Deleterious effects of khat addiction on semen parameters and sperm ultrastructure.

The semen parameters and sperm ultrastructural morphology have been described in semen samples from two groups of Yemeni subjects. The first 'exposed' group comprised 65 khat addicts, while the second control group included 50 non-khat addict subjects. The mean age was 39.94 +/- 13.85 and 35.72 +/- 11.35 years in the exposed and control groups respectively, without a significant difference. The mean duration of khat addiction among the addicts was 25.34 +/- 12.96 years (range 6.00-48.00). Statistically significant differences were detected between the semen parameters of the two groups. Such parameters, including semen volume, sperm count, sperm motility, motility index and percentage of normal spermatozoa, were lower among addicts. Significant negative correlation was also found between the duration of khat consumption and all semen parameters (r ranged from -0.30 to -0.74). At the transmission electron microscopy level, a counting system was incorporated to compare the numbers of normal spermatozoa with deformed and dead spermatozoa in ultrathin plastic sections. The total mean percentage of deformed spermatozoa was approximately 65%. Different patterns of sperm deformation were demonstrated, and included both the head and flagella in complete spermatozoa, aflagellate heads, headless flagella and multiple heads and flagella. Deformed heads showed aberrated nuclei with immature nuclear chromatin and polymorphic intranuclear inclusions; these were associated with acrosomal defects. The deformed flagella demonstrated numeric aberrations of the axonemal 9 + 2 configuration and structural defects of their associated elements. Persistent cytoplasmic droplets were observed frequently. This study has shown for the first time the deleterious effects of khat addiction on semen parameters in general and sperm morphology in particular of all addicts, especially those who have consumed khat for longer periods of time.