Infertility: The male factor

THESE days, 1 in 8 couples are impacted by infertility. This percentage is set to increase notably in cities, more so among couples who are both working professionals.

Infertility is defined as not being able to conceive after trying for more than 12 months (6 months for women more than 35 years old), without any contraceptive precautions.

It is not something new but its increase in recent years is likely due to increasing awareness of the condition.

Infertility has traditionally been thought of as a woman’s problem. But as it turns out, men are not spared. In fact, men contribute to more than 40 per cent of the causes of infertility. Women contribute to another 40 per cent while the remaining 20 per cent is due to unexplained factors.

In view of this, it is crucial to get the husband involved during fertility screening and treatment in order for the fertility doctor to provide a holistic treatment plan.

The leading causes of male infertility are urogenital disease, sexual dysfunction, sexually transmitted disease (STD), obstructed spermatic cords, testicular mumps infection, testicular failure, undescended testis and varicocele. Others include hormonal problems, genetic abnormalities and chemotherapy and local radiotherapy due to cancer.

Recent global data in semen analysis has revealed that there is an increase in sperm abnormalities and sperm count is on a reducing trend. Contributing factors for these include an increase in paternal age, unhealthy lifestyle (smoking, E-cigarettes, alcohol consumption, sedentary lifestyle, recreational drug and steroid use ), processed food, obesity, plastics and chemical toxins, pesticide, herbicides and pollution.

Semen analysis in mature men often shows a lower sperm count and lower quality. Hence, mature men take longer to impregnate their partners and father a child compared to younger men.

Besides this, there is also an increased risk of the child being born with conditions such as autism or an abnormal genetic inheritance.

In women too, as they age, they become less likely to conceive, more likely to have miscarriages and a higher risk of having children with chromosomal problems.

Fertility declines as we age so it’s best to start trying sooner than later. Unfortunately, a contemporary trend sees not only women but men too opting to delay starting a family.

In today’s rat race, many are engrossed in chasing career opportunities and financial stability. Furthermore, we see a change in lifestyles and an increased need for freedom among individuals.

Stress can disrupt fertility, but it rarely causes infertility. Women can continue to bear children during war, famines and other extreme situations.

However, in general, women and men should maintain a healthy lifestyle before they start trying for a baby. Being in optimal weight, not smoking, limiting alcohol intake, exercising regularly, and addressing pre- existing medical problems are essential in increasing the chances of pregnancy.

A healthy lifestyle is important; it includes consuming more fresh fruits and vegetables and having a good sleep rhythm. Others include supplementing yourself with nutritious food, multivitamins, and essential nutrients (folate, Vit D, Calcium, nutrient and good fat). It has been found to be beneficial and can give your fertility a boost.

Nevertheless, regular fertility and gynaecological health screenings are of utmost importance.

Early diagnosis and prompt treatment of gynaecological diseases may help to preserve your fertility function for future parenthood.

*The writer is an obstetrician and gynaecologist at Pantai Hospital Cheras (PHC).

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