ETUDE DES MARQUEURS BIOCHIMIQUES DU LIQUIDE SEMINAL DANS LE DIAGNOSTIC DIFFERENTIEL DE LAZOOSPERMIE SECRETOIRE ET EXCRETOIRE A LINSP DE BAMAKO (MALI)

Infertility remains a major public health problem in Africa, particularly in Mali, as the main purpose of marriage is procreation. The birth of a child in the home is a source of joy and contributes to the maintenance of the household. The woman is almost always to blame for the couples infertility, as men confuse infertility with virility. The male cause is often discovered during an infertility work-up.The aim of the present study was to measure some biochemical markers of seminal fluid (alphaglucosidase and fructose) in the differential diagnosis of secretory and excretory azoospermia.This was a cross-sectional study, which ran from January 2020 to December 2023. It was carried out in the cytogenetics and reproductive biology department of the INSP, Bamako (Mali). It involved 49 patients selected from 125 confirmed azoospermic patients. Seminal fluid fructose and alphaglucosidase assays were performed on an ELx808, version 2021.Data analysis found that the mean age of patients was 37.5 ± 7.2 years, with a median of 37 years and 75% percentiles (Q3 quartiles) less than or equal to 42 years. Primary infertility was observed in 67.3%, compared with 32.7% for secondary infertility. Monogamy was the most common with 75.5%. The most common lifestyle habits were smoking (28.6%) and exposure of the genitals to heat (12.2%). There was no statistically significant difference (p>0.05) between medical history of varicocele, epididymitis, bilharziosis, mumps, orchitis and cryptorchidism and fructose. For the same medical history, only orchitis is associated with a pathological alphaglucosidase value, with a statistically significant difference (p=0.001). This result remains significant with the Bonferroni correction (0.004).The results of seminal fluid biochemical marker assays (alphaglucosidase and fructose) in our 49 patients showed secretory azoospermia in 32 patients (65.3%) and excretory azoospermia in 17 patients (34.7%). Fructose and hypospermia were not associated with the type of azoospermia (p>0.05). The significance of the association with abnormal alphaglucosidase defined the type of excretory azoospermia (P=0.000000001).Indeed, seminal fluid biochemical marker assays should be requested in all cases of male infertility. These results could provide vital information on all the organs of the male genital tract, enabling practitioners to better manage male infertility.