Lhakpa Quendren


A recent study on seminal parameters among patients visiting an infertility clinic revealed that a significant portion of these patients come from the private business sector.

Out of 304 patients who underwent semen analysis at the National Referral Hospital (JDWNRH) in 2022, 129 (42.4 percent) were from private businesses, followed by 88 (28.9 percent) from the civil service, and less than nine percent from other occupations.

Conducted by Gyem Dorji from the Khesar Gyalpo University of Medical Sciences of Bhutan and six others, this first-of-its-kind retrospective descriptive study was published in the Bhutan Health Journal.

While the study did not explore the specific reasons behind this trend, potential factors cited include work-related stress, reduced leisure time, unfavourable working conditions, and exposure to hazardous agents at work.

International research also indicates that work-related stress, long hours, and demanding deadlines can negatively impact reproductive health. Modern work culture often leaves little time for personal well-being, prompting couples to seek medical assistance.

Additionally, exposure to hazardous agents in certain industries may contribute to fertility issues among workers.



The study uncovered that the majority of patients, comprising 214 individuals (70.4 percent), fell within the age range of 30 to 39 years. This was followed by 57 patients (18.8 percent) aged between 20 to 29 years, with only two patients above the age of 60 years included in the analysis.

Among the 304 patients examined, 72 individuals (23.7 percent) exhibited normal semen parameters, while abnormalities were observed in 232 patients (76.3 percent).

Regarding sexual abstinence duration, it was found that 203 patients (66.8 percent) adhered to the recommended three to five days. However, 63 patients (20.7 percent) abstained for less than two days, and 38 patients (12.5 percent) abstained for over six days, raising concerns about fertility.

The authors emphasised the importance of considering sexual abstinence duration in standardised semen reports globally, attributing patient inconvenience and irresponsibility as potential factors.

In terms of semen profiles, 241 patients (79 percent) exhibited normal volume, while 63 patients (21 percent) had low volume. The majority of patients (86.8 percent) had a grey opalescent appearance, while 24 patients (7.9 percent) exhibited a brown appearance.

The authors highlighted the significance of total sperm count in determining male fertility, noting that a higher count correlates with a greater likelihood of achieving pregnancy.

All samples analyzed showed normal pH levels, indicating a balanced acidity level. Additionally, the consistency of semen was normal in 243 patients, accounting for about 91.1 percent of the total.

The majority of patients (91.1 percent) experienced a normal liquefaction time of 60 minutes or less, with only 27 patients (8.9 percent) requiring longer than 60 minutes for their semen to liquefy.

In sperm analysis, 197 patients (64.8 percent) exhibited a low sperm count—less than 35 million per millilitre, while 93 patients (30.6 percent) had a normal sperm count—more than 35 million per millilitre. Fourteen patients (4.6 percent) showed no sperm in their semen.

Furthermore, the study revealed that 183 patients (60.2 percent) had normal sperm movement, while 107 patients (35.2 percent) exhibited reduced sperm movement.


The study

This study provides essential evidence-based insights for the global scientific community, encouraging ongoing research in reproductive medicine. The data presented is expected to become a reliable reference and valuable evidence repository for clinicians and future researchers alike.

Seminal fluid examination, commonly referred to as semen analysis, holds significant importance in reproductive medicine. It serves as a fundamental diagnostic tool, evaluating a man’s semen composition, including spermatozoa and other components, to assess fertility potential and overall reproductive health.

In recognition of the growing demand for infertility services, despite lack of treatment options available in the country, the health ministry established an infertility clinic at the National Referral Hospital in 2016.

This initiative aimed to address the needs of individuals seeking services with fertility-related concerns in the country.