In recent times, a heart-warming change that is seen among people is greater openness in terms of talking about, researching on and gaining a greater understanding of issues relating to health and well-being. Issues which used to be seen as forms of stigma are now being regarded as conditions that should be approached from an objective standpoint with the focus being on treatment options.
One such health condition relates to fertility. Be it for a male or female, the understanding that is there nothing ‘wrong’ or ‘broken’ or ‘inadequate’ with the person who may be experiencing fertility issues is becoming more widespread. And like with all other conditions that affect us, help should be taken at the earliest. Hence, there is greater willingness and openness to discussing such issues with fertility experts.
In this article, we will touch on 10 factors that may impact men’s fertility. An important point to keep in mind is that, given the advancements in assisted reproduction techniques, it is possible for a man with fertility issues to have his own children. So, an understanding of what these issues is more for detecting the first signs and looking to address them.
1. Age: In recent times, due to changes in lifestyles and social preferences, men are having children at a later age. Due to hormonal changes, sexual dysfunction, increased body fat, and various chronic diseases such as diabetes mellitus or hypothyroidism, a person might face fertility issues.
2. Sexual Dysfunction: Conditions such as premature ejaculation (when a man reaches orgasm after beginning foreplay or intercourse, and releases semen from the penis too quickly and without control), and erectile dysfunction (otherwise known as impotence; refers to the inability to maintain an erection that is firm enough and of sufficient duration to have penetrative sexual intercourse) may play a part in hindering conception. In some cases, the stress and anxiety that results from such conditions may result in the man shying away from sex altogether.
3. Increased testicular temperature: For healthy production of sperm, optimal testicular temperature (typically between 34°C to 35°C) is necessary. Several experimental studies have shown that exposure to heat and a continued sedentary posture may reduce semen quality. While these effects may be reversible once the necessary changes are made, it is advisable to keep scrotal temperature at a suitable level. To do so, it is best to wear loose-fitting clothes and underwear, and avoid placing the laptop on one’s lap while working.
4. Medication: The long-term use of steroids, anti-epileptic drugs, antiretrovirals and several kinds of antihypertensive drugs and chemo-radiation therapies have been associated with low sperm production and/or other issues that cause infertility in men. In general, the sperm parameters are reversible if the treatment is discontinued. If it is not possible to stop the treatment, the doctor may recommend the use of antioxidants in the form of vitamins and minerals that may increase sperm count and motility. No matter what the case, it is important to consult the doctor prior to stopping or changing the medication routine.
5. Hormonal Deficiencies: About 10% of all male factor infertility issues arise from hormonal imbalances. The primary hormones that are involved in male sexual health are produced in the pituitary gland – they regulate the production of sperm, and impact the production of testosterone, which is responsible for the development of male characteristics such as muscle mass, strength, fat distribution, sex drive and erection. A simple blood test can help to detect any hormonal imbalances, based on which the urologist/andrologist will determine the underlying cause and prescribe hormonal supplements as required.
6. Genetic factors: Genetics play an important role in the production of sperms, and about 30% of male infertility issues are associated with chromosomal abnormalities and gene mutations. While chromosomal abnormalities may not be not treatable or reversible per se, latest advancements in assisted reproductive techniques have helped many men to father children despite this limitation.
7. Diet and lifestyle: A diet that predominantly comprises of foods high in saturated sugar and fat may lead to increased production of bad cholesterol in the body. This, in turn, may induce excessive generation of highly reactive harmful chemicals called ‘free radicals’, which may damage the testicular cells and affect their ability to produce testosterone. Furthermore, excessive smoking and consumption of alcohol are associated with reduced sperm count and quality. In particular, smoking produces a two-fold decrease in sperm count – one, due to the effect of nicotine; two, the reduction in the concentration of zinc in semen. Switching to a healthy diet that prioritises the consumption of vegetables, greens, nuts, fruits, fish and low-fat dairy products, and cutting back or quitting smoking and alcohol may help improve semen production and quality.
8. Obesity: Obese men tend to have higher levels of estrogen, which may lead to low sperm production (spermatogenesis) due to the suppression of FSH and LH by the brain. The increase in fat mass in men also reduces plasma testosterone levels and increases gonadal temperatures due to increased fat tissue around the testes. The general guideline is to maintain a BMI of less than 25.
9. Psychological stress: Stress reduces reproductive potential and causes suppression of testosterone. In fact, worrying too much about successful conception can slowly drive up stress levels and reduce a person’s sex drive, so it is important to stay positive and keep sex enjoyable. If necessary, the person can undergo non-pharmacological measures for stress management like behavioural therapy, counselling and support.
10. Lack of sleep: Research has shown that too little sleep or irregular sleep patterns can affect a man’s fertility. This is due to the fact that the majority of testosterone release occurs during sleep and improper sleep patterns can upset the balance. Maintaining healthy sleep hygiene is a must for overall good health as well.
