Hormonal profiles and semen parameters in men with primary infertility: Evidence from eastern Libya

Male infertility remains a significant global health concern, with hormonal evaluation playing a critical role in understanding spermatogenic dysfunction. While follicle-stimulating hormone (FSH) is widely recognized as a marker of testicular function, the diagnostic value of other hormones such as luteinizing hormone (LH), testosterone, and prolactin remains debated, particularly in context that are specific to a given region.

To assess the relationship between serum gonadotropins (FSH, LH), total testosterone, and prolactin and semen quality parameters in Libyan males presenting with primary infertility.

This cross-sectional study included 138 males attending a fertility center in East Libya. Semen analysis was performed according to WHO 2010 guidelines. Morning fasting serum levels of FSH, LH, testosterone, and prolactin were measured using standardized immunoassays. Spearman's correlation and multivariate linear regression were used to evaluate associations between hormonal profiles and semen parameters.

FSH was significantly associated with sperm concentration (ρ = -0.324, p < .05; β = -1.107, p = .010). LH showed a weak inverse correlation(ρ = -0.175) but lacked predictive value. Testosterone and prolactin were not significantly associated with semen volume, motility, or morphology. Strong internal correlations were observed between progressive motility and morphology (ρ = .569).

Elevated FSH levels are a reliable indicator of impaired spermatogenesis in Libyan males with primary infertility. The limited associations of LH, testosterone, and prolactin with semen parameters suggest that FSH should be prioritized in hormonal evaluation. These findings support targeted endocrine testing and underscore the need for region-specific reference ranges and expanded hormonal profiling in future research.