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British Journal of Healthcare and Medical Research - Vol. 10, No. 2
Publication Date: April 25, 2023
DOI:10.14738/jbemi.102.14518.
Nana, T. N., Wabo, B., Tchounzou, R., Moby, H. E. M., Assob, C. N., Tchente, C. N., Njamen, C. N., Panny, C., Okalla, C. E., Nsagha, D.
S., Egbe, T. O., & Halle, G. E. (2023). Prevalence of Sperm Abnormalities and Factors Associated with Male Infertility in Douala,
Cameroon. British Journal of Healthcare and Medical Research, Vol - 10(2). 439-447.
Services for Science and Education – United Kingdom
Prevalence of Sperm Abnormalities and Factors Associated with
Male Infertility in Douala, Cameroon
Théophile Njamen Nana
Department of Obstetrics and Gynaecology,
Douala General Hospital, Cameroon and Department of Obstetrics
and Gynaecology, Faculty of Health Sciences, University of Buea, Cameroon
Bernard Wabo
Department of Medical Laboratory Science,
Faculty of Health Sciences, University of Buea, Cameroon
Robert Tchounzou
Department of Obstetrics and Gynaecology,
Faculty of Health Sciences, University of Buea, Cameroon
Herve Edouard Mpah Moby
Department Surgery and specialties, Faculty of Medicine
and Pharmaceutical Sciences, University of Douala, Cameroon
Clément Nguedia Assob
Department of Microbiology, Biochemistry,
Haematology and specialties, Faculty of Medicine and
Pharmaceutical Sciences, University of Douala, Cameroon
Charlotte Nguefack Tchente
Department of Obstetrics and Gynaecology, Douala General
Hospital, Cameroon and Department Surgery and specialties, Faculty
of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon
Cedric Nana Njamen
Department of Obstetrics and Gynaecology,
Faculty of Health Sciences, University of Buea, Cameroon
Christian Panny
Laboratoire Biomedicam, Douala-Cameroon
Cecile Ebongue Okalla
Department of Biology, Douala General Hospital, Cameroon
Dickson Shey Nsagha
Department of Public Health and Hygiene,
Faculty of Health Sciences, University of Buea, Cameroon
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440
British Journal of Healthcare and Medical Research (BJHMR) Vol 10, Issue 2, April- 2023
Services for Science and Education – United Kingdom
Thomas Obinchemti Egbe
Department of Obstetrics and Gynaecology,
Douala General Hospital, Cameroon and Department of Obstetrics and
Gynaecology, Faculty of Health Sciences, University of Buea, Cameroon
Gregory Ekane Halle
Department of Obstetrics and Gynaecology,
Douala General Hospital, Cameroon and Department of Obstetrics and
Gynaecology, Faculty of Health Sciences, University of Buea, Cameroon
ABSTRACT
Introduction: Sperm abnormalities are common causes of male infertility in
Cameroon. The causes of these abnormalities are multifactional. We described the
prevalence of sperm abnormalities and to assess its associated risk factors among
infertile participants visiting four hospitals in Douala. This multicentre descriptive
study was carried out from the January 1rst 2010 to the December 31rst 2020 in four
hospitals in Douala. The study enrolled 94 infertile participants aged between 25 to
53 years. Information from each consented participant was collected using a
structure questionnaire. Following clinical examination, participants were referred
for three consecutive spermograms. Data on the results of spermogram,
demographic and clinical variables were summarized as frequencies and
percentages using SPSS version 20. The frequency and percentage of each variable
were presented on tables. This study enrolled 94 participants aged between 25 to
53 years (mean 39.21±10 years). Concerning the sperm abnormalities, most
participants had Severe Oligoasthenozoospermia (62.7%), followed by those
having severe Oligoasthenozoospermia with necrozoospermia (13.8%). The
majority (60.6%) of them had Chlamydia trachomatis (titre IgG > 128) followed by
12.7% of others who had a varicocele. Severe Oligoasthenozoospermia was the
most prevalent sperm abnormality and Chlamydia trachomatis was the most
prevalent infectious risk factor. In Cameroon, the rate of male infertility is
increasing but can be prevented by sustainable health education programme
targeting exposure to socio-behavioural risk factors favouring sperm
abnormalities.
