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Abstract
Oligo/azoospermia contributes significantly to infertility in male Nigerians, being responsible for most of the problem. By definition, it would appear that the criteria for the diagnosis of this problem in Nigerians should be sperm density below 10 million/ml, total sperm ejaculate below 25 million, motil-ity below 40%, and normal forms below 40% in agreement with more recent findings in other parts of the world. This reinforces the already generally accepted concept that the WHO may need to review its criteria for diagnosing oligo/azoospermia. Preventable causes of oligo/azoospermia in Nigeria include poorly treated infections such as venereal diseases, delayed treatment of torsion of the testis and of undescended testis, and repair of inguinal hernia by inexperienced native doctors [3, 4]. In addition, better approaches to the diagnosis of causes of infertility, such as a careful search for and rational treatment of varicocele, may improve the chances of infertile couples. Hormonal disorders are important factors to consider in oligo/azoospermic Nigerians, as with their counterparts elsewhere. Widespread availability of hormonal assays will therefore be a great help in separating the untreatable (primary testicular disease) from the treatable (hypothalamic/pituitary) diseases and planning rational treatment. With improvement of clinical care, many more patients with sickle-cell disease are reaching reproductive age. Oligo/azoospermia is quite common in patients with sickle-cell disease, and sickle-cell disease will eventually contribute more proportionately to the etiology of oligo/azoospermia in Nigerians.
Extensive investigations have been conducted on the nature, etiology, and diagnosis of oligo/ azoospermia [2–11, 25, 30–56]. A sperm density of 10 rnillion/ml and above, total sperm ejaculate of 25 million and above, motility of 40% and above, and normal forms above 40% would be reasonable criteria for separating fertile from infertile Nigerian males.