Serum testosterone profiling of males with suspected infertility: a case study in the Kumasi metropolis

Infertility affects both male and female alike with male incidence not less than 50% of infertile couples. However, the female counterpart is often suspected as the cause of the couple’s infertility. The aim of this study was therefore to elucidate the serum testosterone profiles of referred male subjects and to ascertain the probable cause of their suspected infertility as a case study in the Kumasi metropolis. Men who had reported for infertility assessment at various regional hospitals and were referred to the laboratory for screening were recruited for the study. In all, a total of 224 men were incorporated into the study. Seminal fluids were taken from the subjects after they had been given guidelines in the production of the seminal fluid. Blood samples were also taken and processed to obtain the serum. The seminal fluids were analysed to determine their sperm concentrations, sperm morphology, and sperm motility. Serum testosterone concentrations of all the 224 men were assayed by an enyme-linked immune assay method (ELISA) (Human Diagnostics). The age of the subjects, type of infertility, number of days of abstinence from any sexual activity before seminal fluid was produced, and the medical history of the subjects were obtained using a questionnaire designed for the project. Analysis of data from seminal fluid, and serum testosterone concentrations of the subjects showed that 22.3% of the patients were azoospermia, 52.7% were oligozoospermia, and 25% were normozoospermia. 4(1.8%) of the patients had erectile dysfunction and could not produce any seminal fluid for analysis. 40(18.2%) of the patients whose sperm concentrations were above 40million/ml were used as controls. Testosterone concentrations were investigated in the 224 subjects. The mean testosterone concentration was found to be 6.8 ±2.4 ng/ml among the 40 subjects used as controls. The 22.3% azoospermia patients had a mean testosterone concentration of 4.3±1.5ng/ml. The mean testosterone concentration of the 52.7% oligozoospermia patients was 5.1±1.3ng/ml, whilst the mean testosterone concentration of the 25% normozoospermia patients was 6.9±2.1ng/ml. It was found that there was a 0.5 possibility of correlation between the mean testosterone concentration and the mean sperm concentrations below 40million/ml.There was a positive correlation between the sperm concentrations and the testosterone concentrations of the primary infertility cases and the secondary infertility cases as well as all the oligozoospermia subjects. The mean testosterone concentrations for the various age groups revealed a significant increase (p<0.05) until 60+ years old where it decreased. The mean testosterone values of the 20-29 age group, 30-39, 40-49, 50-59, and 60+ years old were 4.6±2.8ng/ml, 5.5±3.0ng/ml, 5.1±3.2ng/ml, 8.3±2.8ng/ml, and 3.7±0.6ng/ml respectively. There was a clear positive correlation between the percent motility of the sperm cells and the testosterone concentrations of the oligozoospermia, normozoospermia primary infertility and secondary infertility subjects. The mean testosterone concentration and the mean percent motility of the sperm cells were both higher in the normozoospermia subjects than the oligozoospermia subjects. The study clearly demonstrated that oligozoospermia with a sperm concentration in the order of less than 20million per ml is the major cause of male infertility in all the referred cases whilst erectile dysfunction accounted for only 1.8% of the cases studied. It is therefore imperative for medical experts concerned with reproductive health of males to elucidate the underlying causes of oligozoospermia and azoospermia cases at an early stage so as to manage cases promptly in the face of the fact that advances in the treatment of male infertility such as microsurgery and gonadotropic stimulation are now available.

Source: KNUST