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

Abstract

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.