High prevalence of male infertility in southeastern Nigeria.

Three hundred and fourteen Nigerian couples were evaluated thoroughly for the cause of their infertility in our clinics located at Nnewi and Awka in Southeastern Nigeria. Two hundred and four (65.0%) of them had primary infertility and 110 (35%) had secondary infertility. The median duration of the infertility was 5 years and majority of the female patients (67.2%) were aged between 25 and 34 years. A positive male factor alone was found in 133 (42.4%) couples and female factor alone in 81 (25.8%) couples (P<0.01). Sixty-five (20.7%) couples had a combination of male and female factors, while the cause of infertility was unexplained in 35 (11.1%) couples. Oligozoospermia (35.9%) and asthenozoospermia (32.3%) were the most common aetiological factors responsible for male infertility. Tubal occlusion (49.0%) was the most common cause of female infertility. Genital tract infection resulting from sexual promiscuity and poorly treated sexual transmitted diseases were responsible for these abnormalities. In this part of the world, the wife is commonly blamed whenever there is infertility. However, this study has revealed the greater contribution of male factors to infertility. More attention should be paid to male partners whenever a couple presents for infertility. Men should also be a major target of any intervention aim at prevention.