30 April 2020

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Fibs & facts – Male infertility today

frank quinn

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Dr Frank Quinn

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Infertility is almost always thought of as a woman’s issue. What’s the reality?

Conceiving a baby depends on a number of factors for both men and women, but what many don’t know is that male infertility is the second biggest issue after a woman’s age – accounting for almost 40% of all cases of infertility.

One study in the Human Reproductive Update suggested sperm count has declined more than 50% in less than 40 years. Why might that be?

The study itself does not analyse factors that contributed to the decline, but in my experience, the evidence suggests causes in sperm quality decline point to lifestyle namely:

  • A combination of medical causes (range from structural issues to production of sperm)
  • Environmental influences i.e. chemical and heavy metal exposure to overheating saunas, bike shorts, laptops 
  • Smoking, alcohol and the use of illicit drugs

Why don’t men talk about it? Is there a secret shame about infertility in males?

There shouldn’t be, it’s incredibly common. However in my 20 plus years’ experience caring for patients with infertility, there does seem to be a link in Australia around virility and infertility.

Male infertility is a medical condition that shouldn’t have the stigma. It is something that needs to be investigated and treated – but it’s important for all men to know that male infertility is incredibly common. The good news is that it’s easily diagnosed and most conditions can be treated.

What are some of the common reasons for male infertility?

The good news for men is we continue to reproduce sperm every 72 days, so in many cases with lifestyle improvements we can positively affect the quality of sperm.

The most damaging factor that affects sperm health is undoubtedly smoking - it worsens sperm production, motility (movement) and morphology (shape). Other factors include being overweight, alcohol intake, recreational drug use and steroids.

Women are often told to have babies early. Is there a biological clock ticking for men too?

Ageing sperm unfortunately does have an effect on the health of the offspring and we see an increase in autism, schizophrenia and other genetic diseases with risks having increased 10 fold over a 40 year period.

When men reach the age of 45, they tend to have higher rates of fertility complications as their sperm volume, motility and morphology declines. There is also the increased likelihood of damage or breaks to the sperm DNA that may result in a negative effect on fertility. 

It’s often said that heat such as resting a laptop in your lap, or visiting a sauna can affect the testicles, is this true?

The testicles produce the best quality sperm when they are a few degrees below normal body temperature. Working in hot temperatures, or simply relaxing, such as in a sauna frequently, can increase testicular temperature which can result in abnormal sperm count and quality. It’s best to avoid taking long hot baths on a regular basis.

Tight bike shorts are often raised as a risk – but I would suggest the potential benefits form an active lifestyle offset the risk of obesity.

Lots of guys use steroids to beef up. Does this harm fertility?

Steroids are proven to affect sperm production and function, and in some cases, men become azoospermic (no sperm) which would require fertility treatment. That’s not even taking into account the other risks associated with these drugs.

If you’re a user, you need to stop! The biggest issue is, even if you stop using - not all men’s sperm quality returns and they may be rendered sterile.

What’s your advice for healthy sperm?

Try and be as healthy as you can. Absolutely stop smoking, look at how you can improve your diet and maintain a healthy weight, keep alcohol intake moderate; don’t use any recreational drugs or steroids.

If anyone is concerned or would like to understand their fertility better, chat with your GP, there is a simple semen analysis that can give you answers.

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