Effect of Hormonal Imbalances on Semen Quality in Male Infertility: A Cross-Sectional Study in Puntland, Somalia

Introduction: This cross-sectional study investigated the relationship between hormonal imbalances and semen quality parameters in 52 male patients seeking fertility treatment in Puntland, Somalia. Semen analysis and hormonal assays were conducted to examine correlations between reproductive hormones (FSH, LH, Prolactin, and Testosterone) and a composite Semen Quality Index (SQi). Results: Statistical analysis revealed a significant positive correlation between testosterone and SQi (r = 0.28, p = 0.042) and a negative correlation between FSH and SQi (r = -0.31, p = 0.024). Multiple regression analysis demonstrated that hormonal factors accounted for 32.4% of the variance in semen quality (R² = 0.324, p < 0.001). FSH showed a significant negative association (β = -0.286, p = 0.003) while testosterone demonstrated a significant positive relationship (β = 0.245, p = 0.012) with semen quality. Conclusion: These findings suggest that hormonal imbalances, particularly in FSH and testosterone levels, significantly influence male fertility parameters. The study provides valuable insights for understanding male infertility in the Somali context, though larger longitudinal studies are needed to establish causality and explore additional contributing factors.