|Year : 2020 | Volume
| Issue : 4 | Page : 293-295
Prevalence of abnormal semen analysis in patients of infertility in a rural setup at Tiwsa Tehsil District, Amravati (Maharashtra): An observational study
Nandkishor Bhaurao Kale1, Madhuri Ramaji Bhoyar2
1 Department of Rognidan and Vikrity Vigyan, Shri Gurudeo Ayurved College, Gurukunj Ashram, Amravati, Maharashtra, India
2 Department of Prasuti Tantra and Streerog, Shri Gurudeo Ayurved College, Gurukunj Ashram, Amravati, Maharashtra, India
|Date of Submission||02-Nov-2020|
|Date of Decision||09-Oct-2020|
|Date of Acceptance||20-Nov-2020|
|Date of Web Publication||11-Feb-2021|
Dr. Nandkishor Bhaurao Kale
Department of Rognidan and Vikrity Vigyan, Shri Gurudeo Ayurved College, Gurukunj Ashram, Amravati, Maharashtra.
Source of Support: None, Conflict of Interest: None
Background: Semen is produced in the testicles and stored in the seminal vesicles, which contribute to 50% of the semen volume. Semen or seminal fluid contains sperms. Sperms are capable of fertilizing female ova. The climax of sexual excitement, that is, orgasm, in the male is accompanied by the discharge of semen. Semen analysis is important to evaluate the infertility in male partners. It provides the direction to determine the prevalence of abnormal semen parameters in our environment. Materials and Methods: Women who experienced childlessness were examined in the department of Streerog and Prasutitantra with diagnosis of primary infertility. Semen samples of 212 men aged 20–45 years were collected at Shri Gurudeo Ayurved Hospital, Gurukunj Ashram. Semen analysis of the same male partners was done for volume, sperm count, and motility according to the World Health Organization (WHO) guidelines for semen analysis. This study was conducted in the pathology laboratory of the Department of Rognidan and Vikrity Vigyan at Shri Gurudeo Ayurved Hospital, Gurukunj Ashram. Results: Overall, 8% cases of azoospermia and 30% incidence of abnormal semen quality behind male infertility was noted. Conclusion: The current study data also match with the WHO incidence data regarding male infertility in a rural setup. The exact and early causes of azoospermia need to be corrected and managed. Also, there is a need to correct the rare causes of male infertility related to semen, even though the percentage of the same may be low. The role of male partners in infertility needs more significant research work to be conducted.
Keywords: Analysis of semen, infertility (male), semen, sexual excitement
|How to cite this article:|
Kale NB, Bhoyar MR. Prevalence of abnormal semen analysis in patients of infertility in a rural setup at Tiwsa Tehsil District, Amravati (Maharashtra): An observational study. J Indian Sys Medicine 2020;8:293-5
|How to cite this URL:|
Kale NB, Bhoyar MR. Prevalence of abnormal semen analysis in patients of infertility in a rural setup at Tiwsa Tehsil District, Amravati (Maharashtra): An observational study. J Indian Sys Medicine [serial online] 2020 [cited 2021 Mar 9];8:293-5. Available from: https://www.joinsysmed.com/text.asp?2020/8/4/293/309127
| Introduction|| |
Seminal fluid discharged from the male urethra at the climax of orgasm is a thick, opalescent, and viscid secretion. It is secreted by the testes, epididymis, vas deferens, seminal vesicles, and prostate and bulbourethral glands. The occurrence of a pregnancy is determined by the genomic quality of the oocyte and sperm, implantation capability of the embryo, and the endometrial receptivity. Semen or seminal fluid contains sperms that are capable of fertilizing female ova. Infertility is the inability or diminished ability to produce offspring in spite of regular and adequate unprotected sexual contact in a couple over a period of one year.
