Introduction

Infertility resulting in men has evoked considerable medical and social interest. According to WHO, the infertility isa disease of the reproductive system, defined as the inability to achieve clinical pregnancy over one year or more of regular unprotected sexual intercourse. Male infertility refers to a males inability to result in pregnancy in a fertile female.Male infertility affects approximately 10% of couples worldwide.¹ Sperm abnormalities have been significantly associated with male infertility. The normal sperm concentration plays a substantial role in fertilisation and pregnancy outcomes.²

The dermatoglyphic study has been proven to be a useful diagnostic tool as a marker for genetic origin diseases. During a few decades, the magnitude of male infertility has increased globally. Early detection of infertility is still a problematic medical task in such cases. The dermatoglyphic study may play an important role to identify suspected infertile males from a vast population.

An objective of the present study was to investigate dermatoglyphic patterns in azoospermia and oligozoospermia male patients and compare the findings of patients with the general population.

Material and Methods

This study was done on seventy-six infertile males (35 individuals having azoospermia and 41 individuals having oligozoospermia) visiting the Indira IVF Centre, Patna, Bihar. The male individuals who have infertility with not less than three years period were included in the infertile group.The average age of included males in the infertile group was 39.84years. The control group included normal healthy individuals representing the general population having the same reproductive age group and socioeconomic status. The infertile and control subjects without any particular genetic disease were taken.The verbal and informed consent from individuals of each group were taken.All of them were explained about the procedure of taking dermatoglyphics before having fingerprints and palmar prints.

Clinical information of subjects were collected including age, the period of the marriage, history of infertility and parity. Semen was collected for estimation of sperm count as per the World Health Organization guidelines.³ The individuals ofthe infertile group were classified based on sperm concentration, as azoospermia (no spermatozoa) and oligozoospermia (<20million sperm/ml). In the fertile control group, the sperm count was ranged from 35-200 million sperm/ml. The ethical clearance was obtained from the Institutional Ethics Committee, AIIMS, Patna (IEC/AIIMS/PAT/158/2017) before doing this study.Confidentiality and anonymity of subjects were ensured.

Necessary equipment required includes good quality printer ink, a flat glass, rubber roller,glazed surface paper (A3), cotton,turpentine oil, spirit,measuring protractor, sharpener, pointed pencil, and a hand lens (Magnavision).

The standard ink method was used to take prints.⁴ The hand was impregnated with a thin layer of ink and gently pressed on the paper from proximal to a distal end. The patterns were classified into loops, whorls, arches and unknown (Galton system).⁵ We considered “unknown” to any prints other than these three main classes and their subgroups. The ridges counting of each fingerprint pattern was analysed using a hand lens. The palmar angles such as ‘atd’, ‘dat’ and ‘adt’ were measured after drawing lines connecting the ‘a’, ‘d’ and ‘t’ triradii. The findings of both hands of cases and controls were compared. All data were collected and statistically analysed using the student’s t-test and chi-square test. After the sampling data was compiled and analysed in the Department of Anatomy, All India Institute of Medical Sciences, Patna.

Results and Discussion

The mean age (in years) of cases and control was 39.84±6.02 and 36.30±5.32,respectively. Most of the infertile males were in the age ranging from 41-50 years, comprising approximately 49% of the total cases. Examination on fingerprint patterns revealed that the loop was the most common type of fingerprint, followed by whorls and arches in men with azoospermia and oligozoospermia (53.14% and 57.32% respectively). Astatistically significant difference (p<.05) was noticed on comparing the fingertip ridge patterns of both hands of azoospermia males and control group. In men with azoospermia demonstrated a higher prevalence of whorl and arch patterns with a low prevalence of loop patterns as compared to the males of the control group(Table1).

Table 1: Comparison of Tip ridge pattern of all fingers (both hands) between men with azoospermia and control men.

*Significant at p<.05

Similarly, on observing the frequencies of different types of fingertip patterns in men with oligozoospermia and control males, we also found the statistically significant differences in these groups (p<.05). The total number of arches was increased in men with oligozoospermia (35; 8.54%) as compared to control males (20; 4.88%) (Table 2).

Table 2: Comparison of frequencies of different types of fingerprint between men with Oligozoospermia and control men.

*Significant at p<.05

The mean of ‘dat’ angle (left hand) of cases (azoospermia and oligozoospermia) was statistically significant on comparing with the control group. In contrast, the other angles, such as ‘atd’ and ‘adt’palmar angles were found insignificant in both hands of infertile and control groups (Table 3).

