Women are so often the focus in conversations about infertility, but a third of fertility issues lie with men. Photo / 123RF
Women are so often the focus in conversations about infertility, but a third of fertility issues lie with men. Photo / 123RF
With male infertility increasing at an alarming rate, we look at why the issue is now so prevalent and the interventions that could help.
Women are so often the focus in conversations about infertility – which is defined as “a failure to establish a pregnancy after 12 months of regular, unprotected sexual intercourse”.
In reality, when you look at the causes of infertility, a third of the issues are with the woman, a third are due to the man and a third are caused by either a combination of both or are unexplained.
One in seven couples in the United Kingdom has difficulty conceiving. Over the past 40 years, sperm counts worldwide have halved and sperm quality has reduced.
As we’re seeing male infertility increase, it’s more important than ever to bring men into the joint focus. Fertility clinics need to be more inclusive, men need to be better educated about what lowers their sperm count and there needs to be more emotional support in place for them.
Over the past 40 years, sperm counts worldwide have halved. Photo / 123RF
What is good sperm health?
When we talk about sperm health, we’re talking about sperm quantity as well as quality. The structure of the sperm is important. It needs to be able to swim and survive in the female reproductive tract. A successful conception is most likely if the ejaculate contains at least 15 million sperm per millilitre. Too few sperm cells makes it more difficult as there are fewer candidates to successfully fertilise the egg.
What lowers sperm count?
Several factors contribute to lower sperm count, although the cause of the problem on a global scale is yet to be determined. When addressing these issues on an individual level, some can’t be avoided. If you’re trying to improve the chances of conception, focus on reducing the ones you can prevent.
Keeping your phone in your pocket and other habits
Environmental toxins are potentially the biggest suspect. Pollutants including tobacco smoke, plastics and traffic emissions have been shown in laboratory studies to reduce both sperm count and quality.
These chemicals are thought to cause problems with sperm cells’ DNA, causing them to reduce in number or change in structure and ability to swim. Some chemicals, known as endocrine-disrupting chemicals (EDCs), can also impact your endocrine system and affect the levels of hormones, such as testosterone, which affect sperm production. Examples of EDCs include plastics, pesticides and other chemicals used in manufacturing.
Keeping your mobile phone in your pocket can reduce sperm count due to heat and electromagnetic activity. Photo / 123RF
Rising temperatures and global warming also have potentially detrimental effects. Sperm cells need to be kept cool, which is why the testicles are outside the body. For the same reason, keeping your phone in your pocket can reduce sperm count due to the heat and electromagnetic activity it releases.
Diet, exercise and sleep
Poor diet, a sedentary lifestyle, stress, alcohol, smoking (including vaping) and drug use can all harm sperm health. So does lack of sleep. A study in the Fertility and Sterility journal reported that men who consistently slept for fewer than six hours a night were 31 per cent less likely to conceive with their partners compared with those who slept the recommended seven to nine hours.
Age
Men have a biological body clock too. While the rate of fertility decline is more pronounced in women as they age, and tends to happen earlier (fertility peaks at 20, with the most rapid decline from about 35), men also see a reduction in fertility with increasing age. Statistics show men over 45 are about half as fertile as those under 25.
Sexually transmitted infections
If left untreated, common sexually transmitted infections (STIs) such as chlamydia and gonorrhoea can cause epididymitis, in which the tube at the back of the testicles that stores and transports sperm becomes inflamed. The good news is that, unlike women, who are born with all the eggs they will ever have, males constantly produce new sperm. If the STI is treated with antibiotics, sperm count should return to normal.
Excess fat tissue can negatively impact male fertility. Photo / 123RF
Being overweight or obese
Excess fat tissue can harm male fertility directly through damage to sperm cells, or indirectly through changes to hormone levels. Excess fat can disrupt normal endocrine processes and hormone production as it releases oestrogen and can cause testosterone to convert to oestrogen. Lower levels of testosterone and higher levels of oestrogen can affect how the testicles produce sperm, resulting in lowering splowerts.
What should you do if you think you may have a low sperm count?
See your GP if you and your partner have been having regular sex without using contraception for over a year (or six months if your partner is 36 or over) and have not been able to get pregnant. The main check for low sperm count is a semen analysis test, which can also look at the sperm quality, such as how effectively it can swim.
Improve your lifestyle whether you’re looking to conceive, or have been diagnosed with low sperm count. Reducing alcohol consumption, stopping smoking, including vaping, and losing weight (if you’re overweight) can all help.
Exercise regularly as studies have shown that men who exercise three to five times a week have higher sperm counts and improved sperm quality compared with those who are more sedentary.
Eat a balanced diet rich in nutrients and plenty of plants. Sperm is constantly being produced by the testicles, so a continuous supply of nutrients is important to support sperm production. Irrespective of weight loss, diet changes can be helpful. For example, tomatoes containing a chemical called lycopene may boost sperm quality, which is just one example of the benefits of eating more fruit and veges.
Have sex every two to three days without using contraception if you want to conceive. While low sperm count can be a cause of infertility, it is still entirely possible to conceive naturally and couples aiming to do so should continue to have regular sex while seeking medical advice.
Dr Francesca Jackson-Spence is a clinical research fellow at Barts Cancer Institute, Queen Mary University of London.
