Total Round Cell Concentration in Semen and Its Association With Sperm DNA Fragmentation Index Among Ghanaian Males in Kumasi

Abstract

Male infertility affects millions worldwide, yet its underlying causes remain incompletely understood. Total round cell concentration (TRCC) in semen, particularly leukocytospermia, has been suggested as a biomarker of impaired sperm function. However, its relationship with sperm DNA fragmentation index (DFI) remains unclear, particularly in sub-Saharan Africa, where research is scarce. This study examines the prevalence of elevated TRCC and its associations with semen parameters and sperm DNA fragmentation among men attending a fertility clinic in Kumasi, Ghana. A cross-sectional study was conducted among 227 men, with semen samples analyzed following WHO guidelines. Sperm concentration, motility, and morphology were assessed, while TRCC was quantified using a Neubauer hemocytometer and light microscopy. Sperm DNA fragmentation was determined using the Sperm Chromatin Structure Assay, and multivariate logistic regression models were employed to evaluate associations between TRCC and semen quality parameters. Elevated TRCC was detected in 19.4% of participants. Higher TRCC levels were significantly associated with lower odds of oligozoospermia (c<i>OR</i> = 0.30; 95% CI [0.20, 0.92]; <i>p</i> = .030), a relationship that remained significant after adjusting for confounders (a<i>OR</i> = 0.18; 95% CI [0.05, 0.67]; <i>p</i> = .010). However, TRCC was not significantly associated with asthenozoospermia (<i>p</i> = .656) or teratozoospermia (<i>p</i> = .592). Additionally, no correlation was observed between TRCC and sperm DFI (<i>r</i> = .009, <i>p</i> = .958). It can therefore be concluded that the presence of round cells in semen does not influence sperm DNA integrity.