BackgroundMale infertility is a growing reproductive health concern in Ghana, contributing significantly to the burden of infertility among couples. Bacteriospermia, the presence of bacteria in semen, has been implicated in male infertility through its potential adverse effects on sperm quality; however, its association with semen parameters remains inconsistent across studies. This study aimed to determine the prevalence of bacteriospermia and examine its association with semen parameters among males attending a fertility clinic in Kumasi, Ghana.Materials and methodsSemen samples from 226 males attending a fertility hospital in Kumasi were collected and evaluated according to WHO guidelines. Additionally, samples were cultured for bacteria using standard bacterial culture techniques.ResultsThe prevalence of bacteriospermia was 46.5%, with Escherichia coli (41.9%), Klebsiella spp. (25.7%), Staphylococcusspp. (24.8%), Streptococcus spp. (2.9%), and Bacillus spp. (1.9%) identified. Abnormal semen parameters were observed in 47.6% of participants, predominantly teratozoospermia. No significant association was found between bacteriospermia and semen parameters (p > 0.05), though semen volume approached significance as a predictor of bacteriospermia (p = 0.057), with hypospermia associated with significantly lower odds of bacteriospermia (aOR = 0.558; p = 0.047) and hyperspermia showing no significant association (aOR = 0.961; p = 0.160).ConclusionsA high prevalence of bacteriospermia (46.5%) and abnormal semen parameters (47.6%, predominantly teratozoospermia) were observed among men seeking fertility evaluation, with E. coli as the most frequently isolated organism. No significant association was found between bacteriospermia and semen parameters, though hypospermia was associated with significantly lower odds of bacteriospermia. Routine screening and further research incorporating molecular techniques and larger cohorts are recommended.