New Delhi: Recent studies have found that over the last 50 years, human sperm counts appear to have fallen by more than 50 per cent around the globe. A review saw experts say it would also be a harbinger of declining health in men in general, since semen quality is a mark for overall health as well.
While the review and its conclusions have sparked a debate about male fertility, we got in touch with experts to find out what they think.
Decline in sperm count
Dr. Sneha Sathe, Fertility Consultant, Nova IVF Fertility, Mumbai, revealed high-quality studies have demonstrated that there has indeed been a decline in sperm parameters over time. According to her, while the causative factors are yet to be fully elucidated, potential causes can include “increased rates of obesity, unhealthy diet, and exposure to environmental toxins.”
Similarly, Dr. Shalini Vijay, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospitals, Lullanagar, lists rising levels of stress, alcohol consumption, smoking, illicit use of drugs, hormonal imbalance, genetics among others as possible reasons for reduced sperm count.
“About one-third of infertility is caused by male factor, one third by a female factor and another third is due to a combination of both male and female factors,” says Dr. Sathe, adding, “In more than 50 per cent of cases, a male factor causes or contributes to the problem. In fact, some degree of male subfertility is found in most couples undergoing fertility evaluation.”
Dr. Sathe states that semen analysis is the most basic test used to evaluate the male partner. “Men with sperm parameters below the World Health Organization (WHO) normal values are considered to have male factor infertility,” she says, adding, “While the sperm count is an important parameter, sperm motility and morphology are also significant measures. A low sperm count, poor motility and poor morphology all contribute to reduced male fertility. ”
“Men are often shy, feel embarrassed, and do not come out in open,” says Dr. Vijay, adding that there is a fear of being ridiculed or getting judged by society. “One is not considered man enough if he is unable to produce a child. But, this thinking can deeply impact one. It can make one feel worthless. It is the need of the hour for men to come forward and speak about their health problems,” she opines.
Similarly, Dr. Sathe says,” If the semen analysis shows reduced or abnormal sperm parameters, the first question the man/couple asks is why.”
She adds that oftentimes, when the fertility evaluation shows an abnormal semen analysis, the male partner initially feels shocked and overwhelmed by the diagnosis and develops a sense of failure. “Often, men feel uncomfortable expressing depression and sadness, so their outward reaction may come out as anger. Most men respond by suppressing their emotions and withdrawing in order to protect themselves and also their partners from pain,” the doctor opines.
What should couples do?
“Depending on the severity of the male factor and the presence or absence of any other infertility factors, the couple should be counselled regarding the fertility treatment options available to them,” Dr. Sathe explains.
She educates that counseling has a big role to play and a supportive spouse and well-meaning family and friends make the journey easier. When treating a couple struggling with infertility, it is always better to look at the couple together as one unit and decide the way forward.
“As professionals we need to keep in mind that even men suffer the psychological toll of infertility, though it can present differently than in women,” she says.
“There can be paranoia among men as they will feel they are worthless and will not be respected by society. They will think that society will refuse to accept them. It is better to take charge of your health and seek the assistance of a fertility consultant,” Dr. Vijay said.