A case-control study of risk factors for male infertility in Nigeria

Alcohol Consumption, Risky Sexual Behaviors, and HIV in Nigeria: A Meta-Analytic Review

BACKGROUND

Alcohol consumption is associated with risky sex, which increases the risk of acquiring and transmitting HIV.

OBJECTIVE

To examine the prevalence of, and associations among alcohol, risky sex, and HIV, in Nigeria.

METHODS

We searched electronic databases and reviewed reference sections of relevant papers to locate studies that sampled people living in Nigeria and assessed both alcohol and sexual risk behavior. We calculated effect sizes to determine (a) prevalence of alcohol and sex behaviors and (b) associations between alcohol consumption and risky sex, and examined moderators to determine if sample characteristics predicted behavioral or biological outcomes.

RESULTS

Of the 696 unique records identified, 35 manuscripts reporting on 42 separate studies met the inclusion criteria. Participants in these studies (N = 83,350; M age = 26 years; 48% women; 10% HIV-infected) reported high rates of heavy drinking (63%) and low rates of consistent condom use (24%). One-third of participants (30%) also reported using alcohol before sexual activity. Participants who consumed alcohol were more likely to report sexual activity (OR = 3.66, 95% CI = 3.09, 4.33), multiple partners (OR = 3.22, 95% CI = 2.38, 4.36), and condomless sex or inconsistent use of condoms (OR = 2.30, 95% CI = 1.54, 3.43).

CONCLUSION

High rates of heavy drinking and low rates of condom use have been well-documented in Nigeria. Results from this meta-analysis can be used to inform critically needed alcohol-related HIV interventions.

Low dose bitter leaf improves sperm quality disrupted in immunosuppressed Wistar rats: An experimental study

Background

Synthetic prednisolone (PRED) is a widely used over-the-counter glucocorticoid. Glucocorticoids have inhibitory effects on the immune system and are often used as immunosuppressive agents. Suppressed immunity may impact fertility via the hypothalamic-pituitary-adrenal axis. Bitter leaf (BL) has been shown to improve sperm parameters, but its effects on immunosuppression-associated infertility have not yet been documented.

Objective

To determine the fertility effects of bitter leaf on immunosuppressed Wistar rats.

Materials and Methods

A total of 30 male adult Wistar rats were randomly assigned to 6 groups (n = 5/each). Group A served as a control and were given distilled water in addition to normal feeds, group B received 2 mg/kg PRED for 14 days and served as the standard immunosuppressed group, and groups C-F were immunosuppressed as in B but in addition received 50 mg/kg levamisole, low-dose (250 mg/kg) BL, high-dose (375 mg/kg) BL, and low-dose BL + levamisole, respectively. The CD4 counts, hematological parameters, and sperm parameters were analyzed and compared.

Results

There were significant decreases in sperm motility, progressive motility, morphology, and life/death ratio in the animals given PRED only compared to the controls (p = 0.002, 0.001, 0.001, and 0.01, respectively). These were significantly increased in the treated groups, and animals given levamisole and 250 mg/kg BL showed significantly increased sperm counts compared to the controls (p = 0.04 and p = 0.04, respectively).

Conclusion

Low-dose BL (250 mg/kg) restored the sperm parameters altered by prednisolone administration.

The effect of modifiable lifestyle factors on semen quality

INTRODUCTION AND OBJECTIVES

To examine the association between lifestyle factors (body mass index, smoking, alcohol consumption, coffee intake, physical activity, sauna and cell phone usage, wearing tight-fitting underwear), and conventional semen parameters.

MATERIALS AND METHODS

1311 participants who attended the Andrology Clinic were included in the study. All participants were separated into two groups as men with normozoospermia and dysspermia. All participants answered a questionnaire which contains questions about the modifiable lifestyle factors. The total risk scores were calculated after all the positive lifestyle factors had been counted.

RESULTS

Men with normozoospermia and dysspermia consisted of 852 (65.0%) and 459 (35.0%) participants respectively. A negative relationship between the wearing of tight underwear and having normal semen parameters was detected between the two groups (p=0.004). While going to a sauna regularly was negatively related to semen concentration, wearing tight underwear was also related to both lower motility, normal morphology as well as semen concentration (p<0.05). While the total score of all participants was 5.22±1.34 point, there were no statistical differences between the two groups (p=0.332). It was found that having 3 more or fewer points was not related to any type of semen parameters and results of a spermiogram.

CONCLUSION

The clinicians should give advice to infertile male patients about changing their risky lifestyle, for infertility, to a healthy lifestyle for fertility. Better designed studies, with larger sample sizes using conventional semen analysis with sperm DNA analysis methods, should be planned to identify the possible effects of lifestyle factors on semen quality.

Senecio biafrae defeated Tetracycline-Induced Testicular Toxicity in Adult Male Sprague Dawley Rats

Objective

The current study focused on the pro-fertility potential of Senecio biafrae (Sb) extract and vitamin C in Male Sprague Dawley (SD) rats with tetracycline-induced infertility.

