Major Etiologies of Male Infertility Among Couples Attending Fertility Clinics in Osun State, Nigeria: Findings From a Mixed-Method Study

Abstract

Male infertility accounts for nearly half of the infertility cases globally. Seminal fluid analysis (SFA) is a critical diagnostic tool in the evaluation of male infertility. This study aimed to assess the implications of SFA on male infertility among patients attending fertility clinics in Osogbo, Nigeria. The study employed a mixed-method approach of both qualitative (key informant interview [KII]) among 10 participants and quantitative methods (cross-sectional survey) using a pretested structured questionnaire among 305 respondents. The respondents in the cross-sectional survey were also made to undergo SFA. The data from the qualitative study were analyzed using ATLAS.ti, while the data from the quantitative study were analyzed using IBM Statistical Product for Service Solution (SPSS) version 27.0. Descriptive statistics was carried out for all variables. The univariate, bivariate, and multivariate analyses were done using p < 0.05 as the level of significance. The SFA of the respondents revealed that 241 (79.0%) had normal sperm counts (> 32 million per ejaculation), while 64 (21.0%) had abnormal sperm counts. Only 101 (33.1%) had sperm cells with normal progressive motility (> 32%), while 204 (66.9%) had abnormal (Athenospermia) progressive motility. One hundred and ninety-five (63.9%) were found to have abnormal morphology (Teratospermia, i.e., < 4%). The analysis of the data from the KII further explained the implications of SFA parameters on infertile males, and these were substantial, extending beyond physical health to encompass psychological, emotional, and social well-being. The study concluded that lifestyle modifications, early diagnosis, and prompt treatment of medical conditions can help reduce the high prevalence of SFA abnormalities and, consequently, decrease male infertility in our environment. This study recommends that advocacy programs, early screening, and public health education will further reduce the burden of infertility among the men.