- Obesity
- Smoking & Addictive Substances
- Mobile/ Cell Phone Radiation & other types of Radiation
- Nutrition
- Supplement Substances of unknown origin & Anabolics
- HighTesticular Temperature
- Infections
- Genital Injuries
- Varicocele
- Age
10 Risks for Male Fertility
Craving for having a child and the social fear and pain for sterility have always been an indispensable part of human nature. The problem of infertility is very common. In Europe alone, the incidence of infertility amounts to about 14% (according to official data of the National Collaborating Centre for Women's and Children's Health). It is estimated that in 40-50% of infertile couples the problem lies exclusively in the man alone or in the man in combination with his partner's reproductive problems, although even today some men strongly dispute their potential contribution to the problem of infertility. Unfortunately, most of diseases and disorders resulting in male infertility do not manifest visible symptoms and are thus identified only after the couple's persistent unsuccessful attempts for conceiving a child.
So, what is it that negatively affects semen quality and male fertility?
1. Obesity
Excessive body weight/ Obesity [BMI (Body Mass Index)< 20kg/m2] negatively affects semen parameters.
This is probably due to the effect of fat on a number of hormones and peptides, as happens with the distortion in the balance of androgens/estrogens. It has been found that when BMI exceeds 25-30 kg/m2, there are significant alterations both in the morphology of sperm cells and in the genetic material (DNA) they carry with them.
2. Smoking & Addictive Substances
It is known that tobacco and combusted chemicals in tobaco products have a negative effect on male infertility. According to numerous studies published in scientific journals, smoking and its inhaled addictive substances induce the so-called 'oxidative stress' and impair the reproductive sperm capacity, even if semen parameters appear to be normal. In smokers of over 20 cigarettes/ day, it has been found that sperm cells cannot 'adhere to' the oocyte (egg); even DNA changes have been observed, i.e. alteration in the genetic material. The effect is more harmful in men whose semen parameters are not normal, since smoking aggravates sperm counte, motility and morphology. It should also be known that the testis has nicotine and cannabinoid receptors and therefore marihuana and cannabis have a tremendously harmful effect. The same goes for cocaine, which reduces severely sperm motility and distorts sperm morphology. It has been shown that giving up smoking and addictive substances reverses the above negative consequences.
3. Mobile/ Cell Phone radiation & other types of Radiation
A lot is heard but only very little is really known about the effect of radiation emitted by mobile/cell phones. Unfortunately, there is only one scientific study indicating that long use of mobile/cell phone can significantly affect male infertility. Of course, it is known that exposure to any type of intense and prolonged radiation may harm sperm production.This is the reason why the medical community has adopted the practice of Sperm Cryopreservation in men suffering from cancer before starting radiotherapy/chemotherapy, as well as in men who are not yet in the phase of attempting conception/pregnancy but whose sperm quality has already started dropping.
4. Nutrition
Food rich in antioxidants is highly beneficial for a healthy male reproductive condition. There are high antioxidant properties in food rich in Vitamin A (e.g. cheese), Vitamin C (e.g. citrus fruit), Vitamin E (e.g. sunflower seeds), ω-3 fats (e.g. fish), Zinc (shellfish) and folic acid (e.g. broccoli). Also, beans and artichokes are rich in antioxidants.
5. Supplement Substances of unknown origin & Anabolics
Supplements very often contain substances that are harmful to fertility and should be taken only after the physician's recommendation. In addition -as it has been emphasized again and again- anabolics are the man's greatest enemy with regard to fertility! Anabolics -particularly testosterone-, causes huge hormonal changes! It has also been recently shown that hot coffee or tea served in plastic glasses favors estrogene production and, when consumed excessively on a daily basis, has a negative effect on fertility.
