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DECLINING MALE FERTILITY An alarming trend

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ProjECt Collab

Declining male fertility - an

alarming trend

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by Himanshu Sharma

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Factors Responsible for Male Infertility

7KH PRVW FRPPRQ FDXVHV RI  PDOH LQIHUWLOLW\ UHODWHWRWKH SURGXFWLRQ DQG PDWXUDWLRQ RI  VSHUP 6SHUP PD\ EH LPPDWXUHDEQRUPDOO\VKDSHGRUXQDEOH WR VZLP SURSHUO\ 1RUPDO VSHUP PD\ EH SURGXFHG LQ DEQRUPDOO\ORZQXPEHUV ROLJRVSHUPLD RUVHHPLQJO\QRW DWDOO D]RRVSHUPLD 7KHVHSUREOHPVPD\EHFDXVHGE\PDQ\ different conditions including:

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8QGHUFHUWDLQFRQGLWLRQVWKHERG\ VWDUWVSURGXFLQJ inappropriate immune response against its own cells RUWLVVXHVDQGGHVWUR\WKHP7KLVFRQGLWLRQVRPHWLPHV PD\OHDGWRLQIHUWLOLW\LI LPPXQHUHVSRQVHLVVWLPXODWHG DJDLQVWERG\RZQVSHUPFHOOVDQGWKXVWKH\DUHGHVWUR\HG

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Genetic diseases (most are associated with sperm DEQRUPDOLWLHV HLWKHU GLUHFWO\ RU LQGLUHFWO\  VXFK DV F\VWLFÀEURVLV1RRQDQV\QGURPHP\RWRQLFG\VWURSK\ +HPRFKURPDWRVLV.DUWDJHQHU·V V\QGURPH GHWDLOHG LQIRUPDWLRQFDQEHREWDLQIURP>@6H[FKURPRVRPDO DEQRUPDOLWLHV VXFK .OLQHIHOWHU V\QGURPH 7XUQHU V\QGURPH RUPXWDWLRQV LQWKH JHQH UHVSRQVLEOH IRU spermatogenesis such as androgen receptor gene PXWDWLRQVRU<FKURPRVRPDOPLFURGHOHWLRQDUHDOVRDQ LPSRUWDQWJHQHWLFIDFWRUUHVSRQVLEOHIRUPDOHLQIHUWLOLW\

Illustration by Kong Yink Heay

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Declining Male Fertility

$IDOOLQWKHVSHUPFRXQWLQWKHUHSURGXFWLYH\HDUVLVQRZ DVHULRXVJOREDOSUREOHP>@$VWXG\VKRZVWKDWVSHUP FRXQWRI KHDOWK\PDOHVLVGHFUHDVLQJDWDUDWHRI SHU \HDU>@7KLVZLOOGLUHFWO\DIIHFWSRSXODWLRQJURZWKUDWHRI  DQ\FRXQWU\ZKLFKLQWXUQZLOODIIHFWWKHHFRQRPLFJURZWK RI DFRXQWU\'HFOLQLQJPDOHIHUWLOLW\FDQDOVRFDXVHPHQWDO GLVVDWLVIDFWLRQDQGGLVUXSWUHODWLRQVKLSV7KHJUDGXDOGHFUHDVH in sperm count in worldwide male population prompted :+2WR UHYLVHGLWVJXLGHOLQH UHFHQWO\E\GHFUHDVLQJWKH VSHUP FRQFHQWUDWLRQ UDQJH GHHPHG DV QRUPDO IURP  PLOOLRQPOWRPLOOLRQVPOLQDKHDOWK\LQGLYLGXDO>@

Aside from genetic and other idiopathic causes of male LQIHUWLOLW\UHSRUWVLQUHFHQW\HDUVKDYHVKRZQWKDWLQFLGHQFH RI PDOHLQIHUWLOLW\KDVLQFUHDVHGDVDUHVXOWRI YDULRXVIDFWRUV VXFKDVHQYLURQPHQWDOSROOXWLRQ VWUHVVDQGOLIHVW\OH>@ 7KHUHDUHYDULRXVFRQWULEXWLQJOLIHVW\OHIDFWRUVUHVSRQVLEOH IRUGHFOLQLQJVSHUPFRXQW,QWKLVDUWLFOH,ZLOO IRFXVRQ PDMRUIDFWRUVVXFKDVSK\VLRORJLFDOVWUHVVJHQLWDOKHDWVWUHVV smoking, and alcoholism.

