P-42: Declining Trends in Sperm Qualityof Infertile Tunisian Men: A Possible Role of Genital Tract Infections

Background: Declines in semen quality over time are not well understood. It is suspected that infectious disease may affect reproductive function. The aim of this study was to investigate semen quality in men in infertile relationships who were under investigation for couple infertility and attended a clinic for routine semen analysis over a period of 15years. Materials and Methods: We investigated trends in semen parameters between 1996 and 2012 in the Sfax area of southern Tunisia in a sample of 4117 men in infertile relationships. Age at semen collection, duration of sexual abstinence, volume of seminal fluid, the sperm count, percentages of motile and morphologically normal spermatozoa, and semen leukocyte concentration were determined. Linear regression was used to examine trends over time in sperm count, sperm motility, normal morphology, and semen leukocyte concentration. Results: Mean age and semen volume did not change between 1996 and 2012. Data adjusted for age and abstinence showed a decreasing trend in sperm count and percentage of normal morphology over the last 12 years [(R(2) = 0.8, p=0.0001, and R(2) = 0.8, p<0.0001, respectively)]. There was no significant change in sperm motility. However, semen leukocyte concentration increased significantly over time [(R(2) = 0.43, P =.01)]. Conclusion: These results coincide with the high prevalence of genital infectious diseases in the Sfax area suggesting that infection of the accessory glands lead to decreased sperm counts by functional impairment or partial occlusion of the seminal ducts. Thus, if in the general population declining sperm counts are observed, genital tract infections may be suspected as a contributing factor.