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It's a Guy Thing. What's Causing the Rise in Male Infertility?

by Cody MacInnis - July 23, 2018


Photo Credit: by CanadaPharmacyOnline.com
Photo Credit: by CanadaPharmacyOnline.com

Throughout history women have shouldered most of the blame for the failure to conceive a child, with nearly all ancient cultures having practiced female centered fertility rituals. Today’s $21 billion dollar fertility industry aimed entirely at women shows us that things have yet to change. Recently a dramatic rise in the prevalence of male infertility is emphasizing what we all intuitively know - men play an equal role in the conception of a child.

Over the last 40 years male sperm counts have fallen by a staggering 59.3%. A low sperm count is responsible for 50% of all male infertility cases. This has contributed to the rise of male infertility affecting 7% of all males today. Infertile males are responsible for 40 – 50% of all total cases of infertility amongst couples worldwide. As average sperm counts amongst men all across the globe continue to fall each year, and while male infertility rates steadily increase, the issue of male infertility is receiving more attention. So, why are more men infertile than ever before? And what can these men do to overcome this emotionally, and physically difficult hurdle along the path to create a family?

What Are the Causes of Male Infertility

The World Health Organization defines infertility as the inability of a couple to conceive a child after one year of regular, unprotected intercourse. This is surprisingly more common than one may suspect, affecting roughly 15% of all couples worldwide with men contributing to roughly half of the cases. Although societal stigma suggests that impotence, otherwise known as erectile dysfunction, is to blame for male infertility, more often it is in fact sperm defects or lack of sperm that are the main factors. The majority of cases have been diagnosed as idiopathic - attributable to more than one cause. As a result, narrowing down the main causes of this epidemic has been challenging for the scientific community. Several known factors form the basis of the current male infertility crisis, these include: genes, lifestyle, pollution, varicoceles and infections. One or a combination can interplay in any particular case.

A large amount of research on the cause of male infertility has been directed at determining the genetic basis of sperm defects. In the middle east there has been a disproportionately high rate of male infertility, and as a result many groups of researchers have used this population to determine the importance of genetics in fertility. A recent study using an advanced genetic sequencing technique, studied several different brothers from consanguineous (related to a distant ancestor) families that each had issues with infertility. They discovered that they all shared specific recessive genes that contributed to the sperm defects of: oligospermia (low sperm count), and azoospermia (no sperm mobility). This provides some strong evidence for the genetic piece to the puzzle, however only one out of ten cases have been determined to have a genetic basis. That being said, many of the infertility cases with an unknown basis are believed to have a genetic basis. Future advances in genetic sequencing technology could reveal the genetic basis of these cases.

Cigarette smoking, excess consumption of processed food, lack of exercise, psychological stress, and the increasing age of fathers have all become characteristic of modern society. All of these lifestyle factors can contribute to male infertility. A study published in the World Journal of Men’s Health examined the role of smoking, and found that the oxidative stress caused by smoking, overpowered the ability of specific enzymes in the body that are designed to protect cell membranes. This resulted in negatively altered sperm. The same study also found that the increased levels of lead and cadmium in the body - metals present in cigarettes- were linked to low sperm count, poor sperm shape, and sperm that were immobile. Cigarette smoking can directly impact male fertility in a negative way. Not only could a quit smoking aid improve your health but it could bolster your chances at fathering a child.

As well, over the last 30 years the rise in male infertility has been accompanied by the rise of an obesity epidemic throughout most of the developed world. Obesity plays a large role in the prevalence of male infertility as it can cause hormonal changes within males, where testosterone - the male sex hormone - is chemically changed into estrogen. This has been shown to be directly linked to poor sperm development and low-quality sperm. So, the increase in prevalence of obesity would most likely play a role in the increase of male infertility.

Another recent lifestyle change that could contribute would be the increasing age of which men decide to become fathers. In recent decades society has emphasized the need to first have a good career, and a home before having children. This has influenced many couples to wait until their 30’s or 40’s before having children. Naturally as men age their bodies reduce the production of reproductive hormones. The subsequent decrease in testosterone has a negative effect not only on libido, or the amount of sperm created, but also has been shown to increase dna defects in sperm.

Considering the subjective nature of stress it hard to argue that the current era is psychologically more stressful than the pre-internet, pre-email, era 40 or even 50 years ago. However, stress is linked to infertility whether it be now or in the past. Studies have shown that high levels of anxiety and depression can cause lowered testosterone levels. A healthy level of testosterone is necessary in the development of a healthy sperm count. As well recent research has discovered that prolonged usage of Ibuprofen is linked with male infertility. This again operates under the same principle as one common side effect of the drug was shown lowered testosterone levels.