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Physiological Stress and Work Pressure Smoking

3K\VLRORJLFDO VWUHVV LV RQH RI  WKH LPSRUWDQW IDFWRUV &LJDUHWWHVPRNHFRQWDLQVDWOHDVWWR[LFVXEVWDQFHVZKLFK FRQWULEXWLQJ WR PDOH LQIHUWLOLW\ 6WXGLHV KDYH VKRZQ LQFOXGHDUVHQLF IRUPDOGHK\GHDQGQLFRWLQH7KHDGYHUVH WKDW LQ DQLPDOV VRFLDO VWUHVV KLJK DOWLWXGH VXUJHU\ DQG effects of smoking such as its association with an increased LPPRELOLVDWLRQ VWUHVV DIIHFW ERG\ ZHLJKW WHVWRVWHURQH risk of lung cancer, heart disease and oral cancer are often OHYHODQGFRSXODWRU\EHKDYLRXUZLWKYDULDEOHHIIHFWVRQ KLJKOLJKWHG\HWWKHHIIHFWRIVPRNLQJRQLQIHUWLOLW\DQGVH[XDO WHVWLFXODUPRUSKRORJ\>@(YLGHQFHH[LVWVWKDWPLOGWR G\VIXQFWLRQLVUDUHO\PHQWLRQHG$VDUHVXOWDZDUHQHVVDERXW VHYHUHHPRWLRQDOVWUHVVGHFUHDVHVWHVWRVWHURQHDQGLQWHUIHUHV these additional ill effects of smoking is limited. Smoking not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found in the semen of infertile smokers who had poorer HQKDQFHOLSLGSHUR[LGDWLRQLQVSHUPFHOOZKLFKFRXOGDIIHFW VHPHQSDUDPHWHUVWKDQQRQVPRNHUVWKHVHWR[LFFKHPLFDOV LWVPRWLOLW\DQGPRUSKRORJ\7KHSUHVHQFHRI DQWLR[LGDQWV VHYHUHO\DIIHFWVSHUPTXDOLW\1RWDEO\HOHYDWHGOHYHORI 526 LQVHPLQDOÁXLG UHGXFHV526FRQWHQWDQGWKXVHQKDQFHV LQVHPHQRI VPRNHULVDOVRWKHPDMRUFDXVHRI GHFUHDVHG UHSURGXFWLYHFDSDELOLW\>@ VHPHQTXDOLW\LQVPRNHUV  3HQLOHHUHFWLRQUHTXLUHVODUJH ÁRZRI EORRGDQGLWVKRXOGEHUHWDLQHGLQSHQLOHVRIWWLVVXHV Genital Heat Stress to maintain erection. Smoking causes narrowing of blood YHVVHOVDQGWKXVGHFUHDVLQJWKHEORRGÁRZWKDWOHDGVWR Normal sperm production depends on an optimal HUHFWLOHG\VIXQFWLRQ5HSRUWVKDYHDOVRVKRZQWKDWVPRNLQJ WHVWLFXODUWHPSHUDWXUHZKLFKLVPDLQWDLQHGƒ&EHORZERG\ PD\DOVRFDXVHFKURPRVRPDODEQRUPDOLW\WKXVDIIHFWLQJ WHPSHUDWXUHW\SLFDOO\EHWZHHQWRƒ&>@6HPLQLIHURXV VSHUPDWRJHQHVLV>@ epithelium, where the maturation of sperm cell takes place is WHPSHUDWXUHVHQVLWLYH0RUHRYHUHQ]\PHDFWLYLWLHVLQYROYHG Alcoholism in spermatogenesis will be affected at higher temperature. 7KHUHIRUHDQLQFUHDVHLQWKHWHPSHUDWXUHRI WKHVFURWXP ,WLVDFRPPRQPLVFRQFHSWLRQWKDWDOFRKROFRQVXPSWLRQ sac affects spermatogenesis, and thus maturation of GRHVQRWDIIHFW IHUWLOLW\LQPDOHV$OFRKROLVPFRQWULEXWHV sperms. Prolonged sitting can lead to genital heat stress and HLWKHUGLUHFWO\RULQGLUHFWO\WRWKHGHFOLQHLQPDOHLQIHUWLOLW\,Q FRQVHTXHQWO\QHJDWLYHO\DIIHFWVHPHQTXDOLW\)RUH[DPSOH WKHIHUWLOLW\SDUDPHWHUVRI SURIHVVLRQDOGULYHUVZKRVSHQG ORQJSHULRGVVLWWLQJLQYHKLFOHVDUHUHSRUWHGWREHLPSDLUHG “Male infertility has >@0RGHUQGUHVVVW\OHLQPDOHVVXFKDVZHDULQJWLJKWÀWWLQJ XQGHUZHDUDQGMHDQVLVDOVRDVVRFLDWHGZLWK VLJQLÀFDQWO\ profound psychological higher scrotal temperatures. and social effects.”

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Conclusion

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