The testicles produce around 100-200 million new sperm every day.
With a global trend towards delayed parenthood, male fertility naturally declines with age, both qualitatively and quantitatively, contributing to the overall rise in male infertility rates
Globally over the past 40 years, both the sperm counts and seminal quality have declined by 50% and alarmingly with 1 in 20 men currently facing reduced fertility. Overall, infertility is on the rise with 1 in 6 couples wishing to conceive being diagnosed as infertile. The use of assisted reproductive technologies (ART) is therefore increasing at a rate of 5–10% per year.
Earlier, the female factor was considered as the predominant cause for a couple’s infertility (80% vs 20%). But this trend has changed. Male factor contributes equally to the couple’s infertility. Male infertility is the reason behind 1 out 3 IVF cycles. Contemporary studies reveal that, there continues to be a 2% decline in the sperm quality every year.
As per recent surveys, about 45% of men with infertility oligospermia and azoospermia. Nearly two decades back, most causes of male infertility were reversible, like varicocele, seminal infections and hormonal imbalances. But currently, irreversible, genetic and idiopathic (unknown) causes are predominantly seen. This alarming rise could be attributed to multiple contributing factors, like lifestyle choices, environmental influences, secondary to technological advancements, stress associated with work and delayed parenthood.
Dr. Sanjay Prakash J, Consultant Microsurgical Andrologist & Urologist, Asian Institute of Nephrology and Urology, Chennai, says, “Modern lifestyle factors like sedentary behaviour, poor diet, obesity excessive alcohol consumption, smoking and drug abuse are taking a toll on male fertility. The modern diet, often rich in processed foods, low in essential nutrients, fibres and antioxidants, can negatively affect sperm quality. Obesity, in particular, is associated with hormonal imbalances like low testosterone and excess estrogen levels and high oxidative stress levels, which can directly change the testicular homeostasis and lead to altered sperm production, motility and DNA damage.”
The rise of technology and its influence on lifestyle also plays a significant role. “Prolonged exposure to heat from laptops or mobile devices placed on the lap, extended periods of sitting, can increase scrotal temperatures, adversely affecting sperm production. The radiofrequency electromagnetic radiation is a known factor to cause asthenozoospermia (poor sperm motility),” adds Dr Prakash J.
The stress associated with the fast-paced life and work culture, irregular sleep pattern, night shifts, leads to high cortisol levels (stress hormone) and low testosterone levels which negatively impacts the overall sperm quality.
Dr Prakash J shares, “Environmental factors are another major concern. The increasing presence of endocrine-disrupting chemicals like bisphenol A and phthalates, found in pesticides, plastics, personal care products, and industrial pollutants, can lead to reduced sperm count and quality. Studies have shown that air pollution, particularly fine particulate matter (PM2.5), can damage sperm DNA and reduce sperm quality. Heavy metals like lead and mercury, often found in polluted water and soil, are also known to have deleterious effects on male fertility.”
With a global trend towards delayed parenthood, male fertility naturally declines with age, both qualitatively and quantitatively, contributing to the overall rise in male infertility rates. The potential for genetic abnormalities in offspring increases with age.
Genetic causes account for nearly 20% of male infertility. Apart from the know usual causes like Klinefelter syndrome (XXY) and Y chromosome microdeletion, there are nearly 700 new genes identified to cause non-obstructive azoospermia which could be either inherited or acquired. These new genetic factors are studied to be associated with the above discussed factors.
The increasing prevalence of male infertility is a multifaceted issue caused by more of irreversible factors. In the past male infertility has been heavily stigmatized. However, this is gradually changing. Addressing this growing concern requires a holistic approach, including lifestyle modifications, reducing exposure to environmental toxins, and raising awareness about the importance of male reproductive health.
