokers as Measured by Sperm Chromatin Dispersion Test

Introduction: Traditionally, seminal fluid analysis is done to assess male infertility particularly sperm concentration, morphology and motility. Sperm chromatin dispersion test explores the quality of the sperm DNA structures. High sperm DNA fragmentation is associated with unexplained infertility, failure of assisted reproduction and recurrent miscarriages. Smoking has been associated with high sperm DNA fragmentation in some studies but not in others. Materials and Methods: A comparative cross-sectional study, involving 32 smokers and 32 non-smokers to determine the association between cigarette smoking and sperm DNA fragmentation. Semen samples were collected from patients undergoing seminal fluid analysis (SFA) at the IIUM Fertility Centre and IIUM Medical Centre O&amp;G Clinic from January 2017 to June 2018. Sperm chromatin dispersion test was done and level of 15% is considered upper limit of normal. Results: 53.1% in the smoker group have abnormal level of sperm DNA fragmentation compared to 34.4% of nonsmokers. The median and interquartile range for smokers were 15.30 and 19.0 (10.425 - 29.375) respectively while for non-smokers were 8.25 and 17.8 (4.075 - 21.850) which was statistically significant (p= 0.012). It was also noted that three participants in the smoker group (9.4%) has very high sperm DNA fragmentation index of more than 80% even though they have normal seminal fluid analysis. Conclusion: There is an association between smoking and high sperm DNA fragmentation. There is a trend of increased in DNA fragmentation in smokers even though their SFA results were normal.

Histo-morphological and seminal evaluation of testicular parameters in diabetic rats under antiretroviral therapy: interactions with Hypoxis hemerocallidea.

Objective(s):Broad range of metabolic changes associated with highly active antiretroviral therapy (HAART) has been reported over decades including reproductive perturbations. The current study aimed at investigating the role of Hypoxis hemerocallidea (Hyp) in the seminal and morphometric alterations in the testes of streptozotocin-nicotinamide-induced diabetic rats under HAART.Materials and Methods:Sixty-two adult male Sprague-Dawley rats were divided into A-H groups, containing 6 rats in the control group A and 8 rats in the treatment groups B-H. Diabetes was induced by intraperitoneal injection of nicotinamide (110 mg/kg BW) followed by streptozotocin (45 mg/kg BW). The animals were then subjected to various treatments with HAART, Hyp, and melatonin.Results:weights (body and testicular), histological, histochemical, seminal fluid, and morphometric analyses were carried out. Sperm count and motility were reduced in HAART (P<0.05/0.003) and Hyp200 (P<.003) groups compared with normal and diabetic controls, respectively. Sperm count was higher (P<.003) in HAART+ Mel and HAART+Hyp100 groups. Morphometry showed the reduction in germinal epithelium height and basement membrane thickness (P<.003) in the Hyp100 group compared with diabetic controls. Adjuvant use of Hyp and melatonin with HAART did not significantly raise these indices (P>.05). Histological slides showed gross distortions in HAART, diabetic and HAART +Hyp groups with marked atrophy in tubules, germ cell loss and areas of focal depletion of the cell. PAS staining revealed detached basement membrane in diabetic groups with strong PAS-stain. Conclusion:The use of Hyp or melatonin does not ameliorate the testicular damages in diabetic animals under antiretroviral therapy.

Molecular detection of Chlamydia trachomatis infection among males with abnormal semen

Many studies revealed that Chlamydia trachomatis is the most prevalent bacteria “that cause sexually transmitted infections in the world.. Most of these infections are asymptomatic and there is a remarkable relationship between CT infections and male infertility. Therefore, “the present study is established to determine the effect of Chlamydia trachomatis infection on seminal fluid quality in males suffering from infertility compared with fertile males.. “Semen samples were collected from 63 infertile male and 13 fertile male as control group, attending the clinical laboratory for routine seminal fluid analysis. Seminal fluid was analyzed according to World Health Organization guidelines, the whole genomic DNA was extracted for molecular study. Real time PCR technique was used to specifically detect the presence of CT DNA in semen samples.” trachomatis was demonstrated in the semen samples of 11 (17.4%) infertile male and all control samples were negative. Infertile, infected males had semen samples that showed statistically significant differences in the mean of total sperm count, motility and morphology as compared with fertile uninfected control samples. These differences indicate that chlamydial infection of genital tract could negatively influence the quality of seminal fluid.”

