"Is there a male fertility crisis? I hear sperm counts are decreasing!"
There has been controversy about this topic and many, many news outlets have reported on it. Researchers are also studying it. Most recently, there is a 2017 paper that reviewed the scientific literature and analyzed 185 articles with over 42,000 men regarding their sperm counts and sperm concentrations, in what is called a “meta-analysis.” The meta-analysis is a way to re-evaluate past studies and use statistics to assess the strength of the findings.
This paper has shown a genuine decline in both sperm concentrations and total sperm counts by 50-60% from 1973 through 2011. This decline is significant! This paper reported that this decline was most significant in the Western developed portion of the world, which included North America, Australia, Europe and New Zealand.
These findings are disturbing. When these findings are mapped into a graph, the slope of the line is impressive and it does not show any sign of leveling off!
This decline impacts Western men, unselected for fertility, the most.
Why is this happening?
The data from these papers used in this meta-analysis did not look at causes or associations for these findings. So we do not know. What we do know is that certain things can be associated with low sperm counts and some may be possible causes.
Sperm counts are linked to fertility. Men with low sperm counts have more difficulty getting their partner pregnant. Men with very low sperm counts usually need to use assisted reproductive technology to conceive. So what are possible causes or associations with declining sperm counts?
Possible causes of sperm count decline
We know that certain things can make the sperm count go down. Some of these things are exposures to environmental or chemical substances or heat. In the environment, men exposed to pesticides, battery components, phthalates, and several other substances may have lower sperm counts.
Typically, most things that smell bad are a problem (i.e. blacktop/asphalt, oil-based paints and their solvents, etc). Pesticides may consist of chemicals that have an impact on hormonal function (i.e. estrogen disruptors). Cadmium is one of the battery elements that has been reported to have an impact on sperm. Heat from being in hot tubs, sauna, or working in hot environments like foundry or welding, are a problem.
Some occupational or recreational activities have been reported to impact sperm numbers: truck driving for long distances, bicycling for long distances, smoking cigarettes/cigars, excessive alcohol.
Medical problems may result in lower sperm counts (several cancers, uncontrolled systemic medical problems, obesity, testicular torsion or benign testicular masses). Certain medications may impact how the sperm function, too.
Of course, radiation and chemotherapy agents may impact sperm counts and fertility preservation should be discussed prior to being treated with these medical approaches.
Lifestyle factors and stress may impact sperm counts, too. Sedentary activities have led to increasing obesity as the sperm counts decline. Increasing stress has resulted in lowering sperm counts.
What fertility treatment can do
So what do we recommend? If a man or a couple is concerned about their fertility, then one should seek the assistance of a reproductive endocrine and infertility specialist. What will happen during this visit? We would review your history in detail and order a semen analysis. The semen analysis should be one of the first steps in any infertility evaluation. The physician will review the results of the history and evaluation with you.
All testing can be done within a couple weeks. Then you will know if you are affected by low sperm counts. We can give you suggestions regarding treatment, which may be life style modification, taking supplements, or advanced reproductive technology treatments.
Questions about male fertility issues? Come to one of our four Chicago locations to consult with a board-certified fertility specialist. Make an appointment online today!
Dr. Elizabeth Puscheck is a nationally recognized Reproductive Endocrinology and Infertility (REI) specialist and board certified in both REI and Obstetrics and Gynecology. Her expertise expands beyond these areas to include gynecologic ultrasound where she has been active in writing/revising the national practice guidelines.
In addition she has taught numerous symposia and workshops throughout the country for American Society of Reproductive Medicine, American Institute of Ultrasound in Medicine and the American College of Obstetrics and Gynecology and authored over 100 manuscripts, reviews, chapters, and books. She is active in a number of clinical trials regarding new drugs and devices dedicated to improve our medical care.
Her passions include providing the best clinical care for her infertility patients. She is proud to be a member of the InVia Fertility Specialists team, and is ready to work with parents of all backgrounds to achieve a healthy pregnancy.