PATIENT RESOURCES

The Trouble with Men and Baby-Making

Did you know that at least 30 million men around the world suffer from infertility? The statistic is not a well-known one – even among men – because, for a long time, infertility was considered to be a “woman’s problem”, but with men now contributing to 50 per cent of cases overall, male infertility is officially bawling for serious medical attention.

Did you know that at least 30 million men around the world suffer from infertility? The statistic is not a well-known one – even among men – because, for a long time, infertility was considered to be a “woman’s problem”. But experts are reporting male infertility as being on the rise over the last several years – and one look at the numbers will tell you: it’s a disease that cannot be ignored anymore.

A study, published in the Reproductive Biology and Endocrinology journal in April this year, states that infertility affects an estimated 15 per cent of couples globally (amounting to 48.5 million couples), with males “solely responsible for 20-30 per cent of infertility cases and contributing to 50 per cent of cases overall”. Yet, the authors argue this number cannot accurately represent all regions of the world due to several challenges, key among them being persistent cultural notions and the fact that “male infertility has never been defined as a disease”, thus resulting in sparse statistics.

“Infertility is still considered a woman’s problem in many parts of the world,” says Dr Raed Ahmed, a consultant urologist at Dubai’s Bourn Hall Clinic, who specialises in the subject. Quoting the study, he says, “In the MENA region, the female partner is often blamed for the problem, even though in the Arab Gulf population, male infertility affects three in five couples. Men also do not usually agree to undergo evaluation, resulting in underreporting of the problem.”

And this, he explains, is especially true in countries where cultural differences and patriarchal societies may prevent accurate statistics from being collected and compiled. “In the Gulf region, men are quite sensitive to such issues, as there is a belief that a man is not a man unless he fathers a child. Having said that, however, people are now slowly opening up to understanding that there are two factors involved in becoming parents.”

Multi-Faceted Problem

Senior infertility consultant Prof. Dr. C. Mohamed Ashraf is an eminent gynaecologist who visits the UAE for a couple of weeks every month and sees roughly 50-60 couples a day – out of which “more than half of the cases” now are due to male infertility, a number that he says has only been increasing every year. “Over the past 10 years, the male incidence of infertility is increasing at an alarming rate,” says the specialist, who practises both in India and the Middle East.

“There are several causes for this, but I believe the most important one to pay attention to right now is the one relating to environmental pollution. Toxins are present in everything today, right from the air around us down to the shampoos and nail polishes we use, and it’s because of this uncontrolled exposure to them that we’re seeing infertility rates shoot up so drastically.”

Take a recent study conducted among traffic policemen in Brazil, for instance, he says. “The study found that the policemen’s continuous exposure to traffic pollutants, over a period of eight months, greatly affected their sperm quality and motility.”

Of course, environmental factors are not the only culprits. Unhealthy lifestyles, workplace hazards and obesity are all key aspects of poor sexual health. “Prolonged exposure to workplace hazards such as ink, heavy metals, hydrocarbons and radiation can lead to low sperm counts,” explains Dr Ashraf. “Substance abuse also plays a major role, as studies have shown traces of nicotine in the ovum fluid of those women with heavy smokers for partners. The presence of nicotine there is the result of passive smoking and it takes at least three to four months for the toxins in the blood to decrease, after one quits.”

In terms of unhealthy lifestyles, Dr Ashraf blames the consumption of preservative-laden junk food in particular, as it leads to hormonal imbalances (“the preservatives are converted into female hormones in men, thus harming sperm production”). And a recent study published by researchers from Harvard University and the University of Murcia, in Spain, that examined hundreds of men between the ages of 18 to 22, seems to concur. The authors of the study noted that all the men examined were in good health and had no other issues that could negatively affect fertility. They actively engaged in regular exercise and were of a balanced weight, yet their sperm were shown as less likely to survive inside the womb. The common link between these men was that they regularly ate junk food, high in trans fats. The study concluded that regular consumption of junk food lowered the quality of sperm in younger men.

Interestingly, while age is often quoted as a critical factor for women looking to have children, Bourn Hall Clinic’s Dr Ahmed adds it can also affect men. “Some studies have fairly convincing epidemiological evidence that older men do find it harder to conceive a child, regardless of female age. Research also shows that sperm quality in men declines with age and that, as they get older, their partners also face increased risk of miscarriage.”

As a final personal observation, Dr Ashraf posits that a link between the disease and the number of mobile phones male patients carry is also very likely. “I’ve noticed that there usually is a relation in men who carry more than one mobile phone around,” he suggests, referring to the amounts of radiation such patients are inevitably exposed to.

“Keep Expectations Realistic”

The problem with male infertility is that treatment is very empirical, according to Dr Ashraf. “Hormonal disturbances can be corrected. But, in more than 70 per cent of cases, there isn’t a real cause.” The good news, however, is that medical advancements in the field of infertility treatments have abounded in recent years and men now have various treatment options for dealing with infertility, including hormone replacement therapy and, of course, assisted conception techniques such as in-vitro fertilisation (IVF).

“Too often, people desperately turn to quacks, or so-called remedies that are abundant online, for treatment,” he cautions. “But all they get through such unprofessional treatment is a waste of time and money with no results.”

Dr Ahmed encourages couples to maintain realistic expectations at all times, so that the process does not become unnecessarily stressful. “When a couple has undergone their evaluation, a treatment plan is outlined according to the diagnosis, duration of infertility, and the woman’s age. If pregnancy has not been accomplished within a reasonable time, the couple and the doctor may consider further evaluation or a different treatment plan.” High levels of confusion and anxiety are common during this journey, he says, but with a clear rationale and treatment plan, patients can remain both hopeful and realistic about holding their own bundle of joy, someday down the line.

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