About 30% cases of infertility are due to the problem with males. In India, the overall percentage of the prevalence of primary infertility is 4–17; 19% of the general population is affected by infertility of couples. The region-to-region prevalence rate differs. The common etiological factors that cause male infertility are oligospermia and asthenozoospermia. Hormonal or structural problems of integrity are found within the semen determined by the sperm chromatin structure assay (SCSA). The detection of DNA integrity is conducted to assess the problem encountered by the males experiencing infertility. Conventional analysis of seminal fluid has a less significant role in the determination of fertility. In the laboratory evaluation of an infertile male, a routine semen analysis is the baseline investigation. Careful examination of abnormal seminal fluid will evaluate the significant and cardinal causes of infertility. This will help in treating and managing the infertility.
Male fertility is measured by semen quality. The ability of the sperm in the semen to fertilize the female ova is measured. Semen quality involves both sperm quantity and quality, which is affected by geographical variation. Semen quality in men are declining worldwide due to sedentary lifestyle, including stress and environmental factors. The aim of the study is to assess the various seminal factors and characteristic patterns of the male partners of infertile couples in a rural setup, that is, Tiwsa Tehsil. Various significant changes in the seminal fluid help to assess the possible contribution in the infertility of the male factor.
The study aims at determining and evaluating the role of abnormal semen parameters affecting prognosis in infertility in male partners of wives attending the outpatient department at Gurukunj Ashram, District Amravati.
The objective of the study was to assess the role of semen volume, count, and motility in male infertility, to assess the age-wise distribution of male infertility and analysis according to age to manage early infertility
| Materials and Methods|| |
Two hundred and twelve semen samples of the age group 20–45 years were collected of the male partners of women attending the outpatient department at Shri Gurudev Ayurved Hospital. Their wives were examined by the Department of Streerog and Prasutitantra. Subjects consuming antibiotics and who found it inconvenient to indulge in semen sample collection were excluded from the study.
After obtaining demographic data, samples were collected by giving the following instructions:
- Semen samples to be collected after 3–4 days of the abstinence period.
- Samples to be collected in a sterile container and maintained at body temperature (37°C)
- Samples should reach the laboratory within one hour post-ejaculation.
- Samples should be collected by the masturbation method only.
The analysis of the samples was done in the central pathology laboratory of the Department of Rognidan and Vikrity Vigyan.
The study was conducted in the period from January 2013 to July 2020, and it was a prospective study. Samples were examined within 60min of collection. Analyses were conducted for the volume that comes under physical examination. Sperm count and motility examination were done under a binocular microscope as per the standardization and guidelines by the WHO. The data analysis was done.
| Results|| |
Male fertility generally starts to decline around the age of 40 to 45 years. Advanced age affects the sperm quantity and quality. Chances of conception were also reduced during advanced age. In this study, 65% of men are older than 30 years. There were 31 men in the age group between 35 and 45 years [Table 1].
As far as semen volume is concerned, 72% males had a volume between 1.5 and 2.5 ml, 28% had a volume between 0.5 and 1 ml, 24% had a sperm count <20 million, and 13% had a sperm count between 20 and 60 million/ml. In this study, there were 8% cases of azoospermia (Zero Sperm) [Table 2].
[Table 3] suggests that out of 212 subjects, 59 had a volume between 0.5 and 1 ml. Out of that, 22 subjects had a normal count and actively motile sperms. Also, 14 subjects had actively motile sperms even though their count was below normal.
| Discussion|| |
As per the available data and sources, there are very few studies on infertility in rural areas. Abnormalities in semen volume, count, and motility were discussed and highlighted in this study. Out of the 212 subjects studied, 30% have abnormal semen parameters.
Overall, 72% males had a volume between 1.5 and 2.5 ml, 28% had a volume between 0.5 and 1.0 ml, which is relevant with a previous study of Gerzia state. Low semen volume (<1.5 ml) is associated with low sperm count. In this study, 72% males had a normal semen volume. There was no relationship between semen volume and pregnancies obtained. However, this parameter is often overlooked if other semen abnormalities are also present.
