Question

A 30 y male was delivered to andrology department for medical evaluation due to ineffective sexual competency. His physical examination and interview with the specialized physician revealed some other symptoms that were related to wounds that won’t heal, unexplained weight loss, hair loss, lack of alertness and sometimes diarrhea. These symptoms were seen in the last 6 months only and nothing seen before.

Semen analysis and other tests were prescribed and the results were:

Semen analysis

Days of abstinence: 3 days

Time of collection: 9:30 am

Time of receipt: 9:45 am

Liquifaction time: 30 min

Volume: 4ml

Viscosity: normal

pH: 8.5

Sperm concentration: 12 million/ml

Sperm motility: marked decreased motility

Morphology: more than 50% normal forms

Spermatids and WBCs: less than 1 million/ml

Other tests

Fructose level was in normal range

Viability testing showed that most sperm are viable

Low serum testosterone

Discuss these results, what is the expected case, mention any confirmatory tests if required
Note : My doctor sad that it was related to zinc deficiency , how i can explain that .

Answer 1

Having looked at a part of the result which includes ineffective sexual competency, low level of serum testosterone, decreased sperm motility, one can expect that the person is suffering from the problem of Erectile Disfunction.

Additional physical examination also showed that the male has an unhealed wound, reported unexplained weight loss, hair loss, lack of alertness, and sometimes diarrhea.

Now combining the above two problems (sexual and physical) one can infer that this 30 yo male was suffering from a moderate level (since the symptoms are for the past 6 months only) zinc deficiency.

Zinc is a micronutrient required to be consumed regularly through dietary intake. The deficiency of zinc is a very common occurrence and mainly occurs through improper diets and malnutrition. Although required in trace amounts, zinc controls several bodily functions including growth, development, immunity, and fertility (produces males sex hormone testosterone and the development and functioning of male sex organs).

This explains why the male was experiencing both sexual concerns (loss of sexual competency and low level of testosterone) as well as key immunological issues like an unhealed wound, weight loss, and diarrhea (zinc helps to fight intestinal infection). The problems that he was experiencing are some of the common symptoms (including a low level of energy and thus alertness) of zinc deficiency.

Since zinc is a micronutrient required in trace amounts, it is difficult to be detected by common tests. Usually the physical symptoms most importantly the hair loss and thinning pattern help in diagnosing the deficiency. A confirmatory test, however, would involve estimating the accurate amount of zinc in blood plasma and urine.