In the modern era, lifestyle plays a very important role in keeping us mentally and physically healthy and when it comes to men’s health, we often talk about cholesterol, diabetes, hypertension, early onset myocardial infarction, life expectancy, etc., but when it comes to reproductive health, leading to infertility or reproductive losses, men seem to be less informed. Today, there is a huge increase in late marriages and couples who choose to have only one or two children, as infertility is now one of the main concerns of these couples.
In about 50% of these cases, the infertility is attributable to the male partner, mainly due to a failure in spermatogenesis and, according to several studies, a severe decrease in sperm quality has been observed, which is mainly due to the style of including smoking, drinking, long hours of driving, stress and pollution. In a study by Levine H et al., 2017, it was reported that there is a 50% to 60% decrease in sperm count among men from North America, Europe, Australia, and New Zealand.
It is important to understand the various factors that affect sperm quality and male fertility. In an interview with HT Lifestyle, Upasana Mukherjee, Senior Genetic Advisor at the Neuberg Center for Genomic Medicine, shared: “Modern man, during his reproductive period, is exposed to the negative influence of pervasive lifestyle habits such as smoking, drinking alcohol, drugs, less physical activity, etc. The effect of cigarette smoking on male fertility may result from the combined roles of elevated oxidative stress, DNA damage, and cell apoptosis, which could explain not only reduced semen quality but also altered spermatogenesis, maturation of sperm, and sperm function was reported to be present in smokers compared to non-smokers.
He added: “Smoking is not only associated with lower sperm quality, but has also been found to be responsible for sperm morphological changes and also sperm DNA damage. The high rate of sperm DNA fragmentation may contribute to male infertility and has also been associated with multiple miscarriages It has been found that the higher the rate of sperm DNA damage, the lower the chances of achieving an ongoing pregnancy Many laboratories now offer sperm DNA fragmentation testing to assess the level of damaged sperm. This, in turn, may help the couple take alternative reproductive methods (ART) for a successful pregnancy. Chronic alcohol use has also been found to have a detrimental effect on both the quality of the semen and levels of male reproductive hormones.
Gaur DS et al., 2010 conducted a study on the male partners of couples facing primary infertility and found that teratozoospermia (abnormal sperm morphology) was present in 63% and 72% of men who drank alcohol moderately ( 40-80g/day). ) and strongly (>80 g/day), respectively. None of the heavy alcohol drinkers were normozoospermic and most were oligozoospermic (64%), suggesting progressive testicular damage in relation to increased daily alcohol intake. Although the effects of alcohol on male reproductive function depend on the amount of intake, a threshold amount of alcohol beyond which the risk of male infertility increases has not yet been determined. Various recreational drugs such as marijuana, cocaine, anabolic-androgenic steroids (AAS), opiates (narcotics), and methamphetamine are examples of illicit drugs that negatively impact male fertility.
Upasana Mukherjee noted: “About 15% of men with infertility have an underlying genetic cause. The genetic landscape of male infertility is very complex and at least 200 genes have been implicated in spermatogenesis. More than 25% of azoospermic men have genetic causes. These primarily include chromosomal abnormalities (eg, sex chromosome abnormalities, Y-chromosome microdelion) implicated in severe spermatogenic disturbance and autosome-linked genetic variations implicated in central hypogonadism, monomorphic teratozoospermia, congenital obstructive azoospermia, and familial cases of Quantitative spermatogenic alterations. Genetic tests are relevant for their diagnostic value, clinical decision making and appropriate genetic counseling”.
According to Dr. Sheetal Sharda, Clinical Geneticist and Director of Genomics Development and Implementation, unlike women, men are less aware of their reproductive health and when it comes to being evaluated for infertility or pregnancy loss, they are often evaluates the woman first, but pregnancy and a positive pregnancy outcome depends on both partners. She revealed: “With better understanding and awareness, timely evaluation for a genetic diagnosis and making lifestyle modifications can improve the reproductive health of both partners.”
Source: www.hindustantimes.com