Decrease in male fertility: causes, consequences, and solutions

The decline of global fertility and its factors

From 1960 to 2015, the global fertility rate halved, and scientists attribute this process, among other things, to the deterioration of men's reproductive health. Besides biological factors, the decline in fertility is also due to changes in the social structure of society, economic difficulties, and the increasing age of marriage.

In recent decades, the average number of sperm in the semen of men worldwide has significantly decreased. At the same time, the incidence of erectile dysfunction has increased, and testosterone levels in men have declined by 1% per year.

Decrease in sperm count and testosterone levels

Today, men have an average concentration of 47.1 million sperm per milliliter of semen, compared to 99 million for their fathers. Studies have also shown that the testosterone level of a 65-year-old man in 2002 was 15% lower than that of a man of the same age in 1987.

The main factors influencing the decrease in testosterone levels and poor sperm quality are as follows:

• Changes in lifestyle and decreased physical activity;
• Exposure to chemicals in the environment;
• Increased levels of chronic stress;
• Age-related changes and hormonal imbalances.

It is therefore not surprising that the frequency of prescriptions for hormone replacement treatments for men doubled between 2010 and 2013, according to Forbes.

Decrease in sexual activity

Men's sexual activity has also significantly decreased. Today, men consult a doctor for erectile dysfunction an average of seven years earlier than before. At the same time, about 26% of patients with this problem are under 40 years old, indicating serious changes in men's reproductive health.

Environmental and lifestyle influences

According to Shanna Swan, PhD, a public health professor at the Icahn School of Medicine, the decline in male fertility is related to a number of factors, including:

• Unfavorable environmental conditions;
• An unbalanced diet and lack of essential micronutrients;
• Alcohol abuse and poor habits;
• High levels of pollutants in food and water.

Furthermore, studies show that cycling can have a negative impact on male fertility. Prolonged pressure on the groin area can lead to decreased blood flow to the testicles and increased temperature in the scrotum, which negatively affects sperm production. Men who cycle for more than 90 minutes per week have a sperm concentration in their semen that is 34% lower than that of men who do not engage in this activity.

Stress as a factor affecting fertility

A recent study conducted in Denmark showed that stress is an important factor affecting male fertility. Chronic stress:

• Increases cortisol levels, which suppresses testosterone production;
• Negatively affects the hypothalamic-pituitary-gonadal axis;
• Reduces sperm concentration by 38%;
• Leads to deterioration in sperm quality and decreased libido.

Ways to preserve male reproductive health

According to Shanna Swan, to preserve male fertility, it is necessary to:

• Lead a healthy lifestyle and avoid bad habits;
• Maintain a balanced diet rich in vitamins and trace elements;
• Engage in regular physical activity, avoiding excessive exertion;
• Manage stress levels and pay attention to psychological well-being.

These measures will help preserve men's reproductive health and reduce the risks associated with decreasing fertility. It is important to consider that a comprehensive approach and a mindful attitude towards your health can significantly improve the situation and increase the chances of natural conception.

IVF methods for men with significant infertility

In severe cases where natural conception is not possible, modern methods of in vitro fertilization (IVF) for men can help. Among the most effective technologies are

• ICSI (intracytoplasmic sperm injection) - a method in which a sperm is injected directly into the cytoplasm of the egg, which helps even in severe forms of male infertility.
• TESE (testicular sperm extraction) - a procedure to extract sperm directly from testicular tissue in men suffering from azoospermia.
• MICRO-TESE (micro-surgical testicular sperm extraction) - a more sophisticated and precise method that increases the chances of finding viable sperm.
• IVF with sperm donation - used in cases where the man is completely devoid of viable sperm. This method allows a couple facing severe male infertility to have a child.

These technologies enable men facing serious reproductive issues to have biologically related children (in the case of ICSI, TESE, MICRO-TESE) or to use donor sperm if other methods have failed.