Recent research suggests there are a number of threats to male fertility, writes Ciarán Brennan
IT SEEMS that male fertility is under increasing threat. Recently, scientists found that even modest consumption of soya products, such as meat and dairy substitutes and bean curd, can have a significant impact on sperm count. Men who ate an average of half a serving of soya food a day had lower concentrations of sperm than those who did not.
New research from Queen's University Belfast confirmed that diabetes is a threat to male fertility. And it seems that a man's job could be undermining his chances of conceiving.
Research carried out a number of years ago found that men who worked as painters, decorators and printers are much more likely to have a low sperm count compared to other male professionals, due to their repeated exposure to organic solvents, such as paint thinner and turpentine.
It wasn't that long ago when male infertility and low sperm counts didn't even feature on the medical radar, says Helen Browne, chairwoman of National Infertility and Support Group.
"Years ago, women were known as barren," she says. "If a couple didn't have children it was presumed it was the woman's fault simply because they didn't do semen analysis."
But that attitude is changing, says Browne.
"There is definitely a change coming on board that it is a couple issue, and both need to be seen by the GP," she says.
Globally, it is understood that low sperm count in the semen, decreased sperm motility which is when the sperm are unable to swim, or the abnormal shape of the sperm, are responsible for infertility in about 40 per cent of couples having problems conceiving.
Browne says a recent survey carried out by her organisation has found similar results for Ireland.
The major cause of male infertility is failure to produce enough healthy sperm. Sperm count ranges between 80 and 120 million sperm per millilitre of semen for normal healthy men. The US scientists, led by Dr Jorge Chavarro, from the Harvard School of Public Health in Boston which carried out the research into soya products found that among the men they studied, those with the highest soya intake produced much less sperm. On average their counts were 41 million/ml lower than those of men who did not consume soya products.
However, Browne says that there can be many reasons for a low sperm count at any given time, such as whether the man has been on antibiotics, under a lot of stress or has had flu.
"All of these will affect sperm count," she says. "No diagnosis is given from a first sample. Usually the male is asked to come back a few times.
"The sperm reproduces every 72 hours. Just because they have a low sperm count doesn't mean they will have a low sperm count for the rest of their lives."
Often lifestyle changes are recommended to help boost sperm count as it is thought that cigarette smoking, drinking alcohol in excess, drug use and stress can all contribute to a low sperm count, while exercise and a healthy diet can have beneficial effects.
"Usually if a man is grossly overweight or a heavy smoker, definitely he would be encouraged to give up smoking and to lose weight," says Browne, who also advises men trying to conceive with their partners, to skip hot baths or wearing tight underwear as heat is known to be bad for sperm production.
Taking zinc is understood to be good for sperm production, she says.
However, a big problem is getting men to present to their doctors to discuss the problem, according to Browne. Whereas women will speak about ovarian cysts and irregular periods, men won't talk about the issues involved, she says.
"They find it very difficult. We find that among the members who come to the meetings the female will take the blame but we will always say there is no blame issue. It's a couple's decision to have a child, there should not be a blame issue."
Generally, if a couple have been trying to conceive for more than one year, it's recommended that both the man and the woman see a doctor.
Advances in treatments such as IVF means that couples, where the man has a low sperm count, have better chances of conceiving than in the past. Another option where the sperm is chronically low is Intra-cytoplasmic Sperm Injection (ICSI), a micro-injection procedure where a single sperm is physically injected into each egg.
In the case of some couples where the sperm count is not chronically very low they may opt for IUI, which involves the injection of a sample of prepared sperm from the husband or partner into the woman's uterine cavity around the time of ovulation.
"If sperm count is borderline low, lifestyle changes could help it but if it is very low, we still encourage lifestyle changes because the low amount of sperm that is there may become healthier," says Browne.
Boosting your chances
Quit smoking -smoking is long-established as a general health hazard, and has been shown to affect reproductive health in both men and women.
Avoid excessive alcohol intake -heavy drinking has been shown to double the time taken to achieve pregnancy.
Avoid exposure to paints, solvents, paint thinners -It has been shown that males exposed to these solvents on a regular basis are likely to have reduced sperm count and quality.
Lower the heat - regularhot baths and regular saunas/steam rooms would be best avoided. Loose fitting underwear has also been suggested, to avoid problems with overheating of the testes.
Chill out -high levels of stress have also been shown to reduce the quality of sperm.
Eat healthily -put fresh fruit and vegetables on the menu and increase your intake of zinc, which can be found in grains, beans, milk and meat. Get some exercise and lose weight.
Sperm count - some definitions
Oligozoospermia:low sperm count
Asthenozoospermia:reduced motility and/or impaired progression
Teratozoospermia:raised levels of abnormal sperm
Azoospermia:no sperm present in the ejaculate
Immunological infertility:significant anti-sperm antibodies bound to the sperm