In the largest study of its kind, researchers have found that sperm counts have fallen by more than 50% in the past 46 years globally, including in India, and that the decline is only accelerating with time.
The findings, published last week in the journal Human Reproduction Update, show a significant decline after the year 2000 — a trend that the medical community calls alarming for multiple reasons. While the implications are being felt evidently in terms of fertility, experts warn this could also have serious ramifications for men’s overall health and well-being.
The big numbers
The researchers collected data from over 57,000 men from 53 countries, including India.
The study notes sperm count has fallen by 62.3% between 1973 and 2018.
Average sperm concentration has fallen by 51.6 percent (101.2 million per millilitre to 49 million per millilitre) during this period.
This decline has accelerated over time. The pace of decline increased from 1.2% each year since 1972, to 2.6% each year since 2000.
Researchers say multiple factors could be at play — including prenatal exposure to environmental chemicals and poor health behaviours in adulthood. “Environmental factors include exposure to pollutants, toxins in the air, radiation hazards from mobiles, laptops, plasticisers in plastics or pesticides in our food,” says Dr Aman Gupta, additional director, Urology, Fortis Hospital Vasant Kunj. Shedding light on the kind of lifestyle choices that impact sperm count, Dr Rajiv Kumar Sethia, associate director and head, Urology, Asian Hospital, says, “Sedentary lifestyle, smoking, alcohol, junk food, endocrine disruptors, chronic illnesses and their medications, anabolic steroid use, etc. — all impact sperm health.”
The implications of a global decline in sperm count and concentration are wide. The study notes that while sperm concentration above the 40 million per ml threshold does not imply a higher probability of conception, fertility could be impacted if sperm concentration falls below this level.
This impact is being felt by doctors in their daily practice, too. Dr Manish Kumar Choudhary, HOD, Urology, Marengo QRG Hospital, Faridabad, confirms this when he says, “We are seeing an increasing number of patients with low sperm counts and infertility coming to clinics for treatment.” While these concerns have commonly been observed in men over 40, things are now changing, informs Dr Sayed Zaffar, urologist at Masina Hospital, Mumbai. He says, “I now see that the number of younger males coming with this concern is really high. It is worrisome.”
Fertility, however, is only one aspect of it. Dr Choudhary adds that since sperm count is considered a marker of men’s overall health, a decline is correlated with worsening overall health and an increased future risk of morbidity.
There is plenty of research to back this up, says Dr Sethia. “Studies have shown that low sperm count is associated with an increased risk of testicular cancer, decreased lifespan and chronic illness,” he adds.
The researchers of the study also observed that decline in sperm count and concentration is “consistent with the adverse trends in testicular cancer, hormonal disruption and genital birth defects”.
The risk is especially higher for men with comorbidities such as diabetes, immunodeficiency, alcoholic liver disease, hypertensive nephropathy, etc. “These groups need to be more aware in this regard,” says Dr Rajeev Sood, director and HOD, Urology, Uro-oncology, Andrology and Robotics, Sanar International Hospitals.
While environmental and genetic factors may not be in one’s control, lifestyle choices that are known to help with sperm health can be adopted. Dr Sood explains, “The modifiable factors include maintaining a healthy BMI, regular exercise (at least 3 times a week), getting adequate sleep, avoidance of hypertension and diabetes, limiting intake of salt and sugar, quitting nicotine, moderating alcohol consumption and preventing STDs.”
Mental health requires an equal amount of focus. “Stress levels also activate the sympathetic nervous system, resulting in the inhibition of haemoglobin access and hormonal decline,” says Dr Sood. This is why a good work-life balance, taking up meditation and yoga, or seeking professional help is recommended to keep mental health in shape.
Eggs: Eggs are packed with protein. They also protect the sperm from free radical damage and improve motility. Spinach: It is an excellent source of folic acid, which helps in healthy development of sperms and reducing abnormal sperms in semen. Bananas: Vitamins A, B1, and C in bananas help the body produce healthier sperm cells. They also contain bromelain, a rare enzyme that prevents inflammation and boosts sperm quality and count.Dark chocolate: Loaded with an amino acid named L-arginine HCl, dark chocolate is proven to contribute to higher sperm counts and volume. Walnuts: Healthy fat is required for the production of the cell membrane for sperm cells, and omega-3 fatty acids in walnuts promote blood flow to the testicles. Pumpkin seeds: Phytosterols in them boost testosterone production, while omega-3 fatty acids improve blood circulation and semen volume. Zinc-rich foods: Foods such as barley, beans and red meat are rich in zinc, aiding in increased higher sperm count. Deficiency of zinc can even lead to a decrease in sperm motility. Pomegranates: They boost sperm count and semen quality, and are full of antioxidants that fight free radicals.Tomatoes: Tomatoes contain vitamin C and a substantial amount of lycopene, a powerful antioxidant beneficial for male fertility.
(Inputs by Diksha Dayal, HOD, Nutrition and Dietetics, Sanar International Hospitals)
Author tweets @SaakhiChadha