OBJECTIVE: Currently semen analysis is used indiscriminately for all men who present with infertility. Our objective is to assess whether Caucasian, African American (AA), and Middle Eastern (ME) men being evaluated for infertility present with different findings on semen analyses and hormonal profiles.
DESIGN: Retrospective review.
MATERIALS AND METHODS: An institutional retrospective data review was performed on men who underwent semen analysis for clinical suspicion of infertility from July 2012 to February 2018. Men who presented for an initial assessment were identified, and of this sub-population, men without prior treatments or interventions for infertility were analyzed using a t-test analysis, p-value of <0.05 considered significant.
RESULTS: A total of 265 men underwent at least one SA. 25 patients were excluded for having interventions prior to their initial assessment. The remaining 240 patients were subsequently analyzed. The ethnic composition was 42.5% Caucasian, 27.1% AA, and 12.9% ME. The rest had an unknown or other ethnicity. Compared with Caucasian men, AA men had significantly lower total sperm count (92.43 million vs 175.23 million, p = 0.0017), semen volume (2.63 mL vs 3.32 mL, p = 0.0214), total motility (39.87% vs 49.22%, p = 0.0086), progressive motility (30.52% vs 42.72%, p = 0.0012), and normal morphology (4.89% vs 7.28%, p = 0.0381) on semen analysis. The azoospermia rate was not equivalent between ethnic groups (X2 = 9.4088, p = 0.0091) with rates of 32.4%, 29.2%, and 13.0% for ME, AA, and Caucasian, respectively. 180 had a hormonal profile on file. ME men had an average testosterone level of 276.4 ng/dL, which was significantly lower than Caucasian men who had an average value of 358.5 ng/dL (p = 0.0020). There was no significant difference in age, BMI, or smoking history between ethnic groups.
CONCLUSIONS: AA present with significant lower sperm concentration, motility and sperm morphology compared to Caucasian and AA men. ME and AA men more likely to present with azoospermia compared to Caucasians. The significance of the ethnic variable in the aforementioned study suggests that further focused on this variable is necessary to understand the potential relationship between sperm parameters and ethnicity.