Etiological factors of male infertility in Africa.

Of the 595 infertile African males studied, 192 (30.8%) were azoospermic and 413 (69.40%) had oligospermia. Azoospermia was caused by obstruction to the vas and/or epididymis in 44% of cases and testicular lesions in the remaining 56% of cases, whilst the oligospermia was probably caused by obstruction in 4.7% of cases and testicular lesions in 85.3%. Bilateral testicular biopsies were performed on 302 patients. A variety of pathological conditions were observed; the most prevalent was hypospermatogenesis, in 12% of cases. A significant portion (37.2%) of patients without testicular biopsies had clinically detectable testicular or epididymal abnormalities. There was a higher incidence (12%) of inflammatory testicular or prostatic conditions in this study as compared with those found in Europeans, suggesting that inflammatory conditions contribute more to male infertility in Africa. Only a single case of chromosomal abnormality was detected.