Declining semen quality in North Africa: from 2019 to 2024: retrospective multicentric study of 21,585 patients

Recent evidence suggests a global decline in semen quality, raising significant concerns about male reproductive health. Data from North Africa are limited, and the region faces unique environmental and lifestyle challenges. In addition, the COVID-19 pandemic may have caused transient or lasting effects on male fertility. This retrospective study aimed to evaluate changes in semen quality among North African men between 2019 and 2024, in comparison with data from 2013 to 2018, and to assess the potential impact of the COVID-19 pandemic on sperm parameters. A total of 21,585 semen samples from men aged 19-74 years, originating from three North African countries (Tunisia, Algeria, and Libya), were analyzed. Semen analyses were performed in a Tunisian andrology laboratory in accordance with WHO 5th and 6th edition criteria. The assessed parameters included sperm concentration, motility, morphology, vitality, and DNA integrity. Temporal and regional trends were evaluated and compared to a historical cohort from 2013 to 2018. Sperm concentration and progressive motility showed a marked decline in 2020, coinciding with the first COVID-19 wave (P < 0.001). Although a gradual recovery was noted after 2021, the 2024 values remained lower than those of 2019. Sperm morphology exhibited a continuous decline throughout the study period. Libyan men had the highest median sperm concentration, while Algerians had the lowest. Compared to the 2013-2018 cohort, there was a 27.6% decrease in concentration, a 20.5% reduction in motility, and a drop in normal morphology from 12.1 to 5%. Semen quality among North African men continued to deteriorate between 2019 and 2024, with a temporary accentuation during the COVID-19 pandemic. These findings underscore the multifactorial nature of male fertility decline in the region and highlight the need for preventive public health strategies.

Studies show that men's sperm quality is getting worse around the world, which can affect their ability to have children. There is not much information about this in North Africa, a region with special environmental and lifestyle factors. The COVID-19 pandemic might have also influenced men's fertility. This study looked at sperm samples from men in three North African countries between 2019 and 2024 and compared them to samples from 2013 to 2018. The goal was to see if sperm quality changed and if COVID-19 had any effect. The results showed that in 2020, when COVID-19 first appeared, sperm numbers and how well they moved dropped a lot. After 2021, there was some improvement, but sperm quality was still lower in 2024 than before the pandemic. The shape of sperm got worse steadily over the years. Men from Libya had the best sperm counts, while men from Algeria had the lowest. In short, sperm quality in North African men got worse over the years, especially during COVID-19. This shows that many things may be causing this problem, and it is important to take steps to protect men's reproductive health.