Over 200 years of industrialisation have saturated the earth with pollution, toxic fumes hang in the air, and heavy metals are even found in drinking water. Environmental pollution eventually becomes a health concern for humans, and in this case it is robbing some men of the ability to become fathers. A study on Chongqing, a city in southwestern China with a very high level of polycyclic aromatic hydrocarbons - a harmful pollutant resulting from industrial exhaust - in, determined that these same pollutants were showing up in the urinary tracts of males. Furthermore the study showed that these pollutants were significantly responsible for damage to sperm DNA. This provides a strong link between air pollution and male infertility. A Spanish group of researchers suggested that the increased use and exposure to toxic heavy metals by men in the workplace or through drinking water could affect sperm quality. Their findings showed that the high levels of cadmium, mercury, and lead that were in their male participant’s bloodstreams as a result of exposure to pollutants lead to defects in sperm morphology. If environmental pollution continues to increase it could mean fewer fertile men.

Sex is being used nearly everywhere you look in modern culture to promote or sell merchandise. It’s believable that the sexualisation of modern society could be to blame for influencing the behaviours that contributed to an all time high of 2 million cases of gonorrhea,syphilis, and chlamydia in the United States in 2016. Sexually transmitted bacterial infections such as Chlamydia can promote disturbances within the reproductive tracts of men, creating DNA defects in sperm. Also, the bacteria responsible for gonorrhea was shown to significantly impair the ability of testicles for two years following the initial infection. Sexually transmitted infections are on the rise and can directly impact male fertility.

A final, albeit important piece to the infertility puzzle remains - the influence of varicoceles. Varicoceles are a clump of varicose veins that inhibit testicular production of healthy sperm. No clear understanding as to why they occur exist, with several theories suggesting physiological defects. It is difficult for scientists to say whether there has been an increase is varicocele clumps in men corresponding to the rise in male infertility over the last 40 years, however it has been shown that varicoceles are the most significant cause of male infertility accounting for 40% of all cases.

What Can A Guy Do to Increase Fertility

When many men first hear that they are the reason for their partnerships failure to conceive, the news can be tragically disheartening. That being said, there is no reason to give up hope. Some basic measures that a man can take to promote his fertility would be staying physically active,a healthy diet including eating nuts, and minimizing substance use. Good physical health promotes a normal balance of sex hormones in the body, thereby increasing chances of healthy sperm production. For some men solving their fertility issue can require some added steps.

1. Counselling - Seeking out a fertility counsellor is a good place to start, not only to develop a course of action to overcome the physical challenges but also to deal with the mental and emotional difficulties that many men face.

2. Medical examination - Varicoceles are the most common cause of infertility and can be detected through medical examination. Varicoceles can be easily fixed through a minor surgical procedure. This proactive approach could eliminate unnecessary stress and suffering providing many individuals with the solution for their infertility.

3. Assisted reproductive technologies - Several modern assisted reproductive technologies (ART)’s have been developed to provide solutions when all else fails. In vitro fertilization (IVF) for example, although expensive - $7000 CAD per treatment, has been shown to be effective 33% of the time. This means that if you can afford multiple in vitro attempts it could increase - but do not guarantee - the chances for fertility.

Another modern advancement in fertility treatment is known as intracytoplasmic sperm injection (ICSI). Although up to twice as expensive as IVF it is far more effective with 4 out of 5 couples successfully conceive through ICSI. Also, a recently developed surgical procedure known as Micro-TESE can help men who are afflicted with azoospermia – the complete inability to produce sperm.

Aside from the rise of chronic obesity, sexually transmitted infections and environmental pollution, it’s hard to really say why more men are becoming infertile in each passing year. If you dream of fathering a child, taking care of your mental and physical wellbeing is a good place to start in order to ensure optimal reproductive health. For some men the problem runs much deeper. But remember guys - you’re not in this alone, and if you’ve tried all the latest health trends but are still struggling with this difficult challenge, don’t give up there’s a high chance that there’s a modern fertility treatment waiting to make your dream of having a family come true.

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Cody MacInnis is a writer currently studying the connections between biological and mental processes in Victoria B.C. His free time is spent outside enjoying the fresh Vancouver Island air.

References:

Avi Harlev, Ashok Agarwal, Sezgin Ozgur Gunes, Amit Shetty, Stefan Simon du Plessis. (2015). Smoking and Male Infertility: An Evidence-Based Review. World Journal of Men’s Health, 33(3). https://doi.org/10.5534/wjmh.2015.33.3.143

Ayhan,Ö, Balkan M, Guven A, Hazan R, Atar M, Tok A, Tolun A. (2014). Truncating mutations in TAF4B and ZMYND15 causing recessive azoospermia. Journal of Medical Genetics, 51(4). doi: 10.1136/jmedgenet-2013-102102

El Salam. (2018). Obesity, An Enemy of Male Fertility: A Mini Review. Oman Medical Journal, 33(1). doi: 10.5001/omj.2018.02.

Nicolas Olea, Mariana F Fernandez. (2007). Chemicals in the environment and human male fertility. Occupational and Environmental Medecine, 64(7). doi: 10.1136/oem.2007.033621

Niya Zhou, Zhihing Hui. (2014). Air pollution and decreased semen quality: A comparative study of Chongqing urban and rural areas. Environmental Pollution. DOI: 10.1016/j.envpol.2013.12.030


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