TAILORING MALE INFERTILITY IN NORTH MACEDONIA, WHERE ARE WE NOW? A RETROSPECTIVE AND PREDICTIVE EPIDEMIOLOGICAL
Rrezelinda DAUTI, Fatjona JASHARI, Vegim ZHAKU
Abstract
This retrospective study investigates the incidence and prevalence of male infertility in North Macedonia by analyzing data from two regionally focused cohorts encompassing 1,857 men aged 19–50 years. The overall infertility prevalence was 14.7%, with regional differences—urban centers like Ohrid (18.2%) and Centar Župa (17.5%) had higher rates than rural areas such as Vevčani (9.1%) and Debar (10.4%). Infertile men were significantly older (mean age 29.8 ± 4.8 years) than fertile counterparts (26.4 ± 4.9 years; p < 0.005). Rates of infertility increased notably after age 35.
Semen abnormalities—particularly asthenozoospermia, oligozoospermia, teratozoospermia, and azoospermia—were frequently observed. Normozoospermia was present in just over half of participants. Infections, notably with Escherichia coli and Staphylococcus aureus, were significantly associated with abnormal sperm parameters, suggesting a strong infectious etiology. Other contributing factors included oxidative stress, smoking, alcohol use, and environmental exposures.
The findings underscore the complexity of male infertility and the need for standardized diagnostic protocols, public health interventions, early screening, and enhanced reproductive health services. Addressing these issues is vital to reduce the growing burden of male infertility in North Macedonia.
Pages: 257 - 267