Low sperm counts in genitourinary medicine clinic attendees: results from a case–control study
- Christopher A Carne1,
- Sian Chilcott2,
- Christopher Palmer3,
- Oliver Green2,
- Simeon Bridge1,
- Richard Walsh2,
- Anna Gramy-Mason1,
- Maria O'Donovan2
- 1Department of Genitourinary Medicine, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
- 2Department of Cytology, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, UK
- 3Centre for Applied Medical Statistics, University of Cambridge, Cambridge, UK
- Correspondence to Dr Christopher A Carne, Department of Genitourinary Medicine, Clinic 1A, Box 38, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge CB2 0QQ, UK;
Contributors Roles of authors CAC: design of project, recruitment of patients, completion of clinical questionnaires, analysis of results; principal writer SC: design of project, cytological examinations and creation of cytological spreadsheet; co-writer CP: statistical analysis; co-writer OG: cytological examinations; co-writer SB: completion of clinical questionnaires and creation of spreadsheet; co-writer RW: cytological examinations; co-writer AG-M: completion of clinical questionnaires and creation of clinical spreadsheet; co-writer MO'D: design of project and co-writer.
- Accepted 6 April 2012
- Published Online First 11 June 2012
Objectives To conduct a case–control study of abnormalities in the semen of genitourinary (GU) medicine clinic attendees compared with general practice (GP) controls and in patients with asymptomatic and symptomatic non-specific urethritis (NSU) before and after the urethritis resolves.
Methods Rates of semen abnormalities were compared between the different groups (19 with symptomatic and 27 with asymptomatic NSU, seven with symptomatic non-NSU and 64 clinic controls) and between clinic attendees and 417 patients attending GP for the first investigation of possible infertility. Those with symptomatic or asymptomatic NSU gave repeat semen samples on resolution of the NSU.
Results The study included 117 clinic volunteers. They were shown to have statistically significantly worse total sperm counts (p=0.002), volume of semen (p<0.001) and percentage of abnormal forms (p<0.04) compared with 417 GP controls. Compared with the rest of the clinic volunteers, asymptomatic NSU patients had statistically significantly lower total sperm counts (p<0.02). Asymptomatic NSU patients had statistically significantly lower total sperm counts compared with symptomatic NSU patients (p<0.02). Compared with GP controls, clinic controls had statistically significantly inferior total sperm counts (p=0.009) and semen volume (p<0.001).
Conclusions GU clinic attendees are more likely to have abnormalities of semen than patients attending GP for the first check for possible infertility. A high rate of abnormal semen findings are found in patients with and without NSU but the highest rate occurred in those with asymptomatic NSU. Is asymptomatic NSU therefore pathogenic and does it require treatment like symptomatic NSU?
- sexual health
- reproductive health
- primary HIV infection
- antiretroviral therapy
- genitourinary medicine
- clinical trials
- commercial sex
Competing interests None.
Ethics approval Ethics approval was provided by Peterborough and Fenland LREC.
Provenance and peer review Not commissioned; externally peer reviewed.