A glimpse at male infertility based on semen analyses in Brunei Darussalam.

Siti Zurainah ABDUL HAMID ¹ and Pemasiri Upali TELISINGHE ²,

¹ Department of Laboratory Services, ² Department of Pathology, RIPAS Hospital, Brunei Darussalam

Introduction: Infertility is defined as the inability to conceive children and the causes are equally divided between males and females. Considerable advances have been made in treatment of infertility amongst women, especially with the introduction of in-vitro fertilisation. However there is very little progress made in treating the male infertility. Male causes of infertility can be categorised into pre-testicular, testicular and post-testicular. This study looked at the causes of infertility amongst the males, based on the semen analysis in our local setting. Materials and Methods: From 2006-2008, 1,242 semen specimens were received for analysis. Subjects were instructed on proper semen collection using the World Health Organisation criteria, where the specimen is collected following three days of abstinence and sent to the laboratory within one hour of collection. Semen samples were examined microscopically for morphology, motility and the concentration. Results: Interestingly, 109 subjects (8.8%) had normal spermatozoa (normal analyses) and this included 38 patients (34.2%) whose initial analyses were abnormal. 57 (4.6%) subjects were azoospermic. 730 (58.8%) men had more than two abnormalities in spermatozoa and a further 217 (17.5%) men had abnormal morphology alone. Among patients with two or more abnormalities, a majority had three abnormalities and this was consistently seen in all age groups. There was a trend towards less severe abnormalities from 2006 to 2008. Conclusions: Majority had more than two abnormalities and abnormal morphology and they may not be able to father a child normally. However they may be able to have an offspring by assisted reproductive methods. Only a minority was azoospermic and they will not be able to father any children even with assisted reproductive techniques. Interestingly, 8.8% had normal analyses suggesting other causes of infertility such their female partners or improper techniques.

Keywords: Azoospermia, infertility, male infertility, sperm morphology, sperm motility

Brunei Int Med J. 2010; 6 (2): 83-91