OVERVIEW of male infertility

Clinical definition-

        WHO defines male factor infertility as the presence of ≥1 abnormalities in the semen analysis or the presence of inadequate sexual or ejaculatory function.

Generally-

-Male factor alone contributes up to 30% of cases of infertile couples and to an additional 30% to 40% in combination with other factors. 

-approximately 2% of all men will exhibit suboptimal sperm parameters.

        -Male infertility is one of important issues in men’s health as it could alter the man’s self-esteem.

        -Occurs at a significant rate, yet public awareness of the problem is minimal.

        -Ironically, when investigation of infertility is in question, testing and treatment begin down a singular route — the female partner. 😔😔😔😔

        -Men are almost always the last one to be considered when we think about infertility especially in some gender biased societies.

        -Over the past 40 years, sperm counts worldwide have halved and sperm quality has declined alarmingly with 1 in 20 men currently facing reduced fertility globally.

        -Despite half of infertility cases involving male factors, men have been largely neglected in terms of research, diagnosis, and treatment.

        -Diagnostic methods for male infertility are based on outdated, routine and does not does not measure the fertilizing potential of spermatozoa.

        -Sperm Cryopreservation method is inefficient still.

Medical factors involved in male infertility-

·         Diabetes

·         Cystic fibrosis

·         Autoimmune disorders

·         Infections

·         Cancer disease/ treatment

·         Varicocele

·         Hormonal disorders

·         Ejaculatory dysfunction

 

Genetic Factors involved in male infertility-

·         Klinefelter’s syndrome (47, XXY), accounts for about 3% of male infertility cases.

·         Cystic Fibrosis- absence of the vas deferens.

·         Y-chromosome microdeletion (AZF): accounts for 16% of the infertility cases in men with azoospermia or severe oligospermia.

·         Chromosomal translocation:  2.1% of male infertility cases.

·         Mitochondrial DNA (mtDNA) mutations.

 

The following genetic test can be used to determine the genetic causes

•         Karyotype
•         Cystic fibrosis gene mutation testing
•         Y chromosome microdeletion test

Environmental & lifestyle factors involved in male infertility-

·         We are not sure yet but lifestyle and environmental factors have been implicated.

·         Exposure to environmental endocrine disrupting chemicals (e.g, Plasticizers, bisphenol A, and phthalates).

·         Rising rates of obesity.

·         Paternal age and the trend of delayed parenthood.

·         Occupations are also hazardous to fertility in men such as the heavy exposure to flame retardants of firefighters and petroleum workers.

·         Men in high-risk to fertility professions are not informed of the hazards of their occupations to their reproductive health until it is too late.

·         Cigarette smoking has harmful effects on semen parameters.

• It negatively affected all conventional semen parameters in addition to sperm chromatin condensation and sperm viability.
• These abnormalities were proportional to the number of cigarettes smoked per day and to the duration of smoking.

Sperm DNA Damage-

·         The common cause of sperm DNA damage has been shown to be oxidative stress.

·         Studies suggest that high sperm DNA damage can be associated with low potential for natural fertility and decreased pregnancy rates in IVF.

·         Frequent Ejaculation---Some studies suggest that frequent ejaculation achieves 30 -50% reduction in sperm DNA damage.

         

The alarming decline in sperm quality and quantity points to the threat of male infertility in times ahead. Some have suggested an extinction trend in few thousand or million years (topic for another day 😎😎😎).

Sperm parameters plays an essential role in embryo development and outcome of IVF.

We need to create awareness and encourage research in diagnosis and treatment of male infertility.

@yourivfembryologist is a renowned world embryologist, highly skilled and experienced, widely travelled, internationally trained with over a decade of experience in the IVF lab. Knowledgeable in all aspects of reproductive science and genetics. A University College of London and University of Leeds Alumni. First-class and distinction degree holder. Passionate about spreading knowledge of IVF, ensure continuity of knowledge amongst embryologists and helping patients through the IVF journey.