The challenges of supporting male infertility treatment in South Africa

Zarrabi, Amir; Kruger, T. F.

doi:10.1038/s41585-018-0099-5

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…3 Globally, the trend of male infertility is a growing public health concern, subjecting couples and their families to immense pressure. [4][5][6][7] By definition, infertility can be classified into two broad categories: primary and secondary infertility.…”

Section: Introductionmentioning

confidence: 99%

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Male Infertility: A Retrospective Review of Laboratory Charts at a Tertiary Teaching Hospital in Nairobi City County

2024

EASci

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Background: Globally, approximately 50 million couples experience one form of infertility, and 10 million cases of subfertility have been reported in sub-Saharan Africa. Infertility is characterized by a lack of clinical conception among couples who live together for more than one year with regular coitus, without the use of contraception. Factors related to fertility vary by sex and geographical region. These factors include age, lifestyle, infectious diseases, and genetic disorders. In African culture, children are considered a simple inheritance and a measure of masculinity, so efforts are needed to address the growing problem of male infertility in this context. Objective: To determine the prevalence of male infertility among adult men seeking semen analysis services in a tertiary teaching hospital in Nairobi, Kenya. Methods: This was a cross-sectional study that involved a retrospective review of archived electronic data in the hospital information system. These data were from male patients who visited the laboratory with a request for semen analysis between January 2016 and December 2020. A checklist was used to extract data related to sociodemographic factors and laboratory results (age, seminal volume, and diagnosis). Results: The average age of the male clients seen during the review period was 36±8 years, with the majority aged 31-40 years n= 996 (46.7%). The youngest was 21 years old, and the oldest was 70 years old. The total prevalence of seminal abnormalities was 1628 (77%) of the 2131 electronic data that was reviewed. Only 502 (23%) of the patients had a normal seminal diagnosis. Most clients exhibited at least one form of seminal abnormalities, such as asthenospermia 913 (43%), oligospermia 441 (21%), and azoospermia 272 (13%). There was a statistically significant association between age and seminal abnormality (X 2 = 31.393, P=.013). A significant association was also found between seminal volume and abnormalities (X 2 = 94.538, P=.000). Conclusion: Our findings showed that there were some seminal abnormalities among Kenyan men in Nairobi County. More effort is required to identify the cause of this increase in seminal abnormalities. Initiation of health interventions to reduce this burden of infertility may be necessary. Peer Reviewed Acknowledgments:The authors thank Aga Khan University School of Nursing and Midwifery for giving us time to collect the data for this study. The authors also thank our departmental colleagues for their encouragement and help in conceptualising this study.

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Section: Introductionmentioning

confidence: 99%

“…This area has been consistently neglected by governments and most health stakeholders in low-middle-income countries (LMIC). 58,59 Few studies have been conducted in Kenya to address issues related to male reproductive health.…”

Section: Introductionmentioning

confidence: 99%

Male Infertility: A Retrospective Review of Laboratory Charts at a Tertiary Teaching Hospital in Nairobi City County

2024

EASci

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“…Diagnosing this condition is difficult not only because several environmental and genetic factors interfere with spermatogenesis (Cocuzza et al, 2013), but also because of social taboos. In some countries of Africa, men unable to father children are so marginalized that some may even commit suicide (Zarrabi & Kruger, 2018). Moreover, a man is usually only analyzed after the woman has undergone an extensive workup (Cocuzza et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Sequence analysis of 37 candidate genes for male infertility: challenges in variant assessment and validating genes

et al. 2019

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Background The routine genetic analysis for diagnosing male infertility has not changed over the last twenty years, and currently available tests can only determine the etiology of 4% of unselected infertile patients. Thus, to create new diagnostic assays, we must better understand the molecular and genetic mechanisms of male infertility. Although next‐generation sequencing allows for simultaneous analysis of hundreds of genes and the discovery of novel candidates related to male infertility, so far only a few gene candidates have enough sound evidence to support the gene–disease relationship. Objective Since complementary studies are required to validate genes, we aimed to analyze the presence of potentially pathogenic rare variants in a set of candidate genes related to azoospermia in a hitherto understudied South American population. Subjects and Methods We performed whole exome sequencing in a group of 16 patients with non‐obstructive azoospermia from Ribeirão Preto, Brazil. Based on a recent systematic review of monogenic causes of male infertility, we selected a set of 37 genes related to azoospermia, Sertoli‐Cell‐Only histology, and spermatogenic arrest to analyze. The identified variants were confirmed by Sanger sequencing, and their functional consequence was predicted by in silico programs. Results We identified potential pathogenic variants in seven genes in six patients. Two variants, c.671A>G (p.(Asn224Ser)) in DMRT1 and c.91C>T (p.(Arg31Cys)) in REC8, have already been described in association with azoospermia. We also found new variants in genes that already have moderate evidence of being linked to spermatogenic failure (TEX15, KLHL10), in genes with limited evidence (DNMT3B, TEX14) and in one novel promising candidate gene that has no evidence so far (SYCE1L). Discussion Although this study included a small number of patients, the process of rationally selecting genes allowed us to detect rare potentially pathogenic variants, providing supporting evidence for validating candidate genes associated with azoospermia.

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Overview of the Effects of Moringa oleifera Leaf Extract on Oxidative Stress and Male Infertility: A Review

et al. 2023

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According to a recent report by the WHO, 50–80 million people suffer with infertility. Amongst these populations, male counterparts account for 20–50% of infertility cases. The aetiology of infertility in men includes many factors such as psychological issues, lifestyle and environmental factors, hormonal disorders and chromosomal abnormalities. The pathophysiology of these aetiologies may be initiated by a local inflammatory reaction increasing reactive oxygen species (ROS) production, which can negatively affect the male reproductive system by altering the hypothalamic–pituitary–gonadotropin axis (HPG axis). Alteration of the HPG axis may affect testicular steroidogenesis, spermatogenesis, the Leydig cells and Sertoli cells, leading to poor semen quality. The prevalence of male infertility underscores the need for a thorough scientific investigation to identify treatable or reversible factors using plant adjuvants with antioxidative properties. Therefore, this review aims to provide an overview of the currently available knowledge on the aetiologies of male reproductive dysfunction, emphasising infertility risk factors, as well as elucidating the possible ways by which readily available alternatives, such as Moringa oleifera leaves, may mitigate male infertility by highlighting its role on the oxidative stress parameters, reproductive hormonal levels, testicular steroidogenesis and spermatogenesis, gene expression, weight and morphology of the testis and sperm parameters.

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The challenges of supporting male infertility treatment in South Africa

Cited by 3 publications

References 9 publications

Male Infertility: A Retrospective Review of Laboratory Charts at a Tertiary Teaching Hospital in Nairobi City County

Male Infertility: A Retrospective Review of Laboratory Charts at a Tertiary Teaching Hospital in Nairobi City County

Sequence analysis of 37 candidate genes for male infertility: challenges in variant assessment and validating genes

Overview of the Effects of Moringa oleifera Leaf Extract on Oxidative Stress and Male Infertility: A Review

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