Study on semen analysis in the evaluation of male infertility in coastal Karnataka, India

Abstract

INTRODUCTIONInfertility is a condition with psychological, economic, medical implications to the couple resulting in decreasing the quality of life, with a strong emphasis on child bearing. According to WHO infertility is a disease of reproductive system defined by failure to achieve the clinical pregnancy after 12 months or more of regular unprotected intercourse. It can also be defined as failure of couple to conceive after 12 months of regular intercourse without the use of contraception in women <35years, and after 6months of regular intercourse without the use of contraception in women >35years.As per the WHO, the overall prevalence of primary infertility ranges between 3.9% and 16.8%. Also, the estimates of infertility vary widely among Indian states from 3.7% in UP, Himachal and Maharashtra, to 5% in AP and 15% in Kashmir. Moreover, the prevalence of primary infertility has also shown to vary across the tribes and castes within the same region in India. 1 It was reported that 40% of infertility cases were related to men, 40% women and 20% both sexes. According to a multicentric study conducted by WHO from 1982 to 1985, 20% of cases were attributed to male factors, 27% had causal factors identified in both the partners. In ABSTRACT Background: According to current recommendation a couple has to be evaluated if they fail to achieve pregnancy within one year of unprotected regular intercourse. The current incidence of infertility is around 15% which is increasing because of various factors including delay in attaining first pregnancy. The male partner evaluation includes detailed history and examination including the sexual history and semen analysis. Observational study performed on patients with primary and secondary infertility. The detailed semen analysis evaluation done in addition to notifying brief sexual history and chronic medical ailments like diabetes. Method: After proper counselling, and obtaining consent, the patients were made to collect the semen sample in a room attached to the andrology lab. Detailed evaluation of each sample was done. Prior to this procedure, relevant information like occupation, age of the patient, duration of abstinence, coitus frequency and presence of chronic medical ailments like, diabetes mellitus and chronic hypertension were noted. Results: The study, done in a tertiary care centre in coastal Karnataka, revealed that a majority of the patients were in the age group of 25-30 years with a larger group of patients having liquefaction time of <20minutes and 25% were in the oligospermia group. Conclusions: Semen analysis is an indispensable diagnostic tool in the evaluation of the male partner of infertile couples in addition to brief sexual history and occupational history.

Seminal parameters among patients visiting infertility clinic at the National Referral Hospital, Bhutan

“…Regarding macroscopic semen analysis, the majority of the patients in our study had normal semen volume, appearance, pH, viscosity, and liquefaction time. Our findings in this regard closely resembled the findings from various other studies conducted in the regions 9,10,12 . These studies concluded that the semen volume is one of the most important factors associated with infertility.…”

“…The factors affecting the semen parameters in the country were not considered in our study, the significance of this age range in fertility issues cannot be correlated with the semen parameters at the moment. Interestingly, there exists a lot of evidence supporting the association between male age and reduced fertility after the age of 60 in other countries 9,10 , but no such evidence existed for the age range 30 to 39. Amongst different occupational groups, private businesses 129(42.4%) had the highest number coming for semen analysis followed by civil servants 88(28.9%).…”

“…It has been proven by previous studies that sexual abstinence of less than two days, the semen volume might become low, lowering the total sperm count. More than five days of sexual abstinence, most of the spermatozoa might become immotile affecting progressive and non-progressive percentage 10 . Hence, the recommended duration of sexual abstinence is fixed at three to five days 8 .…”