How living in modern times is rendering men infertile

By Sola Ogundipe, Health Editor

IN today’s fast-paced world, fertility struggles are quietly on the rise. While conversations around infertility often centre  on women, an invisible  but significant crisis is steadily unfolding, challenging traditional notions of fatherhood and family. In Nigeria and across the world, men are discovering that their sperm count is becoming “critically low”.   An increasing number of men  are  grappling with declining sperm  counts and diminishing sperm quality  even as fertility specialists are reporting that male fertility is plummeting at such an alarming rate and is currently constituting a silent crisis that is causing sleepless nights. For more than four decades, medical experts have warned that male fertility is in rapid decline because sperm count, sperm concentration,  and sperm quality are decreasing  worldwide.     

Red flag

“We have a serious problem on our hands that, if not mitigated, could threaten mankind’s survival,” said Professor Hagai Levine of the Hebrew University- Hadassah Braun School of Public Health, who led a landmark study on declining sperm count in collaboration with a team of scientists from Denmark, Brazil, Spain and the United States.  Noting that the findings from the study are a red flag, Levine stressed the importance of human reproduction to the global environment and for future existence  of mankind.  “Sperm count is more than just a good marker of a man’s ability to participate in conception, but has also been linked to his general health, including premature mortality and morbidity risks. A man with  lower sperm count  has  higher chances of becoming sick or dying at a younger age,” Levine cautioned. Data from Nigeria and 52 other countries showed a decline of around 2.5  per cent each year in total sperm concentration since year 2000, which Levine admitted is a clear signal that something is wrong with men’s sperm count around the world, something that cannot be explained by genetics.    Semen quality is frequently used as an indirect measure of male infertility and studies have shown that poor semen quality is responsible for 20-40 per cent of infertility in couples in Nigeria. Fertility experts are unanimous that male fertility is not just about having an erection or producing sperm, elements of sperm quality and semen characteristics play vital roles in fertility.  Sperm count refers to the number of sperms a man produces per millilitre of semen. Low sperm count, medically known as ‘oligospermia’, means there are fewer sperm than normal. A healthy count typically ranges from 20 to 120 million sperm per millilitre, although just a single sperm is required for fertilisation, if the count is too low, the chances fertilising an egg decrease significantly. The sperm’s swimming ability, known as sperm motility,  as well as the morphology (shape), and semen volume  are all crucial. Medical records show that the average readings of these parameters are diminishing. The  decline isn’t just a concern for individuals trying to conceive, but  raises broader questions about public health, environmental influences, and even the future of human reproduction.    

From virility to vulnerability

From research, average sperm counts have fallen by more than 50 per cent over the last half-century and with this development, there is a dramatic rise in male factor infertility and a growing reliance on Assisted Reproductive Techniques, ART, such as In Vitro Fertilization, IVF, among other approaches to aid conception. The journey from virility to vulnerability comes like a thief in the night, the discovery of bad sperm parameters is often unexpected. From medical history, concerns over declining sperm count arose since the deterioration of semen quality and decline in sperm count were first reported by a study carried out between 1938 and 1990 among 15,000 men with no history of infertility from 23 countries. The results of the analysis showed that sperm density had declined globally by about 50 per cent during the second half of the 20th century. A 2022 data from the Human Reproduction Update  — a leading scientific journal focused on reproductive biology and medicine  — established that sperm concentration decreased by 51.6  per cent  and total sperm count dropped by 62.3  per cent  since 1973. From the data, average sperm count declined appreciably from 101.2 million per millilitre in 1973 to 49 million per millilitre in 2018 in America, Europe, Asia, Oceania, Australia and Africa.     

The data showed that the mean sperm count declined by 51.6  per cent  between 1973 and 2018. After 1972, sperm count was decreasing by 1.16 per cent per year but more than doubled after 2000 when it was decreasing by 2.64 per cent per year. The data suggest that the worldwide sperm count decline is continuing in the 21st century at an accelerated pace, amid calls for actions to prevent further disruption of male reproductive health.     

Silent crisis

While  the average sperm count for men in 2018 remained higher than levels the World Health Organisation considers normal, declining sperm count, motility and morphorlogy is a silent crisis. But not all fertility struggles stem from lifestyle choices. Even as fertility struggles are quietly on the rise, few men realise just how vulnerable their fertility has become or the everyday factors that may be working against their wellness. Few  men actually realise that the decline isn’t just a matter of age or genetics, but one of complex environmental, lifestyle, and biological factors shaping the modern world. Fertility struggles once considered isolated cases, today represent a widespread trend, forcing experts to question the root causes. 

Human  fertility complex but inefficient

Human fertility is a complex but inefficient process. Experts say that humans  reproduce internally and  the efficiency is much lower than for animals that reproduce externally. Humans don’t lay eggs, their  reproduction is more complex and therefore less efficient, but the reduced efficiency is natural and it is estimated that  10-20 per cent of human pregnancies are lost naturally.   

