Constant decline in sperm concentration in infertile males in an urban population:: experience over 18 years

Objective: To investigate semen quality in infertile men from an urban population over an 18-year period. Design; Retrospective study. Setting: Andrology clinic at a city university hospital. Patients: A total of 9,327 men were referred to the clinic for infertility investigation. After excluding those with azoospermia, 7,780 samples were evaluated. Intervention(s): Semen samples were analyzed within half an hour of production using computer-automated semen analysis and phase microscopy. Main Outcome Measure(s): Sperm concentration, morphology, and motility; semen pH and leukocyte concentration; and patient age. Result(s): The median patient age over the study period was 31.6 years, with an;increase from 30.8 years in 1986 to 34:4 years in 2003. The median sperm concentration was 10.25 million/mL for the entire period, with a decline from 27.75 million/mL in 1986 to 4:60 million/mL in 2003. The median proportion of normally shaped spermatozoa was 15%, and the proportion of motile spermatozoa was 21%. The pH increased from 7.4 in 1986 to 7.9 in 2003, and the median leukocyte concentration was 1.50 million/mL Conclusion(s): A constant decline in median sperm concentration was found in the infertile men. The reason for this remains unclear, although the high pH and leukocyte concentration indicates the involvement of infection.