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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,