Male fertility doesn’t exist in isolation; a man’s fertility is inextricably influenced by the world around him, so exposure to endocrine-disrupting chemicals, found in plastics, pesticides, and even personal care products, has been linked to lower sperm quality. The same argument holds for heavy metals, air pollution, and processed foods  that all  affect reproductive hormones and testicular function. Male fertility revolves around testosterone  — a hormone responsible for sperm production, libido, and overall reproductive function. Testosterone levels have been dropping generation after generation, leaving men more vulnerable to infertility. Poor diet, lack of exercise, and environmental toxins conspire to disrupt hormone regulation, make it harder for the body to maintain optimal sperm health.  

Even subtle lifestyle habits can make a huge difference as men who interact with modern technology in their daily work could be facing unintended consequences.  Men who engage in habits such as frequent laptop use on their laps, wearing of tight clothing that raises scrotal temperature, and excessive consumption of fast foods and those seemingly harmless habits collectively contribute to declining sperm counts.  

Stress as a factor

For the average man, stress is a mental burden. Men in high-pressure jobs who sacrifice  sleep and wellness for long work hours  are vulnerable. The fast pace of modern life generates chronic stress that interferes with the natural balance of testosterone levels, disrupting sperm production and overall reproductive health. Men who sit through endless virtual meetings  may unknowingly be suppressing their testosterone levels. Factors like sleep deprivation, excessive exposure to smartphones and computer screens coupled with sedentary habits further weaken reproductive health, making fertility issues inevitable. Testosterone levels are sinking across generations and not just for men in their 50s and above, healthy and active men in their 20s, 30s and 40s are not spared this malady. Fertility specialists are reporting a surge in male factor infertility —men who assumed that fertility was something automatic, something they wouldn’t need to worry about until old age.   

Although the situation appears worrisome, there is hope for   halting the reduction in sperm counts and the rise in male infertility. In order to help men with azoospermia (total absence of sperm production), some researchers are developing lab-grown sperm.     

Experts speak  

DNA fragmentation, lifestyle driving declining sperm epidemic  — Dr Abayomi Ajayi  

In an investigation of the common causes of poor semen quality, particularly DNA fragmentation in the sperms of men diagnosed with infertility, fertility experts discovered that sperm DNA integrity is vital for successful fertilisation, embryo development, pregnancy, and transmission of genetic material to an embryo, and to the resulting baby. Findings from the study carried out in Nordica Fertility Centre, Lagos, established  that DNA fragmentation is one of the most frequent DNA anomalies associated with poor semen quality, low fertilisation rates, impaired embryo quality, pre-implantation development and reduced clinical outcomes in assisted reproduction procedures.

The CEO/Managing Director, Nordica Fertility Centre, Lagos, Asaba and Abuja, Dr Abayomi Ajayi, who led the research, confirmed that the world is paying more attention to DNA fragmentation in the sperm because infertility is increasing worldwide. 

“People are paying more attention to DNA fragmentation in the sperm. Infertility appears to be increasing worldwide and we’re trying to solve the problem  by choosing the sperm that has the maximum capability to fertilise the egg.” 

Ajayi, an experienced fertility specialist, explained that investigation of  the DNA Fragmentation Index, DFI, of the sperm has been well studied. 

“One thing that we know is that what the sperm is going to contribute to the egg is the DNA, and if this DNA is already denatured, then the likelihood that the embryo that will be formed will not be of good quality and the probability that it will not be able to become a baby is high.

“We did a study a few years ago where we compared sperm samples from 10 years before to 10 years after, and we saw that the sperm counts of the patients that we are seeing at Nordica were reducing at about 3 per cent per annum. But we also looked at the figures again and saw that 12 per cent of men that we saw in the last five years prior to the study in Nordica had no sperm at all (azoospermia). The bottom line is that out of every two sperm samples we looked at, one had  a problem and we thought it was  something that men need to be further aware of so that they can quickly make the right decisions.”  Ajayi worried that the human race is not yet winning the battle against infertility, because it seems to be going higher  despite availability of better treatment, equipment and facilities. 

“We are governed by unhealthy lifestyles and reducing our fertility ourselves. We are more sedentary, and call it civilisation, we smoke and drink things that just destroy our sperm; the weather is changing, the climate is changing, and there are so many things affecting our fertility. So I don’t think we’re winning on the fertility war, but we have more equipment now to fight infertility because we have created a problem and trying to create a solution for it.  

“We are seeing more male issues than in the past. The problem of deranged sperm count or bad sperm parameters and higher incidence of genetically-deformed sperms is becoming worse, and therefore it is necessary to bring it to the front burner. We know some of the contributory factors are partly  genetic, and we know that the environment also contributes to the problem.

“Semen is continuously being produced in the male body, and takes approximately 74 days to mature, hence positive lifestyle changes can result in improvements in sperm quantity.  A man can overcome male factor infertility with a variety of treatment options depending on whether the condition is categorized as mild, moderate, or severe.”  

