Arun and Nishi, both in their early 30s, have been trying to conceive naturally for the past year and are now doing rounds of fertility clinics. They are even considering assisted reproductive procedures to have a baby. Their angst is not unusual as many young couples are battling infertility with men’s sperm counts going down over the years.
A new study, published in the journal Human Reproduction Update, confirms what has been known for a while, that sperm counts have been falling significantly, globally and in India. The study used data from 53 countries. It includes an additional seven years of data collection (2011-2018) and focusses on sperm count trends among men in regions not reviewed previously, specifically South America, Asia and Africa. What is worrisome is that sperm counts have declined by over 50 per cent in the last 46 years and the dip has particularly accelerated since 2000.
While the current study did not examine the causes of sperm count declines, the data shows, for the first time, that men in newer regions share the significant decline in total sperm counts (TSC) and sperm concentration (SC) seen previously in North America, Europe and Australia.
WHAT ARE REASONS FOR LOWER SPERM COUNTS/INFERTILITY?
Exposures to environmental toxins in the womb could be one of the reasons for reduced sperm count, researchers say. There is growing evidence that plasticisers, pesticides, herbicides, heavy metals, toxic gasses, air pollution and poor lifestyle choices such as sedentary behaviour, poor diet and smoking are tied to abnormal sperm counts. A study of urine samples in July from nearly 100 male volunteers uncovered “alarming” levels of endocrine disruptors known to reduce human fertility.
Cocktails of chemicals such as bisphenols and dioxins, which are believed to interfere with hormones and affect sperm quality, were present at levels up to 100 times those considered safe. The median exposure to these chemicals was 17 times the levels deemed acceptable.
According to Dr (Prof) Pankaj Talwar, VSM, Director, Medical Services, Birla Fertility and IVF at CK Birla Group, rapid urbanisation, poor lifestyles, long working hours, less relaxation and me-time, job pressures, stress and vehicular pollution are some of the other reasons for early infertility among Indians. Infertility may also be caused by lifestyle conditions like obesity and diabetes. Being overweight or underweight are other risk factors.
“There are a multitude of reasons for the drastic drop in infertility rates among women. Biologically, fertility among women gradually declines with age, especially in the mid-30s, and it drops rapidly after the age of 37,” says Dr Talwar. Sexually transmitted infections, polycystic ovarian syndrome, fibroids, genital tuberculosis and early menopause are new concerns for women. “In addition, tobacco use, such as smoking by either partner, has increased the chances of pregnancy complications. Alcohol consumption is a trigger. Whatever the reason, most women look at their inability to conceive as a personal failure. As part of this vicious cycle, the mental pressure around fertility issues can become a cause of infertility,” adds he. “For both men and women, infertility can be managed with changes in lifestyle that include clean, plant-based eating and holistic living. The target is being in the healthy weight range, quitting smoking, cutting back on alcohol, eating a healthy diet, getting plenty of regular exercises and enough sleep. Moreover, a work-life balance is also prescribed, says Dr Talwar.
STATUS OF FERTILITY TREATMENTS
Despite advancements in fertility treatments, India is still far behind in availing them and only less than one per cent seek medical consultation and treatment. “The condition has become a personal and public health issue in the country, with a double-digit increase,” says Dr Talwar. He further recommends seeking medical help in case of any persisting symptoms of infertility. “It is essential to understand that there is nothing to be embarrassed about, and ignorance of these symptoms can worsen the situation. Even after suffering from infertility, there are various treatment options available for men and women that can help,” he adds.
THREAT TO HUMAN SURVIVAL
“We have a serious problem on our hands that, if not mitigated, could threaten mankind’s survival,” said Professor Hagai Levine of Hebrew University, who led the study in collaboration with a team of scientists from Denmark, Brazil, Spain and the US. He described the findings as a “canary in the coal mine – a red flag. There is a loss of biological diversity around the world. We know that reproduction is very sensitive to the environment and it is essential for future existence.”
Data from 53 countries was included in the meta-analysis, including Australia, Bangladesh, Belgium, Brazil, Canada, Chile, China, Cuba, Czech Republic, Denmark, Egypt, Estonia, Finland, France, Germany, Greece, Greenland, India, Indonesia, Iran, Iraq, Ireland, Israel, Italy, Japan, Jordan, Kenya, Latvia, Libya, Lithuania, Malaysia, Mexico, Netherlands, New Zealand, Nigeria, Norway, Pakistan, Peru, Poland, Russia, Singapore, Slovenia, South Africa, Spain, can Sweden, Taiwan, Tanzania, United Republic of Thailand, Tunisia, Turkey, Ukraine, United Kingdom and the United States.