Association of Testosterone with Markers of Inflammation in Men with Infertiity in Imo State, Nigeria
Gilbert Ifechukwu P
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Nwadike Constance N
*
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Nwanjo Harrison U
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Nwachukwu Uchenna C
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Mgbeosuru Benson
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Oko Oluebube M
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Mbarah Ifunanya E
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Arinzechi Ekpereamaka G
Department of Medical Laboratory Science, Imo State University, Owerri, Nigeria.
Ogbuokiri Arnold C
Obstetrics and Gynaecology Department, Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria.
Egwurugu Jude N
College of Medicine, Imo State University, Owerri, Nigeria.
*Author to whom correspondence should be addressed.
Abstract
Background: Male infertility remains a significant reproductive health challenge globally, with increasing evidence implicating hormonal and inflammatory imbalances in its pathophysiology.
Objective: This study evaluated serum testosterone and selected inflammatory biomarkers in infertile men (oligospermic and azoospermic) attending fertility clinics across Imo State, Nigeria.
Methodology: A total of 204 participants were recruited, comprising 68 oligospermic men, 34 azoospermic men, and 102 apparently healthy, age-matched fertile controls. Serum testosterone, C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α) were quantified using Enzyme linked immunosorbent assay (ELISA) methods. Data were analyzed using SPSS version 21.0 and expressed as mean ± standard deviation (SD); Group comparism were made using independent t-test and one way ANOVA. Statistical significance was set at P ≤ 0.05.
Results: Results showed that total testosterone levels were significantly reduced in oligospermic and azoospermic men compared to controls (8.26 ± 1.90 ng/dL) (P < 0.001). Conversely, inflammatory markers were markedly elevated among infertile subjects; CRP levels were significantly higher in azoospermic (10.59 ± 3.11 mg/L) and oligospermic (8.13 ± 2.13 mg/L) men compared to controls (2.63 ± 0.73 mg/L) (P < 0.001). Similarly, IL-6 and TNF-α levels were significantly elevated in azoospermic (respectively) and oligospermic (8.70 ± 1.84 pg/mL and 9.47 ± 1.94 pg/mL, respectively) groups versus controls (P < 0.001). Age and body mass index (BMI) exerted no significant influence on either testosterone or inflammatory markers (P > 0.05). Pearsons Correlation analyses revealed weak and statistically non-significant associations between testosterone and inflammatory (CRP, IL-6, TNF-α) in both oligospermic and azoospermic men.
Conclusion: In conclusion, the study demonstrated a clear pattern of systemic inflammation among infertile men in Imo State, who also presented with hypogonadism given their levels of testosterone. There was more pronounced inflammatory derangements in azoospermic subjects, when compared with the oligospermic subjects. These findings suggest that chronic subclinical inflammation may contribute to impaired spermatogenesis and androgen deficiency, highlighting the need for integrative therapeutic interventions targeting both endocrine and inflammatory pathways in male infertility management.
Keywords: Infertility, testosterone, inflammation, reproductive health