Keyswords: Sperm abnormalities, risk factors, male infertility
INTRODUCTION
Infertility is the failure to achieve a clinical pregnancy after twelve months or more of regular
unprotected sexual intercourse or due to an impairment of a person's capacity to reproduce,
either as an individual or with his/her partner [1]. Infertility is a general reproductive problem
in Africa particularly in the Sub-Sahara. It affects between 8 and 12% of reproductive-aged
couples worldwide.
A study reported that 30-40% males were partly the cause of infertility. Among them, 20% were
the sole cause of the condition [1]. In Douala (Cameroon) where primary infertility was found
to be more frequent, the frequency of male infertility was 5.6% [2]. There are disparities in the
prevalence of male infertility across countries with high prevalence being observed in low
resource countries. Clinical factors justifying such variance include urogenital infections,
hormonal disorders and chronic diseases [3]. Additional factors related to their lifestyle such
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441
Nana, T. N., Wabo, B., Tchounzou, R., Moby, H. E. M., Assob, C. N., Tchente, C. N., Njamen, C. N., Panny, C., Okalla, C. E., Nsagha, D. S., Egbe, T. O.,
& Halle, G. E. (2023). Prevalence of Sperm Abnormalities and Factors Associated with Male Infertility in Douala, Cameroon. British Journal of
Healthcare and Medical Research, Vol - 10(2). 439-447.
URL: http://dx.doi.org/10.14738/jbemi.102.14518.
as tobacco smoking, alcohol, psychological stress and dietary practices have also been
suggested [4]. These risk factors were found to be associated with the production of abnormal
spermatozoa parameters like azoospermia, oligozoospermia, teratozoospermia and/or
asthenozoospermia used for the diagnosis of male infertility [5]. On the basis of abnormal
spermatozoa results, more than 90% of male infertility resulted from oligospermia,
teratozoospermia, or both in a study Cameroon [6].
Given that the sperm quality is the most widely accepted diagnostic marker of male infertility
in most settings, the WHO has advocated standard operating procedures for sperm parameters
analysis [7]. In Cameroon, the rate of a male presenting at medical consultation for infertility
complaints is increasing. The situation is being aggravated by the unhealthy lifestyle of most
males in our country presumably as the result of their poor socio-economic status.
Unfortunately, up till now, the Cameroon Government has no planned programme focusing on
male infertility. Our objective was to determine the prevalence of abnormal sperm quality and
to describe factors related these disorders in infertile participants visiting four hospitals in
Douala.
MATERIALS AND METHODS
Study Design
We conducted a descriptive cross-sectional study starting from the 1st of January 2010 to the
31st of December 2020 in purposely selected health facilities offering specialized reproductive
health services in Douala the economic capital of Cameroon.
Study Sites
Douala is at the same time the regional capital of the Littoral region. The study was
implemented at the Douala General Hospital and the “Clinique de l’Aréoport”, Douala. The
Douala General Hospital, one of the six reference Hospitals in Cameroon created in 1992 is
located in the Beddi area in Douala. It offers multidisciplinary services including gynaecology
and obstetrics. The “Clinique de l’Aeroport” created in 1987 is a specialized private institution
neighbouring the Douala Airport offering gynaecology and In vitro fertilization services. Both
institutions were purposely chosen for their assessibility and high frequentation by couple with
fertility problems. The “BIOMEDICAM” biology Laboratory was also chosen for sperm analysis
and Chlamydia trachomatis serodiagnosis.
Selection of Participants
The study targeted males with fertility complains. All those visiting the study sites were
sensitized to take part in the study. During the study period, we registered 220 volunteers aged
between 25- 53 years. Following the inclusion criteria, ninety-four (94) males were
consecutively sampled for the study.
Inclusion Criteria:
We included in the study, consented infertile males with abnormal sperm quality and chlamydia
IgG level equal or greater than 128.
Exclusion Criteria:
We excluded from the present study, participants who lack financial means for the laparoscopy
of the spouse, those with no temperature measurement in the partner for 03 consecutive cycles,