Headlines on declining male fertility, should men worry?

Over the recent past, there has been headlines about the global decline of male fertility. Scientific studies have tracked sperm quality over the years, confirming a worrying trend. The wider implications of this has undoubtedly caused some anxieties among couples.

But what’s really happening? Many factors have been linked with this observation. For starters, there have been changing lifestyles over the years, linked to industrialization, economics and affluence. Dietary habits have changed over time, combined with more sedentary lifestyles. Men have become more overweight, ending up with a negative effect on control mechanisms of sperm formation. Like for like, overweight men have poorer sperm quality compared with men of normal weight. Overuse of toxins has been a trendy habit. Think of tobacco, alcohol, marijuana and other drugs. There hasn’t been any doubt about the negative effects of toxins on male fertility. One would hope that the current drive to eradicate tobacco smoking, and limit alcohol use will help out. But the clamor for legalizing other drugs may yet cancel out such benefits in the long run.

Pollution levels have risen with industrialization. Motor vehicle fumes, industrial waste and agricultural additives are a few examples. Such pollutants have been linked to what has scientifically been referred to as ‘endocrine disruptors’. Basically, there has been an ever increasing negative influence on the body’s hormonal fertility control mechanisms, leading to poorer sperm numbers.

There will be other factors that are at play within individuals. Increasing rates of some chronic medical conditions, and associated treatments, can interfere with male fertility. Increased rates of sexual infections, especially among young men hasn’t helped either. And then there is the observed trend of delaying child bearing till later ages. As men age, sperm quality naturally declines. Men wishing to start their families well beyond the fourth decade will struggle more and more.

So what’s the way out? It’s obvious that there is a lot that men can do to help preserve their fertility potential. Many of the risk factors above can be avoided, all that is required is a conscious effort to change behavior. Stopping smoking, drinking less, eating right and maintaining a healthy weight are no brainers. Appropriate use of condoms can prevent sexual infections. Governmental agencies and public health authorities must play their role in regulating pollution. And the scientific community must invest more in medical research to inform preventive and treatment strategies for male fertility.

Finally, if you find yourself with a fertility problem, be aware that help is available. All you need is an appropriate evaluation by a fertility expert. Most men will only have minor issues that can be easily addressed. Those with complex problems may end up with advanced fertility treatment. Rarely, the only way out may be donated sperms, or adoption, or choosing to live childless.

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Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke