Male infertility is a significant global health issue. However, lack of reliable epidemiological data on male infertility in Egypt and the Middle East and North Africa (MENA) region poses a challenge to understanding region-specific risk factors.
A recent retrospective study on male infertility in Egypt sought to bridge this gap. The study reviewed the medical records of 3,037 infertile men who presented to a single andrology/infertility center in Egypt between June 2012 and May 2022. It characterized their sociodemographic, clinical, hormonal, and seminal profiles and investigated temporal trends in their reproductive health over a decade. Key findings are included below.
The median age of the men was 32 years. Majority of cases (76.1%) involved primary infertility, where the couple had never achieved a pregnancy. Clinically, varicocele was a highly prevalent finding, detected in 66.47% of patients, with most cases being bilateral.
Semen analysis classified the most frequent abnormalities as asthenozoospermia (reduced sperm motility) 31.7%, oligoasthenozoospermia (reduced sperm motility and low sperm count) 20.8%, and azoospermia (zero sperm count) 9.1%.
Over the ten-year period from 2012 to 2022, a significant decline in several key sperm parameters was observed. Progressive sperm motility saw a significant drop from a median of 25% to 17% (p<0.001) and normal sperm morphology halved, declining significantly from a median of 10% to 5% (p<0.001). The decline in sperm quality was notably exacerbated during the COVID-19 pandemic period (2020-2022), which was associated with the most prominent reduction in progressive sperm motility (from 21% in 2020 to 17% in 2022).
While underlying variables such as rising rates of obesity, cigarette smoking, sedentary habits, and exposure to environmental heat and pollutants known to impair spermatogenesis were not systematically assessed in this study, the authors suggest that their cumulative effects likely underlie the temporal decline in semen quality observed in this population.
In this study, Cigarette smoking was found to negatively influence all sperm parameters, particularly progressive motility and morphology. This confirmed prior evidence of tobacco’s adverse effects on spermatogenesis.
Elevated levels of gonadotropins (Follicle-Stimulating Hormone and Luteinizing Hormone) were inversely correlated with semen quality and testicular volume, potentially indicating a compensatory endocrine response to testicular dysfunction. These results are in agreement with previous studies that have identified gonadotropins, particularly FSH and LH, as more reliable markers of testicular dysfunction than total testosterone. Notably, total testosterone did not correlate significantly with semen parameters or testicular volume.
Despite the high prevalence of varicocele in this cohort, no statistically significant correlation was detected between varicocele grade and semen quality.
These findings contribute important epidemiological and clinical insights into male infertility in Egypt and the MENA region. The observed temporal declines in sperm concentration, motility, and morphology over the past decade, coupled with the negative influence of factors like smoking, signal a growing public health concern.
The authors recommend that future studies be conducted using prospective, multicenter designs with control populations to better define diagnostic thresholds and improve clinical management and public health strategies for male infertility in this region.
Reference Source:
Ramadan Saleh, Mohamad A. Elsuity, Islam R. Saleh, Taha Abo-Almagd Abdel-Meguid Hamoda, Pallav Sengupta, Sulagna Dutta & Ralf Henkel (24 Nov 2025): Epidemiological characteristics and temporal trends of male infertility in Egypt (2012-2022): Analysis of 3,037 consecutive cases, Arab Journal of Urology, https://doi.org/10.1080/20905998.2025.2590924