Out of 212 subjects, 24% had a sperm count <20 million/ml, and 13% had a sperm count between 20 and 60 million/ml. In 8% of the subjects, no sperms were found, that is, zerosperm. Azoospermia, zero sperm count, which accounts for 10% to 15% of all male infertility, refers to a complete absence of sperm in the ejaculate. Our results also agree with this evaluation. Azoospermia can be due to a sperm production defect in the testes that can be triggered by various hormonal or genetic defects. An infective condition leads to abnormalities in seminal plasma, and pathogenic or iatrogenic retrograde ejaculations are other causes of male infertility.
A higher percentage (65%) of male infertility cases were found in the age group 31–45 years, and this is because residual infections were acquired before marital life.
As far as motility is concerned, 16% of males had weakly motile sperms. Rapidly progressive motile sperms are capable of penetrating the ovum and fertilizing it. Hence, this fact is responsible for the percentage of pregnancy and conception rate. In a study of 59 subjects whose volume was low, the sperms were actively motile in 36 cases, that is, 61% cases had actively motile sperms.
| Conclusion|| |
Abnormalities in semen parameters determine the significant role played by male infertility in a rural setup. This study also revealed the important role played by the age factor in determining male infertility. The role of semen volume and count needs to be studied further to evaluate and eradicate male infertility at an early fertile age. Azoospermia should be focused on. Also, there is a need for more elaborative research for healthy progeny. An annual semen analysis for those older than the age of 20 years should be performed to diagnose early infertility and to treat it to avoid further complications regarding social issues. Overall, 10% of couples fail to conceive after two years of marriage. Only rapidly progressive motile sperms are capable of penetrating the ovum and fertilizing it. So, there is a need to calculate the rate of conception by semen analysis.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Clayton L Thomas, Taber’s Cyclopedic Medical Dictionary. 16th ed. Philadelphia, PA: F.A. Davis Company; 1989, p. 1656.
Jajoo S, Kalyani KR Prevalence of abnormal semen analysis in patients of infertility at a rural setup in central India. Int J Reprod Contracept Obstet Gynecol 2013;2:161-4.
Malik S, Agrawal A Understanding male infertility. Evol Male Infertility2012;5:1-7.
Kawthalkar SM Essentials of Clinical Pathology. 2nd ed. Kathmandu: Jaypee Brothers Medical Publishers; 2018, p. 174-6.
Larsen U Primary and secondary infertility in Sub-Saharan Africa. Int J Epidemiol 2000;29:285-91.
Fayig E, Ibrahim B, Saleem AB Clinico-hormonal correlation of oligospermic patients in the below sea level environment (Jordan valley). Neuroendocrinol Lef 2005;26:13-8.
Adetoro OO, Ebomoyi EW The prevalence of infertility in a rural Nigerian community. Afr J Med Med Sci 1991;20:23-7.
Dua A, Vaidya SR Sperm motility and morphology as changing parameters linked to sperm count variations. J Postgrad Med 1996;42:93-6.
Rachel G Does age affect male fertility?2020. Available from: https://www.verywellfamily.com/does-age-affect-male-fertility-1959934. [Last accessed on 2020 october 20].
World Health Organisation. WHO Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction. 3rd ed . Cambridge: Cambridge University Press; 1992.
Bosteffe E, Serup J, Rebbe HRelation between sperm count and semen volume and pregnancies obtained during a 22 year follow-up period.Int J Androl1982;5:267-75.
Agrawal A, Sharma RK, Sharma R, et al
Characterizing semen parameters and their association with reactive oxygen species in infertile men. Reprod Biol Endocrinol2014;12:33.
Chia SE, Lim ST, Tay SK Factors associated with male infertility: Sperm characteristics, strict criteria sperm morphology analysis and hypoosmotic swelling test. Int J Obstet Gynaecol 2000;107:55-61.
[Table 1], [Table 2], [Table 3]