TITLE:
Patterns of Semen Analysis of Male Patients Undergoing in Vitro Fertilization Treatment in a Private Fertility Center in Ghana
AUTHORS:
Dickson Mawusi, Muller Makafui Mawusi, Gideon Kwesi Nakotey
KEYWORDS:
Sperm, Semen. Semen Analysis, IVF/ICSI, Ghana, Fertility Center, WHO
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.13 No.4,
September
29,
2025
ABSTRACT: Male infertility is known to contribute to about half of all infertility cases. In Ghana, the prevalence of male infertility is higher (15.8%) than in females (11.8%). We evaluated descriptive parameters of semen analysis obtained from males in the workup of infertility in some men undergoing sub-fertility/in vitro fertilization (IVF) treatment. We conducted a prospective cohort study in a specialized IVF center in Ghana involving 558 men who reported with their female partners for sub-fertility treatment (clinically diagnosed). Patient selection criteria were based on sub-fertility partners participating in an IVF/ Intracytoplasmic Sperm Injection (ICSI) program. The clients were considered eligible for inclusion in the study if the male partner had motile ejaculated spermatozoa during preliminary semen analysis and before controlled ovarian stimulation (COS). The age group of the men was 27 to 65 years. Exclusion criteria were: previous disease(s) or surgery associated with reproductive function (including varicocele, cryptorchidism, epididymitis, mumps, azoospermia); vasectomy and vasectomy reversal. Clients were questioned regarding their careers, smoking habits, alcohol consumption, medical and family histories. All cases of severe alteration in spermatogenesis, including frozen and surgically retrieved sperm, prostatitis, and or patients who had prior cancer therapy were excluded from this study. Semen samples were then collected by masturbation into sterile containers and analyzed following WHO guidance for semen analysis within 60 minutes after ejaculation and collection. The total number of spermatozoa, and percentages of progressively motile (PR) and morphologically normal spermatozoa, equal to or above the lower reference limits (Normozoospermia) were observed in men less than 40 years (13.38%) and compared to men between 40 - 50 years (13.71%) and those above 50years. The highest percentage of progressively motile (PR) spermatozoa below the lower reference limit (Asthenozoospermia) was observed in men older than 50 years (35.00%) as compared to men less than 40 years (5.43%) and those between 40 and 50 years (4.68%). The highest total number of spermatozoa below the lower reference limit (Oligozoospermia) was observed in men older than 50 years (30.00%) as compared to men less than 40 years (27.20%) and those between 40 and 50 years of age (22.41%). Semen analysis from a small population of some Ghanaian men undergoing IVF treatment showed that morphologically normal spermatozoa below the lower reference limit (Teratozoospermia) were highest (35.15%) in men less than 40 years as compared to those between 40 and 50 years (25.27%) and more than 50 years of age (10.00 %). Knowledge of the factors that influence sperm quality in this geographical region can contribute to informed decisions on the effective management of infertility in Ghanaian men.