Methods

A total of 36 male and 36 female adult SD rats were used for this investigation. The male rats randomly assigned to Group A (controls) were given normal saline 2ml/kg. Rats in Groups B, C, D, E, and F were respectively administered [30 mg/kg of body weight (bwt) of tetracycline], [30 mg/kg bwt of tetracycline + 50 mg/kg of vitamin C], [30 mg/kg bwt of tetracycline + 500 mg/kg bwt of Sb], [30 mg/kg bwt of tetracycline + 50 mg/kg of vitamin C + 500 mg/kg bwt of Sb], and [30 mg/kg bwt of tetracycline reversal] daily for 28 days via gastric gavage. Tested parameters included sperm parameters, hormonal profile, histology, and fertility test.

Results

Significant (p<0.05) increases were seen in sperm quality, hormone profile, organ and body weights of the groups treated with vitamin C, Sb, and tetracycline. There was derangement in sperm quality, hormone profile, and organ and body weight of the animals in group B. Histoarchtecture of the testes showed normal cellular composition in the germinal epithelium with sperm cells in the lumen and normal interstitium in groups A, C, D, and E. Group F showed abnormal spermatogenesis and poor association of spermatogenic cells, however there was depletion in the seminiferous epithelium in the group treated with tetracycline.

Conclusion

Senecio biafrae defeated the deleterious effects of tetracycline on the male reproductive system of rats treated with the drug.

Mycotoxin exposure and adverse reproductive health outcomes in Africa: a review

It is well established that mycotoxin exposure can have adverse effects on reproductive health resulting to poor reproductive potential. The most studied mycotoxin in relation to poor reproductive health in humans is aflatoxin, although fumonisins, trichothecenes and zearalenone have also been reported to impair reproductive function and cause abnormal foetal development. These potent fungal toxins contaminate many food products making them a prominent agricultural, food safety and public health challenge, especially in Africa due to little or lack of mycotoxin regulation in agricultural products. Neonates can be exposed to aflatoxins in utero, as the toxins pass from mother to the foetus through the placenta. This exposure may continue during breast feeding, to the introduction of weaning foods, and then foods taken by adults. The consequences of aflatoxin exposure in mothers, foetus and children are many, including anaemia in pregnancy, low birth weight, interference with nutrient absorption, suppression of immune function, child growth retardation and abnormal liver function. In males, reports have indicated a possible relationship between aflatoxin exposure and poor sperm quality culminating in infertility. Maternal exposure to fumonisin during early pregnancy has been associated with increased risk of neural tube defects among newborns in regions where maize is the common dietary staple with the possibility of chronic fumonisin exposure. Furthermore, zearalenone has been linked to precocious puberty and premature thelarche in girls, correlating with extremely high serum oestrogen levels. This review presents an overview of the several reports linking aflatoxins, fumonisins, trichothecenes, and zearalenone exposure to poor reproductive health outcomes in Africa, with emphasis on birth outcomes, foetal health and infertility.

Evidence for decreasing sperm count in African population from 1965 to 2015

PURPOSE

This meta-analysis, following our previous reports those documented an overall 57% diminution in mean sperm concentration around the globe over past 35 years and 32.5% decline in past 50 years in European population, attempts to report the declining trend of sperm concentrations in African population between 1965 and 2015.

METHODS

In the course of retrieval of data following MOOSE guidelines and PRISMA checklist, we found a total of fourteen studies that have been conducted during that period on altering sperm concentration in the African male.

RESULTS

Following analysis of the data, a time-dependent decline of sperm concentration (r = -0.597, p = 0.02) and an overall 72.6% decrease in mean sperm concentration was noted in the past 50 years. The major matter of concern is the present mean concentration (20.38×106/ml) is very near to WHO cut-off value of 2010 of 15×106/ml. Several epidemic diseases, genital tract infection, pesticides and heavy metal toxicity, regular consumption of tobacco and alcohol are reported as predominant causative factors.

CONCLUSION

This comprehensive, evidence-based meta-analysis and systematic review concisely presents the evidence of decreased sperm concentration in the African male over past 50 years with possible causative factors to serve the scientific research zone related to male reproductive health.

The Disappearing Sperms: Analysis of Reports Published Between 1980 and 2015

Reports regarding the changes in sperm concentration in different counties of the world are inconsistent. Furthermore, the reports that sprung up from specific epidemiological and experimental examinations did not include data of prior studies or geographical variations. The current study, following a previous report of massive fall in semen volume over the past 33 years, attempts to delineate the trend of altering sperm concentrations and factors responsible for this by reviewing article published from 1980 to July 2015 with geographic differences. The current study identified an overall 57% diminution in mean sperm concentration over the past 35 years ( r = -.313, p = .0002), which, when analyzed for each geographical region, identified a significant decline in North America, Europe, Asia, and Africa. An increasing trend of sperm concentration was identified only in Australia. The association of male age with such a trend ( R² = .979) is reported. The authors also correlated male fertility with sperm concentration. Thus, this comprehensive, evidence-based literature review aims to concisely and systematically present the available data on sperm concentration from 1980 to 2015, as well as to statistically analyze the same and correlate male health with the declining pattern of sperm count in a single scientific review to serve the scientific research zone related to reproductive health. It points to the threat of male infertility in times ahead.

