Causes of male infertility

Dubai: Apart from genetic and physiological reasons that cause a low sperm count, environmental and lifestyle factors are increasingly contributing to this problem.

The Bourn Hall study identified five main reasons for male infertility:

1) Stress: Chronic stress or prolonged mental illness adversely affects male fertility. Stress interferes with testosterone produced in the testes, a hormone necessary for sperm production.

2) Obesity: Improper lifestyle, unhealthy eating habits and lack of exercise has resulted in the fact that 36 per cent of men in Abu Dhabi and Dubai alone are overweight. Obese men have worse sperm quality as compared to men of healthy weight. Being overweight or obese can also cause hormonal changes that reduce fertility.

3) Smoking: With each cigarette, over 7,000 chemicals are inhaled into the body, many of which are highly toxic. In men, smoking causes significant damage to sperm and leads to an increase in genetic abnormalities. Sperm takes three months to develop which means that the most important time for men to improve their health and quit smoking is in the three months leading up to conception. 91 per cent of the men interviewed, agreed on the negative effects of passive and active smoking on fertility; opinion split over the impact of increasing age.

4) Low sperm count: More than 90 per cent of male infertility cases result from low sperm count, which can be a direct result of an unhealthy diet, excessive intake of protein shakes, etc.

5) Prolonged sitting: Sitting and watching television for extended hours is negatively linked to sperm count drop and quality of sperm. Prolonged sitting overheats the testicles, which in turn results in lower sperm production.

Other causes

Apart from the environmental and lifestyle factors, male infertility is also caused by diseases such as diabetes, HIV, thyroid problems, Cushing syndrome, heart attack, liver or kidney failure, and chronic anaemia.

Certain types of medications to be taken to treat some of these can impair sperm production, says Dr Dr Styliani Andronikou, chief embryologist, Dubai Health Authority’s Dubai Gyanecology and Fertility Centre (DGFC).

Repeated infections from sexually transmitted diseases (i.e. Chlamydia trachomatis or gonorrhea) can cause scarring and block sperm passage.

Other infections that may affect fertility include prostatitis (inflammation in the prostate gland), orchitis (in the testicle), semino-vesculitis (in the glands that produce semen), or urethritis (in the urethra), perhaps by altering sperm motility.

Even after successful antibiotic treatment, infections in the testes may leave scar tissue that blocks the epididymis.

Treatments for cancer such as chemotherapy and radiation can damage sperm quality and quantity, causing infertility.

The closer radiation treatments are to reproductive organs, the higher the risk for infertility. There is also some evidence that male infertility is itself a risk factor for testicular cancer.

Impact of anabolic steroids and other triggers on male infertility

Dr Pankaj Srivastava, leading fertility expert and founder of the fertility clinic Conceive told Gulf News: “For the last 20-30 years, it is a well-known global phenomenon that fertility is on the decline. There are several triggers for this. The most important is the proliferation of chemicals – pesticides, mercury and other toxic substances that are finding their way into our water table. The widespread use of plastics such as non-stick chemicals and use of substances in our daily life that are hormone disruptors has played havoc with both male and female fertility.”

Dr Srivastava revealed that many of his patients who reported low sperm counts were youngsters in the age group of 18-25 who were working out in gyms that were providing them with body-building substances. “I recently had the case of a 22-year old Syrian man who came to me in great distress as he was to be married in a three months. He told me his physical trainer insisted he take muscle buffing anabolic steroid injections, wait for the effect to wash out for a month and then take fertility boosting tablets to restore normal testosterone levels.”

The boy panicked as he was experiencing low libido and erectile dysfunction. The hormonal tests run on him confirmed that his male hormones were suppressed.

Dr Srivastava said that although the patient did not follow up on treatment, he fears that many young men undergoing physical training are under peer pressure to take these muscle increasing medication that has an adverse effect on their fertility.

Is radiation impacting fertility?

Another probable cause of declining male fertility is electro-magnetic radiation. We are surrounded by electro-magnetic waves — be it those radiated by mobile towers, our microwave, our phone and although these may be impacting in a small measure, the radiation from the Poles definitely has an impact on the fertility of pilots flying those routes.

Dr Srivastava confirmed that he had patients who were pilots flying to the North Pole frequently. “The cosmic radiation that the pilots face through the glass of their cockpit panel does have an impact on their male hormones. Perhaps wearing radiation protective clothing could help, he advised.

Restrictive clothing

The Bourn Hall Centre also found other interesting factors contributing to male infertility such as tight trousers and restrictive underclothing that constricted blood flow.

Of the subjects intervieweed, 84 per cent said wearing tight underwear could lead to infertility issues as well 72 per cent felt that keeping a laptop on the lap and working could be harmful.

Dr Robertson explained: “The optimum temperature for sperm production has to be slightly cooler than our regular body temperature. A tight underwear can raise that temperature, resulting in poor sperm motility, leading to fewer or abnormal sperm production. Similarly resting heated laptops on one’s lap or exposing one’s self to heated Jacuzzi water for long and regular periods can have an adverse effect on sperm motility.

Impact of age on fertility

Interestingly, the research found the opinion split over the impact of increasing age on fertility.

More men 56 per cent, believe that a man’s age can negatively affect couple’s chances of fertility, while 44 per cent believe that it does not. However, Dr Robertson reiterated that age is not a significant contributing factor in men, despite the fact that sperm quality can decrease with age.