Study the Effect of Interleukin36 Gamma and AMH in Iraqi Women with PCOS

Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders and affect approximately (5-10) % of women of reproductive age. Anti-Müllerian hormone (AMH) is a homodimeric glycoprotein, a member of the transforming growth factor-β superfamily, it is secreted exclusively from women by granulose cells of ovarian follicles and it is considered as the precise marker of follicle pool size. AMH has been shown to be a good surrogate marker for polycystic ovary syndrome (PCOS). Interleukins are considered as strong risk markers of inflammation. Interleukin-36 gamma (IL36) also known as interleukin-1 family member 9 (IL1F9) is a protein that in humans is encoded by the IL36G gene. Serum samples were collected on day 2 of the menstrual cycle. Serum IL36ɣ, FSH and LH concentration were measured by using ELISA. This study aimed to evaluate the association between IL36ɣ and AMH and study the relationship between obesity and AMH of women in the age of reproductive (25-35) yrs. This study included 28 infertile women with PCOS their husbands were apparently normal (hormones and seminal fluid analysis), their aged (25-35) years, and 20 healthy women aged (25-33) years as control. All control women &amp; patients were from outpatients unit of Alkadumia teaching hospital at Baghdad and all the parameters were measured in Sigma Laboratory. Serum IL-36 ɣ elevated in PCOS patients mainly those with high AMH levels. This hormone increased in PCOS patients compared with control. There was a non-significant difference between patients and control to LH and FSH levels.

Hematospermia: norm or pathology? Modern approaches to etiopathogenesis, diagnosis and treatment

In most cases, the cause of blood appearance in the semen remains unknown. According to WHO, about 15 % of men experience only one episode of hematospermia, which is never repeated again. Hematospermia cause determination includes clinical examination by an urologist-andrologist and thorough patient history. The main purpose of the examination is to diagnose or exclude andropathology and also to determine the tactics of patients with hematospermia treatment. Aim. To show the relevance of this problem in reproductive medicine, to describe ethiopatogenesis of hematospermia and consider the basic methods of this pathological symptom modern diagnosis and treatment based on the specialized literature data analysis. The presence of blood in the semen can indicate a serious disease, which is the result of andropathology. The exact percent of hematospermia cases is unknown, because ejaculates go unnoticed in the process of unprotected intercourse. The most of patients consult a specialist immediately after the first episode of hematospermia. The basic points are a clinical examination and careful anamnesis. The main purpose of patients with hematospermia examination is determination of the cause or specific condition, which must be cured, and thus the symptomatology and pathological condition irradiation. To confirm the fact of hemospermia, if it’s necessary, a contraceptive can be used, which consists of pathological ejaculate collection into a condom for examination. Further an urologist-andrologist examine the patient, find out an anamnesis, assign a seminal fluid analysis, a clinical and urine culture analysis, a test of blood clotting factors, a clinical blood analysis, ultrasound of the prostate by the TRUS method, prostate-specific antigen (PSA) test, alpha-fetoprotein (AFP), β-subunit of human chorionic gonadotropin (hCG) and blood serum lactate dehydrogenase (LDH) for oncopathology exclusion. Etiologic factor elimination is essential for patients with hemospermia treatment. Due to increased amount of literature data and great advances in the ultrasound diagnostics, many causes of hemospermia have been identified, so the methods of this symptom treatment are also various: conservative and surgical, which completely depend on the etiologic factor. If the pathological condition is not found, then the doctor should be as a psychotherapist to correct the sexual behavior in such men. Conclusions. Blood in the semen can evidence a serious disease, which is the result of andropathology. To determine the cause of hematospermia, it is necessary to perform a clinical examination by an urologist-andrologist and careful anamnesis. The main purpose of examination is to identify or exclude the pathology and, if it is not defined, doctor should encourage the patient on his good health. There are obligatory procedures: a seminal fluid analysis, a clinical and urine culture analysis, a test of blood clotting factors, a clinical blood analysis and ultrasound examination of the prostate by the TRUS method, PSA, AFP, hCG, LDH blood serum tests for malignant etiology of hematospermia exclusion. Modern methods of investigation allow identifying cause of hematospermia in many cases and the most patients are treated conservatively depending on the etiologic factor, but also surgical correction can be used.

