Fertility studies in sickle cell disease: semen analysis in adult male patients

Semen analysis was done on 50 subjects (25 patients with sickle cell anemia and 25 control subjects with normal hemoglobin genotype). The ejaculate volume, sperm motility, sperm density, and normal sperm morphology were significantly reduced in the patients when compared with the control subjects. A significant increase was also observed in the percentage of spermatids and in abnormal spermatozoa with amorphous and tapered heads in the patients' semen. These findings clearly show that there are definite abnormalities associated with semen in sickle cell anemia. Furthermore, they suggest that in addition to testicular dysfunction, there may be abnormalities in the accessory sex organs, such as the seminal vesicles and the prostate gland, particularly in view of the marked decrease in ejaculate volume of the patients.