The Epidemic Of Infertility: Men (part 1)

 Male Infertility

When people talk about infertility or the couple goes to a doctor the usual suspect is often the woman and the man probably receives no empathy or care, however, due to multiple factors infertility due to the man is becoming more frequent. It's coupled with stigma and negative implications for men in society, as if that wasn't enough, it is often expensive to get treatment for it even though it can often fail. 

Introduction

The World Health Organization defines infertility as follows: Infertility is a disease of the reproductive system defined by the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (and there is no other reason, such as breastfeeding or postpartum amenorrhea or lack of menstruation). 

Primary infertility is infertility in a couple who have never had a child. Secondary infertility is failure to conceive following a previous pregnancy. 

Male infertility is responsible for 20–30% of infertility cases, while 20–35% are due to female infertility, and 25–40% are due to combined problems in both parts. In 10–20% of cases, no cause is found. The male infertility crisis is an increase in male infertility since the mid-1970s, sperm counts had declined by 52.4 percent between 1973 and 2011. It has impacted some regions more than others like Japan, South Korea, Italy, Sweden, and many countries in the northern hemisphere which are facing a population collapse.

Infertility has dire consequences on families, especially men because they are the sole responsible for it, including depression, addiction, weight gain, social stigma with isolation, marital fights, infidelity, and even divorces, These issues can lead the man not to look for help.

Causes

Male infertility is commonly due to deficiencies in the semen count (ideally of 16 million sperm per milliliter), and semen quality like the shape and the ability to swim forward. Different factors have been blamed for it however historically male infertility was not diagnosed or investigated due to the social belief that all infertility is due to the women.

Varicocele is a condition in which there is an enlargement of the blood vessels in the testicles which leads to abnormal sperms or no sperms at all. It is the cause of infertility for 40% of male infertility. Thankfully it is reversible with surgery and has a high rate of regained fertility especially if done early.

Smoking Tobacco has been proven to cause infertility. Tobacco damages testicles kills sperms, prevents the production of sperms, and can even predispose to varicocele.

Genetical conditions mainly Klinefelter syndrome, by which men have 47 XXY instead of 46 XY, is found in 1 out of 500 men and is one of the leading causes of permanent infertility due to the lack of sperm production from the testicles, it is familiar with the sons of fathers older than 35 years, age leads to deformed sperms and reduces fertility in men. Another condition is Y chromosome deletion whereby man has no Y chromosome at all.

Issues to do with erectile dysfunction, taking chemicals to gain muscles(steroids), some medications like antidepressants and antiulcer, abnormalities in male genital organs like undescended testes, infections like mumps and malaria, trauma to the testes and testicular cancer have all been linked with male infertility.

Environmental factors like Phthalates which are found in plastics have been shown to predispose to abnormal formation of the male genitals in babies, and anogenital distance is reduced with those babies Also those boys display a preference for girl toys. Also, estrogen-like chemicals which are found in a lot of female cosmetic products like creams and perfumes lead to abnormal formation of the male genitals in babies. Other chemicals which have been linked are pesticides, substances found in receipts and cans which all impact hormones in men, rather temporarily.

Lastly, heat can lead to the death of sperms and abnormally shaped sperms, that is why the testicles are outside the body because of the lower temperature needed for its production. So things that lead to overheating of testicles can predispose to infertility.

Therapy

Often the cause may be due to both the male and the female which would require caring for both through procedures like using the sperm for intrauterine insemination (IUI) which is releasing healthy sperm in the uterus with a device, in vitro fertilization (IVF) which is extracting the sperm and the egg and fertilizing in a glass after taking hormonal injections to boost sperm production, or IVF with intracytoplasmic sperm injection (ICSI) which is the injection of sperm directly to the egg. Unfortunately, most of their procedures don't guarantee 100% success with varying degrees due to factors like age, the severity of the cause, and the technique of the system resulting in multiple trials before success. They often come with a lot of stress, stigma, and expenses ranging from 4000 to 10,000 US dollars.

As a man, there are a couple of things you can do to avoid infertility:

1. Avoid smoking, excess alcohol, and drugs like marijuana.
2. Losing weight, since obesity is linked with infertility.
3. Not taking chemicals like protein shakes and testosterone to gain weight.
4. Avoiding activities that lead to overheating of the testes like putting on fit boxers, not driving for too long, avoiding putting your laptop in your lap, and not going to the sauna or hot tubs.
5. Not meddling in Pornography and vigorous masturbation which can both lead to erectile dysfunction.
6. Avoiding products that contain harmful substances.
7. Taking a genetic or hormonal screening to rule out genetic conditions mainly 47 XXY.
8. Take vitamin E and zinc which reduce damage to sperm, at the same time avoiding processed food and soda.
9. Preferably having children before the age of 35.
10. Wearing a protective guard over the perineal area in case of playing dangerous sports which can cause trauma on the testes.

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