HLA-DQB1 Genotyping in Infertile Iraqi Patients

Atotal of 116 males with primary infertility and 32 fertile males (controls) were genotyped for HLA-DQB1 alleles by the reverse hybridization method (INNO-LiPA). Based on WHO criteria of 2010 for general seminal fluid analysis, the patients were distributed into three groups: 32 azoospermic (AZO), 40 oligozoospermic (OLI) and 44 asthenozoospermic (AST) patients. Four HLA-DQB1 alleles (DQB1*0204, DQB1*0301, DQB1*0302 and DQB1*0601) showed differences between AZO patients and controls, but none of them attended a significant level. In OLI patients, two alleles (DQB1*0301, DQB1*0501) showed increased frequencies as compared with controls, but the difference was not significant for DQB1*0301 allele, while it was significant (P=0.03) for DQB1*0501 allele (25.0 vs. 6.3%). For AST patients, DQB1*0301 (22.7 vs. 6.3%) and DQB1*0501 (27.3 vs. 6.3%) alleles showed increased frequencies as compared with controls, but both differences attended a significant level (P = 0.05 and 0.02, respectively). With respect to the impact of these alleles on anti-spermatozoa antibody (ASA) production, DQB1*0301 allele was probably associated with predisposition to develop ASAs in OLI patients, while DQB1*0501 was probably associated with a protection in AST patients. These results suggest that HLA-DQ locus may harbour genes that are important in the predisposition to develop infertility in Iraqis.

Seminal fluid analysis of male partners of infertile couples in Abakaliki, Ebonyi State, Nigeria

Context: Procreation is one of the greatest desires of every couple, especially in the developing countries like ours. Male infertility is an important but neglected reproductive health issue, and it appears to contribute significantly to infertility in our environment. Aims: The aim of the study is to review the seminal fluid analysis parameters of male partners of infertile couples attending infertility clinic at the Federal Teaching Hospital, Abakaliki (FETHA). Materials and Methods: This was a 5-year retrospective study of male partners of couple attending the infertility clinic in FETHA between January 1, 2012, and December 31, 2016. Case notes of couples managed for infertility were reviewed. Information extracted includes the sociodemographic characteristics, duration of infertility, type of infertility, and seminal fluid analysis results with emphasis on the semen volume, sperm morphology, motility, pH, and the microbacterial isolates. Statistical Analysis: Data were entered into an excel spreadsheet on a personal computer, and statistical analysis was performed using Epi Info 7.2.1 software. Sociodemographic characteristics are presented in frequencies and simple percentages. Means of categorical variables were compared using the Chi-squared test whereas continuous variables were analyzed using Student's t-test. A value of P ≤ 0.05 was considered statistically significant. Assessment of semen analysis was done using the 2010 World Health Organization human values for semen parameters. Results: Case records of 922 couples attending the infertility clinic were retrieved; however, 756 folders had semen analysis results. During the study, the contribution of the male partner to infertility was 41.0%. The mean age of the patients was 40.10 ± 10.23; the modal age was 34 years; and most of the patients were traders. Majority had normospermia 380 (50.3%) whereas 376 (49.7%) had abnormal semen parameters. There was a high level of leukocytospermia (≥80%) in this study, and the predominant organism cultured was Staphylococcus aureus 328 (43.4%). Oligospermia was the most frequent (33.0%) derangement in semen analysis results. The age and duration of the infertility were not significantly related to abnormal semen analysis; however, men who are resident in urban areas, or who consume alcohol or tobacco, and those who were managed for primary infertility had a significant relationship with abnormal semen parameters (P Conclusion: Semen analysis remains an indispensable tool in the overall diagnosis of male infertility in our environment. Men who are resident in the urban areas or consume tobacco/alcoholic beverage had a significant risk of abnormal semen parameters.

Short-term outcome of unaided versus microsurgical inguinal varicocelectomy among infertile men with varicocele

Objective: The objective was to determine the short-term outcome of unaided and microsurgical varicocelectomy on semen parameters and conception after 6 months in patients with infertility and varicocele. Patients and Methods: This was a randomized, prospective, interventional study that was conducted on men with infertility and varicocele. Patients were randomized into two groups. Patients in Group A underwent open inguinal varicocelectomy, whereas patients in Group B had the same surgery with microsurgical technique using ×3.5 magnification loupes. All the patients had preoperative seminal fluid analysis (SFA) performed on two occasions, a scrotal Doppler ultrasound and a postoperative SFA at 3 months and 6 months posttreatment. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software package version 23.0, and the level of significance was taken as 0.05. Results: Thirty patients participated in the study, 14 in Group A and 16 in Group B. The mean age in Groups A and B was 40.07 ± 7.7 and 39.44 ± 7.3 years, respectively. About 85.7% of patients in Group A had bilateral varicocele, whereas 14.3% had left-sided varicocele. In Group B, 75% had bilateral, whereas 25% were on the left side. There was a statistically significant improvement in sperm count, motility, and morphology in both the unaided and the microsurgical groups; however, there was no significant difference in the improvement of seminal parameters between the two groups except the morphology. The pregnancy rate was 14.3% in Group A and 25% in Group B. Overall pregnancy rate in this study is 20% after 6 months. Conclusion: Varicocelectomy leads to significant improvement in sperm parameters; however, there is no significant difference in outcome between unaided and microsurgical varicocelectomy.

