A correlative interaction between thyroid dysfunction and semen parameters in male infertility: A prospective case control study

The role of thyroid function on sperm quality has not been well studied from a pathological aspect. This study aimed to report the degree of association between the status of thyroid hormones, sperm quality and aetiology in infertile men compared to healthy subjects. A prospective case control investigative study was conducted on 100 infertile males and age matched healthy controls. Semen samples were collected for sperm quality examination, and the serum levels of tetraiodothyronine (T4), triiodothyronine (T3), and thyroid stimulation hormone (TSH) were measured. Out of 100 infertile men, oligozoospermia (32%), asthenozoospermia (48%), and oligo-asthenozoospermia (20%) were found. There was a statistical difference between the group I and group II groups related to sperm count (28.32 ± 14.60 vs 66.50 ± 10.50 x 106/ml), sperm motility (40.1 ± 13.8 vs 64.8 ± 7.85%), and sperm morphology (55.92 ± 5.27 vs 83.50 ± 5.25%, p<0.05). There was a statistical difference among the oligozoospermia, asthenozoospermia, and oligo-asthenozoospermia groups related to T3 (115 + 0.40 vs 1.29 ± 0.59 vs 1.25 ± 0.32 ng/ml), T4 (7.35 ± 1.42 vs 9.15 ± 1.85 vs 7.85 ± 1.65 μg/dl), and TSH (1.69 ± 0.55 vs 2.12 ± 1.45 vs 1.98 ± 0.4 μIU/ml) (P<0.05). There was a significant inverse correlation of TSH levels with sperm volume (r = -0.12, p= 0.02), sperm motility (r = -0.26, p= 0.02), and sperm morphology (r = -0.304, p = 0.02) observed. T4 levels were significantly correlated with sperm count (r = -0.278, p = 0.02), and sperm motility (r = -0.249, p = 0.032). T4 levels were very highly associated with asthenozoospermia. Relative operating curve analysis shows that Sperm motility of >40.1%, T3 levels of <1.29 ng/ml, total T4 levels of <8.42 μg/dl, TSH levels of <1.98 μIU/ml inferred the male infertility.

Although thyroid function screening is not currently recommended as a part of the diagnostic workup of the infertile male, it may be reconsidered in light of the physiopathological background. Studies will be necessary to initiate the trial of a small dose of anti-thyroid drug in asthenozoospermic patients.