Does folate deficiency alter sperm parameters in infertile males?

Introduction: There is not enough evidence regarding the influence of folate deficiency in the etiology of idiopathic male infertility. Objectives: The objective of the current study was to examine whether there is an association between serum levels of folate and sperm parameters among infertile males. Patients and Methods: This cross-sectional study was undertaken on a sample of infertile males referring to an infertility treatment clinic in Isfahan province, Iran. Semen parameters, comprising sperm concentration, progressive/total motility, morphology, semen leukocyte, agglutination, and vitality were assessed based on standard protocols. The sperm DNA fragmentation assay (SDFA) and sperm chromatin maturity assay (SCMA) were also assessed by the sperm chromatin dispersion and aniline-blue tests respectively. Results: In general, 70 infertile males including 46 with sufficient serum folate level and 24 with insufficient serum folate level were examined. Subjects with sufficient serum folate level had a significantly higher mean of sperm concentration, vitality, progressive motility, total motility, SDFA, and SCMA (P<0.05). Higher serum folate level was also associated with lower risk of abnormal sperm agglutination (OR: 0.09, 95% CI: 0.01-0.65), and morphology (OR: 0.12, 95% CI: (0.02-0.60) after adjustment for potential confounders. Conclusion: The present study found a significant association between serum folate level and infertility among Iranian infertile males. However, prospective large-scale population-based research is required to confirm the finding.