What is the most common cause of male infertility?

Male Infertility has become much more common today than it was twenty years ago.

Going by current estimates, around 1 in 5 Indian couples will experience problems with infertility.

While the first reasoning in mind could be the rise in fertility diseases and infections, the truth is that such diseases and infections were present 20 years ago, though they are a lot more common today.

Then what is the reason for the rising infertility cases in our times?

The answer is that it is partly environmental, partly lifestyle-related, and partly because of diseases.

Most of the cases of male infertility go undetected.

To understand the situation better, we need to understand what predisposes men to this problem, the corrective measures and preventive steps.

Research clearly shows that low sperm count by itself is associated with metabolic alterations, cardiovascular risk and low bone mass.

Infertile men are likely to have important co-existing health problems or risk factors that can impair quality of life and shorten their lives.

The bottom line is that treatment of male infertility should not focus only on having a child when diagnostic testing finds other health risks, such as overweight, high cholesterol or high blood pressure.

And the good news is that a good proportion of male infertility can be prevented, especially if detected early.

Preventive Fertility evaluation gives men the unique opportunity for health assessment and disease prevention.

Couples having difficulties achieving pregnancy should be correctly diagnosed and followed up by their fertility specialists and primary care doctor because they could have an increased chance of morbidity and mortality.

Semen testing or screening should be done by all men and is a necessity to protect themselves from significant health risks.

As doctors, we meet a lot of men who are concerned about their sexual health and fertility, and yet are confused as to how to go about it.

The good news is that changes in lifestyle and diet have a major role in improving male fertility and maintaining sexual health, beyond conception.

Here are some measures for improving male fertility:

1. Smoking

Tobacco smoke contains ROS at levels that can damage sperm by reducing sperm motility and function and ultimately making sperm less fertile.

Smoking not only impairs male fertility, but also, is also responsible for increase in DNA damage, abnormal embryo – risking higher abortion in early pregnancy.

Available evidence on cigarette smoking and male fertility support the recommendation of smoking cessation and minimizing exposure to tobacco smoke amongst couples who are trying to conceive.

And generally beneficial effects are seen 3 months after cessation of smoking.

2. Alcohol

An analysis involving 290K+ men reported a significant association between alcohol intake and lower semen volume, sperm morphology and sperm motility in a dose-dependent manner.

Moderate and heavy drinking was found to be harmful to sperm motility and morphology

3. Exercise

While exercise is considered an excellent way to maintain a healthy life and sexual health, the right amount of exercise is required in order to maintain healthy sperm motility.

Treadmill exercise (running at moderate speed for 30 to 45 minutes, three to six days a week) showed improved quality of their sperm in terms of volume, sperm count, motility and morphology (shape and size).

Any form of moderate exercise routine may be a better option for men, especially when they have fertility issues.

4. Obesity

The presence of excess fat in obese individuals causes increased conversion of testosterone to estrogen the female hormone altering the male hormone balance, which is harmful to sperm production.

5. Psychological stress

Stress, in its many forms, may cause sperm problems.

Stress activates excess sympathetic nervous system response and causes both hormonal and Leydig cell imbalance, leading the reduction of male hormone testosterone.

6. Diet

Diet and nutrition plays an important role in semen quality.

A healthy, balanced diet could improve semen quality and birth rates amongst males.

For example, the Mediterranean diet, which is rich in omega-3 fatty acids, antioxidants, and vitamins, and low in fats, is the best diet for sperm health.

Vegetables and fruits, fish and poultry, cereals and low-fat dairy products were amongst the foods positively associated with sperm quality.

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However, diets consisting of processed meat, full-fat dairy products, alcohol, coffee, and sugar-sweetened beverages are associated with poor semen quality and lower birth rates.

To summarize, there is a rapid decline in sperm quality among males over the years.

Early detection is key to combating male infertility.

Men should come forward to test, which can now be done in the privacy of their homes.

Further, they should seek proper clinical intervention for the same.

Instead of relying on unscientific drugs and supplements for self-treatment of male infertility, a good lifestyle can help prevent those issues to a great extent.

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