Laboratory Diagnosis of Male Infertility among Sudanese Couples

Abstract

ln view of the increasing number of infertility among the couple male present in the Sudan .This study was conducted to essentially study the factors responsible for decreased male fertility, the impact of toxic and antioxidant elements on male reproductive function .and to introduce biochemical markers to be used in male infertility diagnosis . Group of 500 infertile male subjects were enrolled ;15O azoospermic 150 oligospermic patients, 100 patients with abnormal sperm motility and 100 patients with abnormal sperm morphology were studied, and compared with reference group of 100 fertile male. The fertility and thyroid hormones were measured by ELISA and trace elements in semen and serum/blood by AAS. Semen volume and liquefaction time in azoospermic and oligospermic patients was significantly reduced (p< .05 ). Significant correlation was noticed between both FSH & LH with seminal volume , and blood Pb with liquefactions time in azoospermic patients .Significant correlation was observed between seminal Zn and liquefaction time in both azoospermic and oligospermic subjects.(r < .05). Immunological infertility is higher in patient with abnormal sperm motility (9% lgC-3, 6% lgA) than other test groups. Testosterone in the test groups was significantly reduced , while FSH level was significantly increased (p<.O5). Prolactin level was increased in azoospermia, and significantly increased in the other infertile groups (p<.O5). LH was significantly increased in both azoospermic and oligospermic patients (p<.O5) Significant correlation was noticed between ,LH and semen Cd in azoospermia , prolactin was significantly correlated with Pb in both blood and semen, and with seminal Mn and Zn, LH with seminal Zn in oligospermic patients. Also correlation between, prolactin with blood Pb and FSH with blood Cd in abnormal sperm motility patients (r<.05), .The thyroid hormones showed conflicting levels in the infertile test groups, only T4 was slightly increased. In seminal plasma Cd level was significantly increased in both azoospermic and oligospermic patients (p < .05). Seminal Pb level was slightly elevated in infertile patients with azoospem1ia and oligospermia . Zn level was significantly reduced in the infertile groups (p<.O5). Se , Mg & Ca were significantly reduced in both azoospermic and oligospermic patients (p<.O5). Where as Mn, Ni, Co,Cr and Cu showed no significant variations .ln blood Pb level was increased in the test groups, and Cd level was significantly increased in azoospermia (p<.O5), and the other elements indicated conflicting level , _but within normal range when compared with control group. Pb level was significantly correlated in blood and semen of azoospermic and oligospermic subjects,Also Cd level was significantly correlated in both semen and blood of abnormal sperm motility patients (r<.O5). Seminal NAG was significantly reduced in the study groups , while citric acid was reduced in both azoospermic and oligospermic patients (p<.05).Semen fructose indicated conflicting level ,but within normal range .Significant correlation was noticed between NAG with both FSH and LH in azoospermia, and with prolactin and seminal Mg in oligospermia (r<.O5).2.7% of azoospermia had sertoli-syndrome , explained significant decreased in testosterone ,seminal NAG, citric acid Zn, and increased FSH. (P<.O5). 13% of the infertile have varcocele, recorded significant increased FSH,LH and decreased seminal NAG ,citric acid 8- Zn (p<. 0 5). 9.6% of the test groups had erecting and ejaculating problems. Characterized by significant increased in prolactin and Mn level.7.2% of the test groups are smokers, explained significant increase of both Cd and Pb in blood and semen, and reduced semen volume, NAG and Zn level (p<.05) Treatment of adult male rats with Cd, Pb caused hair loss and enlargement of the testes. Followed by significant increased of blood Cd , blood Pb, FSH and LH (p<.05), decreased testosterone and Zn (p< .O5).With blockage of spermatogenesis at seminiferous tubules level, maturation arrest ,and proliferation of the sertoli cell. Where as treatment with Zn, showed increased number of germs cells and developing spermatide .Mixing of Cd with Pb in one dose exacerbated the toxic action of this elements, caused decreased testosterone and Zn, increased FSH , LH and prolactin with deletion of the germ cell, and proliferation of the sertoli cells . While mixing of Zn with Cd and Pb , reduced the toxicity of this elements on fertility hormones, development of the germ cell, and proliferation of sertoli cells