Sperm Abnormalities and Hormonal Correlates among Infertile Men in Guwahati, Assam, India

Objective: The present study aimed to evaluate the spectrum of sperm abnormalities among infertile men in Guwahati, Assam, and to examine their association with key reproductive hormones. Specifically, it sought to correlate semen parameters with serum levels of follicle-stimulating hormone, luteinizing hormone, testosterone, and prolactin, in order to elucidate hormonal influences on male infertility in this regional population. Methods: This cross-sectional study evaluated semen samples from 178 male between January 2020 and December 2021 aged 21–48 years attending infertility clinics for clinical evaluation of infertility in and around Guwahati, Assam, India. Semen analysis and characterization of infertility, and hormonal profiles (Estrogen, FSH, LH, Prolactin, free testosterone and total Testosterone level) were gathered from the hospital records. Statistical analysis was conducted using Graph Pad Prism software, with P < 0.05 regarded as statistically significant. Results: Increased estrogen level (pg/ml) along with reduced free testosterone levels (ng/dl) were observed in the case of severe OAT (Oligoasthenoteratozoospermia), azoospermia, ED (erectile dysfunction), asthenozospermia, oligo-astheno, oligozoospermia, occasional dead sperm, occasional dead and motile subgroups in comparison to the normozoospermia, clearly indicating an altered testosterone/estrogen ratio. In the same way, the total testosterone level (ng/dl) was abruptly elevated in severe OAT, azoospermia, ED and occasional dead group in comparison to the normozoospermia group, indicating the chances of involvement of Sex Hormone-Binding Globulin (SHBG). Elevated FSH (mIU/l) and reduced LH (IU/l) levels were observed in almost all the groups, indicative of gonadal failure. Both elevated (asthenozospermia, oligo-astheno, oligozoospermia, occasional dead, occasional dead and motile and hypospermia subgroups) and reduced (severe OAT, azoospermia and ED) levels of prolactin were observed in this study, which clearly specified that both altered expressions of prolactin are responsible for infertility. Conclusion: This study highlights significant endocrine disturbances across infertile subgroups, marked by an altered testosterone–estrogen ratio, disrupted gonadotropin secretion, and abnormal prolactin levels. Reduced androgen bioavailability, possible SHBG involvement, and elevated FSH with suppressed LH indicate gonadal dysfunction, underscoring the critical role of comprehensive hormonal profiling in male infertility evaluation.