Histomorphometric studies of the effects of Telfairia occidentalis on alcohol-induced gonado-toxicity in male rats

Background

Available evidence suggests that 50% of couples with infertility are male related. Over 40% of these males consume alcohol which has been reported to be a reproductive toxicant causing depletions in the epithelium of seminiferous tubules hence reducing sperm counts and sperm morphology.

Objective

To determine the effects of aqueous leaf extract of Telfairia occidentalis on alcohol-induced cyto-architectural changes in the testis.

Methods

Aqueous leaf extract of Telfairia occidentalis (T. occidentalis) was administered by gastric gavage at a dose of 250 mg/kg and 500 mg/kg body weight daily, while 2 g/kg body weight of ethanol at 30% v/v was administered daily to mature male Sprague–Dawley rats. The experiment was in 2 phases. Phase 1 had groups A₁–F₁ and lasted for 4 weeks while phase 2 had groups A₂–F₂ and lasted 8 weeks. Parameters tested include: testicular histology, relative volume density, sperm parameters, malondialdehyde (MDA), superoxide dismutase (SOD) and reduced glutathione.

Results

In both phases, there were depletions in the seminiferous epithelium, decreased sperm quality and increased MDA and SOD in animals that received alcohol only compared to control. Likewise, a significant increase of seminiferous epithelium of animals that received respective doses of 250 mg/kg and 500 mg/kg of T. occidentalis only compared to control. Animals that received T. occidentalis and alcohol simultaneously had a significant increase in seminiferous epithelium and sperm quality with decreased MDA level.

Conclusion

T. occidentalis attenuated the deleterious effects of alcohol to the cyto-architecture of the testis, protected the seminiferous epithelium, reduced oxidative stress and promoted spermatogenesis.

Prevalence of Varicocele among Primary and Secondary Infertile Men: Association with Occupation, Smoking and Drinking Alcohol

Background:

Existing data suggests that varicocele plays a central role in progressive infertility.

Aims:

This study was designed to assess the occupational and lifestyle factors of development of varicocele among male infertile, for a better prevention and management of the varicocele.

Materials and Methods:

All males with infertility, who presented at Fatemezahra Infertility and Reproductive Health Research Center between April 2010 and February 2011, were examined. Their occupations, smoking, and drinking alcohol, presence or absence of varicocele were evaluated. The lifestyle factors associated with varicocele were analyzed.

Results:

The data of 816 men, aged 21-71 years, were included in the study. Two hundred and sixty-one men (32%) with varicocele and 555 (68%) without varicocele were found. Percentage of varicocele was significantly higher in smokers compared with non-smokers (P = 0.035). The adjusted OR for varicocele in smokerswas significantly higher than that in non-smoker (OR = 2.420; 95% CI = 1.04, 5.61). No significant differences were seen between varicocele and occupation or alcohol drinking for the prevalence of varicocele.

Conclusions:

The findings of the present study indicated that a high frequency of varicocele was indentified among male infertile. Therefore, it is necessary for those male cigarette-smokers to evaluate their possibilities of infertility and varicocele.

[Sexually transmitted infections relevant in andrologic diagnostics]

Affects on male fertility are associated with many sexually transmitted diseases. Genital tract infections play a major role in this context. The evidence for an impact on fertility differs for the pathogens; however early treatment may be very important. This requires fast and precise clinical diagnostics. Further, sexually transmitted infections may have major relevance in andrologic diagnostics because of the risk of transmission to the mother or fetus. Particularly for the increasingly relevant HIV and hepatitis infections, current guidelines are available for use in diagnostics and assisted reproduction techniques.

Sexually transmitted infections: impact on male fertility

The impact of sexually transmitted diseases (STD) on male fertility is strongly dependent on the local prevalence of the STDs. In Western countries STD-infections are of minor relevance. In other regions, i.e. Africa or South East Asia, the situation appears to be different. Acute urethritis could not be associated with male infertility. Chronic infections (gonorrhoea) can cause urethral strictures and epididymo-orchitis. Chlamydia trachomatis and Neisseria gonorrhoea can be transmitted to the female partner and cause pelvic inflammatory disease with tubal obstruction. Ureaplasma urealyticum may impair spermatozoa (motility, DNA condensation). Trichomonas vaginalis has, if any, only minor influence on male fertility. The relevance of viral infections (HPV, HSV) for male infertility is not resolved. Any STD increases the chances of transmission of the human immunodeficiency virus (HIV). The HIV infection is associated with infectious semen and the risk of virus transmission. Semen quality deteriorates with the progression of immunodeficiency. Special counselling of serodiscordant couples is needed. STDs should be treated early and adequately to prevent late sequelae for both men and women.