Sachin Kumar: Male Infertility on the Rise – A Global Concern

” ‘Survival of the fittest’ is a popular phrase associated with Charles Darwin and his theory of evolution. It states that organisms that are better adapted to their environment are more likely to survive and reproduce. However, today, an important and unexpected question comes to mind when we talk about the rise in male infertility in recent decades:

Are environmental and lifestyle changes affecting male fertility? And what does the future hold?

Male infertility is emerging as a significant global health concern, affecting millions of men and couples around the world.

• According to the World Health Organization (WHO), around one in six people of reproductive age worldwide experience infertility during their lifetime. Male factors are estimated to contribute to infertility in approximately half of infertile couples, i.e., 50%, either alone or in combination with female factors.
• According to a large systematic review and meta-analysis by Levine et al. (2022), mean sperm concentration and total sperm count declined by 51.6% and 62.3%, respectively, over the period from 1973 to 2018.
• Recent studies have increasingly investigated the loss or alteration of Y-chromosome genes and their potential role in male infertility. (Gutiérrez-Hurtado et al., 2024)
• The issue extends beyond the inability to conceive. Infertility can have significant psychological, social, and financial consequences for couples, while the growing demand for fertility investigations and assisted reproductive treatments is also increasing the economic burden on families and healthcare systems.
• A 2024 report by Spherical Insights and Consulting projected substantial growth in the global male-infertility market over the next decade. However, increasing spending on fertility care should not be interpreted as proof that the biological prevalence of male infertility is doubling. Greater awareness, improved diagnosis, increased treatment-seeking, and wider availability of fertility services are also contributing to market growth.

What Is Behind Male Infertility?

Male infertility includes multifactorial factors; i.e., a combination of environmental, physical, congenital, genetic, medical, and lifestyle-related causes.

1. Environmental factors

Air pollution, pesticides, industrial chemicals, heavy metals such as lead and arsenic, excessive heat, and endocrine-disrupting chemicals may affect male reproductive health. It is well known for hormonal regulation; high oxidative stress directly affects spermatogenesis and therefore promotes male infertility.

2. Acquired and physical abnormalities

One of the most well-known abnormalities; Varicocele, (an enlargement of the veins of the testicle). Other acquired conditions include testicular tissue injuries, inflammation, infections of the reproductive tract, and obstruction of the sperm ducts(Obstructive azoospermia). Sexual and reproductive problems, including erectile dysfunction and ejaculation disorders.

3. Congenital conditions

These factors present from birth includes: Undescended testes, or cryptorchidism, can affect normal testicular development and spermatogenesis. Congenital absence of the vas deferens (tubes responsible for transporting sperm are absent or underdeveloped).

4. Genetic factors

Conditions such as Klinefelter syndrome and Y-chromosome microdeletions can severely affect sperm production. Variations in the CFTR gene are associated with congenital absence of the vas deferens and many others.

5. Medical and secondary causes

Diseases like Diabetes, obesity, thyroid disorders, pituitary abnormalities, and hormonal disorders can directly influence sperm production and therefore promote infertility. Cancer treatment is one of the most important concerns; i.e., chemotherapy and radiotherapy may affect sperm production temporarily or permanently. Some therapies and steroids have been well studied to affect spermatogenesis.”

Written by Sachin Kumar

Junior Embryologist, Indira IVF Group

References

Title: Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries

Authors: Hagai Levine, Niels Jørgensen, Anderson Martino-Andrade, Jaime Mendiola, Dan Weksler-Derri, Maya Jolles, Rachel Pinotti, Shanna H Swan

You can read the Full Article in Human Reproduction Update.

Title: Loss of the Y Chromosome: A Review of Molecular Mechanisms, Age Inference, and Implications for Men’s Health

Authors: Itzae Adonai Gutiérrez-Hurtado, Astrid Desireé Sánchez-Méndez, Denisse Stephania Becerra-Loaiza, Héctor Rangel-Villalobos, Norma Torres-Carrillo, Martha Patricia Gallegos-Arreola, José Alonso Aguilar-Velázquez

You can read the Full Article in the International Journal of Molecular Sciences.

Title: Male Infertility

Authors: Stephen W. Leslie, Taylor L. Soon-Sutton, Moien AB Khan

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