Epidemiology and occupational risk factors of male infertility based on 3,025 patients in Eastern Morocco during 2021-2023: a cohort study

Abstract

OBJECTIVE: The objective of our study was to characterize the sperm parameters of men consulting for infertility in our fertility center. METHODS: The study included 3,025 patients investigated from September 2021 to July 2023. Demographic data, infertility risk factors, and the primary or secondary nature of infertility were recorded for each patient. The sperm parameters were analyzed according to World Health Organization (WHO) criteria (2021). RESULTS: The average age of the patients was 40 years. The average duration of infertility was 5.5 years. Primary infertility was noted in 2,736 patients (88.97%). The most common risk factors for infertility were occupational exposure, followed by varicocele. Lifestyle factors associated with male infertility included smoking (24.29%), alcohol consumption (12.49%), and high temperature exposure (30.08%). Spermogram abnormalities were observed in 78.71% of cases. Spermocytogram abnormalities were found in 63.1% of cases. Sperm count, morphology, total motility, and vitality below WHO (2021) reference values were found in 25.60%, 34.13%, 32.29%, and 62.46% of the analyzed samples, respectively. Seminal fluid analysis revealed oligozoospermia in 29.07% of cases, asthenozoospermia in 24.68%, and azoospermia in 17.56%. Oligo-astheno-necrospermia was the most frequently observed combined abnormality (10.0%). CONCLUSION: This study showed a high rate of abnormal semen quality in male partners of infertile couples. Male infertility is often multifactorial and results in quantitative and/or qualitative sperm abnormalities.