Investigation of factors affecting fertility in couples applying to Andrology Outpatient Clinic

INTRODUCTION AND AIM: Infertility is the absence of pregnancy despite regular and unprotected sexual intercourse for at least 12 months. When evaluating male infertility, physical, social, and psychological aspects should be considered. It is aimed to shed light on the factors affecting male infertility from a broad perspective, to investigate the effect of general health status on male fertility, and to reveal the effects of the psychosocial burden of infertility on semen quality. MATERIALS AND METHODS: The files of patients admitted to our andrology outpatient clinic for infertility between 31/05/2021-18/05/2023 were retrospectively reviewed. The data of 1039 patients with complete anamnesis and physical examination records and patients who completed The International Index of Erectile Function-15, The Fertility Quality of Life Scale, the Marital Adjustment Scale, and the Patient Health Questionnaire forms were included in the study. Patients were divided into two groups as normospermic and those with at least one anomaly in semen analysis. Logistic regression analysis was performed to determine the risk of semen anomaly. P values <0.05 at a 95% confidence interval were considered significant. RESULTS: There were 534 patients in the normospermic group and 431 patients in the group with semen abnormalities. Increased testicular size was positively associated with semen quality (OR: 0.925 [CI: 0.862-0.993], p:0.031). History of varicocelectomy (OR: 2.106 [CI: 1.286-3.451], p: 0.003), detection of varicocele on examination (OR: 1.433 [CI: 1.046-1.964], p: 0.025), smoking (OR: 2.210 [CI: 1.084-4.503], p: 0.029) and low income (OR: 1.314 [CI: 0.897-1.925], p: 0.003) were found to be independent risk factors for abnormal semen. There was a statistically significant difference between the groups in all scales applied. CONCLUSION: This study has demonstrated that there is a close relationship between men's health status and reproductive ability and that medical evaluation of men seeking treatment for infertility includes medical history, physical examination, and laboratory examination. In addition, the relationship between semen quality and sexual function, depression, quality of life, and marital harmony in infertile men was also shown. Supporting patients psychosocially during the treatment process can also make significant contributions to the success of infertility treatment. Keywords: Depression, Quality of life, Infertility, Semen analysis