Decline in semen parameters from 2000 to 2016 among Bangladeshi men attending a tertiary care hospital
Nusrat Mahmud1, Eshita Sharmin2, Md. Arif Mamun1, Zayan Shamayeen3, Natalie Rivadeneira4, Roger Rochat2, Akanksha Mehta5
1 Department of Obstetrics and Gynaecology, Centre for Assisted Reproduction, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders, Dhaka, Bangladesh
2 Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
3 Department of Biology, Emory University, 3Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
4 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
5 Department of Urology, School of Medicine, Emory University, Atlanta, GA, USA
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
Source of Support: None, Conflict of Interest: None
Introduction: The objective of this study was to analyze longitudinal changes in sperm parameters of Bangladeshi men. We hypothesized that semen parameters declined for this population.
Methods: We retrospectively analyzed semen data from men aged 18-64 years who sought care for general sperm quality or updates on fertility status at an infertility clinic in Dhaka, Bangladesh, from January 2000 to June 2016 (n = 13,953). Samples with incomplete data were excluded (n = 143). The WHO normal criteria and semen analysis procedures were used to evaluate parameters of the remaining 13,810 specimens. Samples with missing values on sperm concentration (n = 6187) were excluded from concentration analyses. Age and duration of abstinence at testing were recorded and adjusted for. Data were imported into SAS® 9.4 statistical software. Temporal significance was investigated using one-way ANOVA for motility parameters and Chi-square test for raw concentration. Logistic regression analyzed the effects of confounders on azoospermia and raw concentration, while median regression modeling adjusted confounders for concentration, total motility, and rapid linear (RL) motility.
Results: Age distribution was significantly correlated with annual parameter changes (concentration, total motility, and RL motility [P < 0.0001]). Adjusted total motility and RL motility declined by 20% from their maximum values to end of the study (P < 0.0001). Raw concentration lacked clear trends and was unaffected by adjustment. Azoospermia increased by 18% between the 2000–2010 and 2011–2016 participants (odds ratio = 0.16 [0.14–0.16]).
Conclusion: In agreement with the hypothesis, Bangladeshi males attending this clinic have experienced decline in semen parameters (total motility and RL motility) and increased frequency of azoospermia.