Male Factors Associated With Success Following Assisted Reproduction Technology Among Infertile Couples in Ghana

Abstract

Assisted reproductive technologies (ARTs) are increasingly utilized in Ghana, as treatment options for couples with infertility, including male factor infertility. While extensive research has focused on female determinants of ART success, comparatively fewer studies have systematically examined the contribution of male partner characteristics beyond routine semen analysis to clinical pregnancy outcomes following ART. The paucity in research is more pronounced in Ghana. This was a cross-sectional study, conducted at the Chosen Hospital and Fertility Centre between January 2024 and March 2025. The study population comprised 198 male partners of women seeking ART services at the hospital, aged between 30 and 61 years. Baseline data were collected from the male partners before initiation of the ART procedure. The sociodemographic, anthropometric, and clinical data of the men were collected using a semi-structured questionnaire and medical records. Venous blood samples were then collected before ART and analyzed for fasting lipids, glucose, complete blood count, liver, and renal function tests. Semen samples were also collected after 3 to 7 days of abstinence and analyzed. Following the ART procedure, 126 (63.6%) of the women tested positive for pregnancy. The sociodemographic, anthropometric, hematological, biochemical, and seminal variables were compared between ART outcomes. The mean ± standard deviation of serum chloride level in mmol/L was higher in males whose partners tested negative for post-ART pregnancy compared to those who tested positive (101.3±3.5 vs 99.9±2.6, P=0.026). No significant disparities in the other variables were observed between the groups. The findings suggest that, although chloride is essential for normal spermatogenesis, high levels of serum chloride could be detrimental to sperm quality. Routine electrolyte measurements of male partners of infertile couples should be performed before ART procedure.