Infertility in Men
When it comes to optimising fertility, too often than not, the focus is largely on the female’s health and it is usually the female that undergoes all the tests, internal examinations and other invasive investigations before anyone even starts to consider sperm count. However, when it comes to conception, it obviously takes two to tango – it takes one lucky and one healthy sperm. It is now known that for couples struggling to conceive, the cause is 50% male and 50% female (1). The infertility in men is the most overlooked cause of infertility. So let’s take a look at the main causes of male infertility.
Main causes of male infertility:
Sperm & semen abnormalities e.g. sperm count, abnormal sperm and sperm motility
Lifestyle factors e.g. alcohol, smoking, obesity
Iatrogenic causes e.g. radiotherapy or chemotherapy
Ejaculation problems e.g. premature, delayed or retrograde ejaculation
Damage to the testicles – such as infection, heat exposure or varicocele
Genetic conditions e.g. Y chromosome microdeletions
Unexplained infertility (1 in 4 cases of infertility)
Hypogonadism – caused by recreational drugs or a pituitary tumour for example
Certain medicines and drugs e.g. anabolic steriods, sulfasalazine etc.
Over the years the world has seen a huge decline in overall sperm count. A study of 185 countries conducted between 1973-2011, revealed sperm concentrations fell roughly by 50-60% (2). It is still unclear which specific factors are causing this decline in sperm quality and testosterone levels, however, there seem to be two areas which offer potential explanations: environmental and behavioural. Environmental factors include possible effects of water/air pollution and exposure to endocrine-disrupting chemicals. Behavioural factors include nutrition, exercise, smoking and alcohol consumption (3).
When we know the sperm’s life cycle is 3 months, this can be a great opportunity to focus on lifestyle and diet to increase sperm quality.
In my next blog I will discuss some top tips to help maximise male fertility.
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References
(1) Fainberg, J. and Kashanian. 2019. ‘Recent advances in understanding and managing male infertility’. Faculty Reviews, Available at: https://pubmed.ncbi.nlm.nih.gov/31143441/
(2) H Levine, N Jorgensen, A Martino-Andrade, et al. 2017. ‘Temporal trends in sperm count: a systematic review and meta-regression analysis’. Human Reproduction Update, 23(6), pp.646-659.