6. High Testicular Temperature
If men could properly perceive messages sent by their body, they would do everything not to expose their testes to high temperatures. Although ovaries in women are protected in the interior of their body, testes are located outside the male body. This is so not for aesthetic reasons, but for functional reasons. Testicular temperature should be lower than the temperature of the rest of the body, in order for them to be functional! Thus, anything distorting this temperature diversity may harm male fertility. This is why in case of cryptorchidism (undescended testes) in boys, it is imperative to intervene and restore the proper testicular position within the scrotum. Aggravating factors are: obesity, sedentary work/ lifestyle, too tight underwear, over tight pants and prolonged use of laptop on their laps emitting heat to testes and raising testicular temperature (laptop temperature may reach even 70ο C). According to studies, elevation of testicular temperature even by only 2-3ο C because of prolonged laptop use on men's lap is enough to limit spermatogenesis. All this evidence makes us realize how many daily habits may harm male fertility. Some useful and easy-to-apply tips to prevent infertility include wearing loose underwear and pants and having frequent breaks when working in the sitting position for hours. Another common medical condition diagnosed in 15-20% of men is Varicocele. Varicocele is considered to have negative effect on sperm cells for it elevates testicular temperature. About 40% of men with varicocele will have affected sperm parameters. Varicocele is treated surgically. Today, microsurgical repair is the treatment of choice; it is the most effective technique with very few complications and the patient resumes to his normal life and occupations the very next day.
As widely known, sexually-transmitted diseases (STDs) are among the infertility risk factors. The same goes for numerous microorganisms that cannot be traced with a simple observation under the microscope; N. Gonorrhoeae, C. Trachomatis, Trichomonas Vaginalis, Ureaplasma Urealiticum are only some of these parasites which may contribute to infertility when traced in seminal fluid! Their presence or the genital inflammations they may induce (e.g. prostatitis, epididymitis) contribute to alteration of sperm quality. Many times, these infections become chronic and do not give symptoms. Therefore, any atypical disturbance in the genital area has to be investigated. Furthermore, a chronic infection may lead to obstruction of seminal ducts (=canals through which semen is transferred). In case of ejaculatory duct obstruction, although sperm cells keep being produced, they never actually reach the urethra; this condition is known as 'Obstructive Azoospermia'.
8. Genital Injuries
Testicular injuries occurring during a man's life must always be treated without any delay at all. Otherwise, there may be long-term consequences on fertility. Although it is widely accepted that physical exercise is of vital importance for keeping a good physical condition, great caution is necessary particularly with specific sports in which testes are not properly protected and may be seriously injured (e.g. martial arts, cycling, horse-riding). Therefore, when performing such sports, men are advised to wear a jockstrap (undergarment supporter designed for supporting male genitalia).
9. Varicocele
Varicocele is a very common cause of male infertility. It is very insidious for it gives no symptoms. Varicocele is the distention and insufficiency of testicular veins (similar to the condition of varicose veins in lower limbs), resulting in testicular dysfunction. It acts and progresses at a slow pace; so, when men with varicocele already have children at a young age, the negative impact of varicocele on the issue of fertility is of no importance. In rare cases, varicocele may occur in small boys, resulting in their no further testicular growth. Varicocele is treated surgically and Microsurgical Repair is the most reliable method. Surgery results with regard to infertility depend on how affected sperm parameters have already been preoperatively.
10. Age
Although most people believe that age plays no role in male fertility ageas it does in women, this is not absolutely true. Sperm quality reduces with time and studies in sperm banks have demonstrated that after the age of 40 the drop in sperm count and quality is significant. This does not mean though that a man in his 50s or 60s cannot reproduce but certainly conception becomes much more difficult than it used to be at a younger age. Of course, this also depends on the man's general health condition and the extent to which he has been exposed to the above mentioned risk factors. That is why there are cases of men who have a child/children but strangely enough they present infertility problem five, ten or fifteen years after the birth of their first child.
It is good for every man to have in mind all the above mentioned points for they may help him maintain fertility at a better level.
Whatever the case, it would be wise for every man before starting attempts to conceive to have a Semen Analysis and Culture in a Fertility Center or Lab -to trace any potentially occurring infection- and then visit an Expert Urologist/ Andrologist.