Novel treatment approaches

In West Africa, Nordica Lagos pioneered a technique called Intracytoplasmic Sperm Injection, ICSI, to overcome the problem of bad sperm parameters. In the technique, instead of positioning the sperm close to the eggs in the petri dish as in normal IVF, the embryologist actually selects a single sperm and injects it directly into the centre of an egg. Each egg is then monitored for signs of fertilisation and embryo development. Combined with an advanced version of itself known as Intracytoplasmic Morphologically Selected Sperm Injection, IMSI, ICSI has been effective for overcoming male infertility because it doubles the chances of men with abnormally low sperm count and poor sperm motility. Several pregnancies have been successfully achieved through the pioneering initiative.    

Preserve your fertility, consider sperm freezing  — Prof Oladapo Asiru

In the views of a professor of reproductive endocrinology and  Secretary-General of the International Federation of Fertility Societies, IFFS, Professor Oladapo Ashiru,   infertility and the declining sperm parameters  are interlinked.    Ashiru who is Chairman/Chief Medical Director at Medical Art Center, Institute of Assisted Reproductive Technology, Lagos, agreed that fertility is generally declining all over the world.   

“We have done studies that show this decline  in Nigeria  and  in South Africa.  In fact, there is a global decline in fertility from the work that we published  in IFFS. We recognise  that declining sperm count  is  a significant concern in male reproductive health  and emphasise the need for more research to fully understand the causes and impact of this trend.    

“The possible causes include things like environmental problems, infection, and people getting into old age before they  have  their babies.  Late marriage  is part of it; so many men are over 40 and are not yet married, some are over 50, and the same goes for  women.  Fertility declines with age, for both men and women, so there is need to make this awareness to both the men and the women. If you are not yet going the family way and you don’t have a child, it is a good idea to store your eggs and your sperm while you are still young.”

Ashiru called for more assertiveness about declining sperm count as a direct consequence of pervasive environmental toxin exposure. 

“Human fertility is under attack from chemicals embedded in our daily lives. Sperm and eggs are vulnerable to environmental toxins, including heavy metals and industrial pollutants, that directly impair the vital processes of their formation. Pesticide contaminants in food and water, and even the scents from air fresheners, deodorants, floor polish, and upholstery cleaners are often masking a cocktail of harmful substances. 

“These aren’t just irritants, they’re endocrine disruptors that interfere with hormone balance essential for fertility. Ignoring the link between environmental toxins and declining sperm count is no longer an option. We must acknowledge the severity of this issue and demand action to protect reproductive health for current and future generations.”

Mooting a solution, Ashiru stated: “A woman who is over 35 and is not yet married and not yet thinking of getting a baby should go and freeze her eggs before she reaches the age of 40 years, otherwise it is going to be too late. A man can also opt to freeze his sperm until he is ready. Assisted reproductive techniques are available to help in  fertility preservation until you are ready  to be a parent, because if you don’t preserve it,  as  you get older, you are exposed to all environmental pollutants that will become an issue for you when you are ready.”  

Environmental toxins are hidden threat to human fertility  — Dr Paul Faduola  

The    Chief Scientific Director, Founder/CEO  of Androcare Fertility Centre,  Lagos,  Dr. Paul  Faduola, observed that with infertility rates rising, the importance of awareness and early intervention, healthier living habits, and medical advancements cannot be over-stretched to help mitigate the declining sperm crisis, and that men should begin to treat fertility as a priority, rather than an afterthought.  

“It is true that all over the world men are getting less fertile, but I think it is worse among Blacks. Even in Nigeria, it’s becoming worse because of our lifestyle. What we are eating today has been poisoned by the chemicals that can disrupt our body such as endocrine disruptors. Use of pesticides like Gamalin 20, Sniper, and so on is unhealthy because they are endocrine disruptors.”   

Faduola revealed that findings from a local clinical study at his Lagos facility showed that out of 20 young men tested, about 14 of them had low sperm count and they didn’t even know. He proposed sustained public education for lifestyle change in addition to more stringent regulations.     

“In 2015, the EU banned Nigeria from exporting beans to their zone because of the high level of resistant Sniper in our beans. They had already discovered that in their country Sniper was causing infertility and some carcinogenic diseases and they banned Nigerian beans.  Our farmers make use of these pesticides and herbicides that are injurious to our own health and most of them directly affect male and female fertility. What we should do is to regulate the use of these chemicals. You cannot just go to the shop and buy an insecticide for use at home because these are things that are gradually destroying the sperm cells.   

“You go to a restaurant now, and they will serve you hot food in a plastic plate made up of chemicals that contain Bisphenol A, BPA.  These are chemicals that can precipitate low sperm counts and reduce sperm motility. When you microwave food in a plastic container, the chemical in the plastic is released into the food and is eaten along with it. So in several ways we are exposing ourselves.   

“Some painkillers can cause low sperm counts, especially those drugs commonly abused by  military men. If a study is done on military men, the result will be surprising because   they tend to take a lot of this drug. Alcohol and smoking contribute minimally, it is those others not being mentioned publicly that are affecting the quality of sperm in black men and in Nigeria in particular,” Faduola concluded.

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