A Review on Male Infertility- Part 1
Risk Factors for Developing Male Infertility
The World Health Organization defines infertility as the inability to achieve pregnancy after one year of unprotected intercourse. 1 out of 6 Canadian couples experience infertility. 3 out of 10 times, men are the cause of infertility. While certain cases of male infertility are due to anatomical abnormalities and ejaculatory disorders, a large fraction of cases are due to deficient or abnormal production of sperm. Fortunately, many cases of male infertility are reversible and can be corrected.
Myth: Healthy development of fetus is largely associated with the behavior of a mother.
This assumption is wrongfully made based on the active role that the womb has in the development of fetus as well as the extensive media coverage linking harmful exposure to chemical during child-bearing and birth defects. However, research suggest that male behavior and harmful exposure during the life of the father also has an important role in the outcome of the pregnancy.
Alcohol, Nicotine and Caffeine
Development of male infertility is a life-long process with a number of potential contributing causes. Exposure to certain chemicals can cause oxidative damage and is one of the primary pathways of developing infertility.
These chemicals can induce the production of molecules known as reactive oxygen species (ROS) that can reduce the number of viable sperms by promoting cell death (apoptosis). Some of the more common types of these chemicals include caffeine, alcohol and nicotine. Indeed, weekly alcohol intake exceeding 130g (about 10 drinks) is associated with reduction of semen volume, sperm count, sperm mobility and proportion of viable sperm. Surprisingly, moderate alcohol intake has a positive effect on fertility because of an antioxidant protective effect. Fortunately, rapid improvement in sperm profile is observed after alcohol withdrawal. This enhances the patient’s will to remain alcohol-abstinent. Caffeine intake is also associated with a lower probability of achieving pregnancy especially when daily intake exceeds 272 mg (less than 3 cups). This amount exceeds the average daily intake of the general male population (211mg)
Male infertility is one of the many complications induced by smoking. Tobacco-induced oxidative stress has the same harmful effect on sperm quality as excessive alcohol consumption.
According to a recent study, smokers may display reproductive hormone disorders, dysfunction of sperm production (azoospermia), impaired sperm maturation and sperm function Nevertheless, most male smokers are fertile but have a higher risk of sub-fertility or infertility. In combination with other factors, smoking increases the chance of developing male infertility.
Pollution, Cellphones and Aspirin
Exposure to high levels of air pollution can reduce fertility. Air pollution contributes to the development of a number of health complications, especially in polluted cities. Unfortunately, the effect of air pollution on health is gradual and often remains unnoticed.
Individuals located in Ontario may visit the website for Air Quality Health Index (AQHI) to gain information about pollution levels and plan outside activities accordingly Similarly, an individual might unknowingly be exposed to many other of these factors.
According to animal studies, cellular phone emission promotes clumping of sperm cells by causing abnormal production of adhesion protein normally used in the sperm/egg interaction This reduces sperm motility and therefore, can contribute to the development of infertility. The effects of cell phone emissions becomes especially important because men often carry cellphone in their pockets, where its located close to their genitals.
Some common consumer products use a wide range of molecules that can promote male infertility. For example, nonylphenol (used in detergents, hair dyes, intravaginal spermicides, pesticides, etc.) has a negative effect on testosterone levels and reproductive parameters Triclosan (which has a broad antimicrobial activity and is used in personal care products, plastic kitchenware and textiles) also has a negative effect on fertility Exposure to some chemicals during pregnancy may cause complications starting from a young age. According to an animal study, n-Butylparaben exposure (a type of preservative used in cosmetics) during pregnancy and lactation delays the onset of puberty, reduces the production of testosterone and reduces number of viable sperm in the male offspring Avoiding contamination with these molecules would improve reproductive health. However, this is not always feasible due to widespread use of these products. Similarly, aspirin can cause infertility and its use need to be monitored in men being treated for infertility
Male fertility is a complex and dynamic disorder that can develop over the lifespan. Fortunately, many of the risk factors contributing to the development of infertility are reversible and there is much that can be done to increase sperm motility and quality. You can find ways to prevent and manage this complication in the second part of this article.
Author: Parsa Nafari, Bachelor of Science, Kinesiology
Reviewed by: Dr. Pari Saharkhiz, M.D.
References as they appear in the article:
1 Canada, P. (2020). Fertility - Canada.ca. Retrieved 1 Feb 2020, from https://www.canada.ca/en/public-health/services/fertility/fertility.html
2 Guthauser, B., Boitrelle, F., Plat, A., Thiercelin, N., & Vialard, F. (2013). Chronic excessive alcohol consumption and male fertility: a case report on reversible azoospermia and a literature review. Alcohol and Alcoholism, 49(1), 42–44. https://doi.org/10.1093/alcalc/agt133
3 Karmon, A. E., Toth, T. L., Chiu, Y.-H., Gaskins, A. J., Tanrikut, C., Wright, D. L., Hauser, R., & Chavarro, J. E. (2017). Male caffeine and alcohol intake in relation to semen parameters and in vitro fertilization outcomes among fertility patients. Andrology, 5(2), 354–361. https://doi.org/10.1111/andr.12310
4 Qiao, Z.-D., Dai, J.-B., & Wang, Z.-X. (2015). The hazardous effects of tobacco smoking on male fertility. Asian Journal of Andrology, 17(6), 954. https://doi.org/10.4103/1008-682x.150847
5 Jurewicz, J., Dziewirska, E., Radwan, M. ł., & Hanke, W. (2018). Air pollution from natural and anthropic sources and male fertility. Reproductive Biology and Endocrinology, 16(1). https://doi.org/10.1186/s12958-018-0430-2
6 Air Quality Health Index (AQHI). (2020). Ontario. http://www.airqualityontario.com/aqhi/
7 Yan, J.-G., Agresti, M., Bruce, T., Yan, Y. H., Granlund, A., & Matloub, H. S. (2007). Effects of cellular phone emissions on sperm motility in rats. Fertility and Sterility, 88(4), 957–964. https://doi.org/10.1016/j.fertnstert.2006.12.022
8 Noorimotlagh, Z., Haghighi, N. J., Ahmadimoghadam, M., & Rahim, F. (2016). An updated systematic review on the possible effect of nonylphenol on male fertility. Environmental Science and Pollution Research, 24(4), 3298–3314. https://doi.org/10.1007/s11356-016-7960-y
9 Jurewicz, J., Radwan, M. ł., Wielgomas, B., Kałużny, P. ł., Klimowska, A., Radwan, P. ł., & Hanke, W. (2017). Environmental levels of triclosan and male fertility. Environmental Science and Pollution Research, 25(6), 5484–5490. https://doi.org/10.1007/s11356-017-0866-5
10 Maske, P., Dighe, V., Mote, C., & Vanage, G. (2020). n-Butylparaben exposure through gestation and lactation impairs spermatogenesis and steroidogenesis causing reduced fertility in the F1 generation male rats. Environmental Pollution, 256, 112957. https://doi.org/10.1016/j.envpol.2019.112957
11 Banihani, S. A. (2019). Effect of aspirin on semen quality: A review. Andrologia, 52(1). https://doi.org/10.1111/and.13487