Assessment of seminal biomarker of lipid peroxidation among male partners of infertile couples at the university of ilorin teaching hospital, Nigeria.

Seminal fluid analysis (SFA) is the most important investigation of infertile males. It is however limited in revealing the aetiologies of the various spermatozoa abnormalities observed on microscopy. Increasing prevalence of male infertility and the challenges of diagnosis require biochemical investigations, such as assay of seminal malondialdehyde (MDA), a marker of sperm peroxidation and to support SFA in investigation of infertile males. The aim of this study was to determine the seminal level of biomarker of lipid peroxidation by measuring seminal MDA levels among infertile males in Ilorin. This was a descriptive cross-sectional study. One hundred and thirty infertile males served as patients and 50 fertile males as controls. Seminal MDA was assayed using ELISA method. Statistical Package for the Social Sciences (SPSS) version 20.0 (SPSS Inc., Chicago, IL, USA) was used. Normally distributed data were expressed as mean ± standard deviation. The mean age of the patients who were mainly civil servants was 38.6 ± 6.6 years compared to 37.0 ± 5.8 years among controls. Seminal MDA was significantly higher among infertile males in this study (P < 0.05) indicating higher degree of lipid peroxidation in their semen. Seminal MDA concentrations were found to be significantly higher among infertile males with a history of alcohol consumption (P < 0.05), cigarette smoking (P < 0.001) and sexually transmitted infections (P < 0.001) when compared to control with similar history. There is significant lipid peroxidation of spermatozoa among infertile males with lifestyle playing a significant role. Evaluation of infertile males should include assessment of seminal MDA. Prophylactic administration of antioxidants to this group of patients may be beneficial.

Evaluation of Sperm DNA Fragmentation amongst Infertile Black Africans. A Nigerian Study

Background: Male infertility is approaching an epidemic proportion. Almost 50% of all cases of infertility may be associated with a male factor. The diagnostic usefulness of sperm DNA integrity is now accessible as an additional tool to Seminal Fluid Analysis. Objective: To assess sperm DNA fragmentation index (SDFI) in male infertility and its relationship with obesity, alcohol consumption and cigarette smoking among infertile Nigerians. Patients and Methods: Patients who presented for infertility at three health facilities of Nordica Fertility Center in Lagos, Asaba and Abuja cities in Nigeria. STATA 13 was used for student’s t-test to compare the means of continuous variables among smokers and non-smokers and among alcohol consumers and non-consumers. Linear regression analysis was employed to assess the correlation between SDFI as dependent variable and some independent variables. Results: There was no significant difference in the SDFI of men aged <40 years compared to older men. There was also no significant difference in the proportion of men with SDFI of <25% and of ≥25% regardless of their age group. The mean SDFI of men with normal BMI (30.8%) was significantly lower (t = −1.80, P-value = 0.04) than that of obese men (30.2%). Obese men were 2.12 times as likely to have SDFI ≥25% compared to normal weight men (χ2-2.16, P-value = 0.14, OR = 2.12, 95% CI: 0.77, 5.80). Mean SDFI of men who consume alcohol (37.1%) was significantly higher (t = −1.97, P-value = 0.03) than that of those who did not consume alcohol. Although Pearson’s correlation matrix (r) indicated that sperm DNA fragmentation index was positively correlated with history of infertility (r = 0.01), groin surgery (r = 0.04), mumps (r = 0.04) and sexually transmitted illness (r = 0.04), however the degree of correlation was not significant (P-value ≥ 0.5) in each case. Conclusion: This is the first report in Black Africa that describes a correlation between sperm DNA integrity, as measured by the halo test and age, BMI and alcohol consumption. Men with normal BMI were more likely to have excellent to good SDFI and hence good fertility potential. Data from this study indicate that the infertile men had significantly higher sperm DNA fragmentation. Obese men and those engaged in alcohol consumption also had higher sperm DNA fragmentation indices.