Table 3: Comparison of palmar triradii angle patterns in the right and left hands of cases and controls.

*S: Significant at p<.05, †NS: Not significant

The observed mean TFRC (Total finger ridge count) seen between azoospermia and oligozoospermia infertile males was 128.45 and 134.10, respectively, whereas mean AFRC in those two groups was 177.77 and 134.10, respectively. There were insignificant differences between both types of infertile males concerning AFRC and TFRC (Table 4).

Table 4: Finger ridge count (TFRC and AFRC) observed in men with azoospermia and oligozoospermia.

In the present study,most of the infertile males were between the age group of 41-50 (37; 48.68%). Some studies suggested that the advanced age may be associated with impaired sexual function, sperm count profile which may be responsible for increased time to conception, and increased miscarriage rates.^6-8 The main concern of this work was to compare the dermatoglyphic patterns in infertile men with azoospermia and oligozoospermia. Based on the result, the most common type of fingerprints in these cases was a loop pattern. Statistically  significant differences were found in fingerprint patterns of cases and controls. A significant decrease in the frequency of loops in men with azoospermia (186, 55.14%) and oligozoospermia (255, 57.32%). Where as in controls the frequency of loops(217, 57.32% and 259, 63.17% respectively). Similar results were also reflected in a dermatoglyphics study conducted on 24 infertile males by Sontakke et al.⁹ While Makol et al. ¹⁰ in New Delhi and Jafari etal.¹¹ in Iran found significantly increased frequencies of loops in infertile males as compared to that of controls.The increased whorl pattern in the infertile men with azoospermia (104, 29.71%) as compared to that of controls (96, 27.43%). A similar finding was reached by Sontakke et al.⁹ and Jafari et al.¹¹,but this outcome is contrary to that of Singh et al. (2017)who found that in infertile males,there was a significant decrease in the frequency of whorls as compared to the general population.¹³

Figure 1: showing the frequency distribution of fingerprint patterns in men with azoospermia and controls. Click here to View figure

We found a significantly increased frequency of arches in men with azoospermia (53, 15.14%) and oligozoospermia (35, 8.54%) as compared to controls (34, 9.71% and 20, 4.88% respectively). The arches increased frequency was consistent with the findings of Sontakke et al.⁹ and Prasad etal.¹²In another study done on infertile males and compared to controls by Singh et al. reported significantly decreased frequencies in the arches.¹³

Figure 2: Frequency distribution of fingerprint patterns in men with oligozoospermia and controls. Click here to View figure

The present study has shown that the significant differences in ‘atd’ angle (left hand)among infertile males and control group, whereas the findings of the right hand were insignificant regarding differences in’atd’ angle among infertile males and control group. Partial similar findings were reported by Sontakke et al.⁹ and Prasad et al.¹²

The finger ridge count determines the size of the pattern. In this study, we found that differences in men with azoospermia and oligozoospermia concerning TFRC and as well as AFRC were insignificant. Similarly,on comparing with the control,non-significant differences in TFRC and AFRC of infertile patients were reported by Sontakke and colleagues as well as also by Jafari et al.Singh et al also reported similar facts in oligozoospermia affected males.^9,11,13

Conclusions

The dermatoglyphic study is easy due to its cost-effectiveness and non-invasive procedure and would serve as a prediction tool, for early screening of infertile male subjects. This study revealed a significant dermatoglyphic difference between controls and men with azoospermia and oligozoospermia. This study showed an increased number of whorl and arch patterns along with decrease number of loop patterns with an increase in the ‘dat’ angle value of the left hand. Thedetection of such patterns by a physician could aid them toanticipate infertility problems in the susceptible patient.It can be used as a ready cost-effective screener to identify infertile subjects from a larger population for further investigations and to confirm or rule out infertility in such patients.So, physicians may advise for necessary preventive and encouraging health measures for individuals at risk.

Acknowledgements

Authors are very thankful to Dr Dayanidhi Kumar, who gave us the chance to get the fingerprints of infertile males in Indira IVF, Patna, Bihar. We are also grateful to the persons who have extended their cooperation in this study.

Conflict of Interest

There are no conflict of interest.

Funding Source

It was a non-funds project-based work. No financial support or any sponsorship was taken by any of the authors for the same.

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