Fertility alert to young men

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Experts want to educate young men about the risks to fertility. Amy Williams reports.

Sex, drugs and cricket balls are harming the reproductive health of young men. Experts say age, sexually transmitted infections (STIs), illicit drugs, and trauma to the testicles are some of the biggest preventable barriers to a young man’s fertility.

The medical community is targeting young men and raising much needed awareness about male infertility. They are encouraging young men to live healthily and be aware of reproductive age limitations.

Andrology Australia, the Australian centre for excellence in male reproductive health, estimates that one in 20 men have low numbers of sperm in their ejaculate, causing fertility problems.

Former president of the Fertility Society of Australia and current director of the Swinburne University Psychology Clinic, Associate Professor Roger Cook, says the average man will produce between 150 and 200 million sperm per millilitre.

“Diagnosis that there’s a sperm problem actually comes, in many cases, as a real shock to young men because they’re not really trained, or educated to expect that this will happen,” Cook says.

This is despite the male being responsible for the biological issue nearly half of the time when a couple fails to fall pregnant, he says.

In some cases, there is no way to correct poor sperm production and poor sperm transport, which is why experts are focussing on prevention.

When met with fertility problems, some men cannot conceive naturally and will have to use assisted reproductive technologies to make a baby, which is not guaranteed.

While most young men are taking precautions to prevent pregnancy, and having children may seem like a far-off endeavour, they should consider their future family.

Dr Karin Hammarberg, a senior research fellow in the Jean Hailes Research Unit, School of Public Health and Preventive Medicine, at Monash University, says the male desire for children is as strong as the female desire, but men typically talk about it less.

“Nearly 90 per cent of men want children and they expect to have children, and nearly everyone wants to have at least two, or more,” Hammarberg says.

If they cannot have children, the loss of a life goal will leave them with a “lingering sadness”, she says.

 

Age

Men have a biological clock. It does not tick as loud, or as fast as the female clock, but male age is still a contributing factor to fertility.

Professor Robert McLachlan, director of Andrology Australia, says the changes in women are profound, invariable and very problematic.

Hammarberg says that from the age of 45 a man’s fertility potential starts to slowly decline, but if he remains fit and healthy the effects are lessened significantly.

There are, however, health issues associated with older fathers, such as higher rates of miscarriage and physical and mental health disorders in their children, she says.

It is important for young men to know that a woman’s fertility starts to decline at 35. This should dictate when a couple plans to have children and how many, if at all.

Aging eggs cannot be helped with in vitro fertilisation (IVF), Hammarberg says.

 

Lifestyle

To maintain fertility men should be within a healthy weight range. Andrology Australia says obese men have lower sperm counts and this may be related to changes in hormone levels.

Drinking alcohol moderately has no effect on fertility, but binge drinking can harm your general health and may eventually damage testicular function, McLachlan says.

Smoking is bad for sperm production, causing men to produce 20 per cent fewer sperm. It also affects the epigenetics of the child being conceived, he says.

Experts Dr Hammarberg and Professor McLachlan are concerned about epigenetics and the negative impact sperm and eggs from unhealthy people can have on a child.

If the conditions are not right at the time of conception, the genetic material is altered and imprinted so that the child may be destined to suffer the same unhealthy life as their parents, McLachlan says.

“In the end, it’s not just about getting someone pregnant, it’s also about producing a healthy pregnancy and healthy baby,” Hammarberg says.

The good news is that sperm takes three months to make, so men can prepare their bodies before attempting to conceive.

 

Drugs

There is little known about the effects of illicit drugs because they are hard to study, McLachlan says.

“[It] seems like a really bad idea to fill your body up with all sorts of weird chemicals while you’re making the sperm that you’re going to use to make your child,” he says.

Professor McLachlan who is also a National Health and Medical Research Council principal research fellow, warns young men to “not juice up on steroids”.

He says it is a common problem and that steroids act as a contraceptive, turning off the brain’s drive to the testis.

“So, if you go to the gym and see those guys with great big muscles, lifting 150 kilograms with their earlobe, those guys probably have very small testes and are infertile,” McLachlan says.

Recovery of the system can take a year or more and it may not be reversible, he says.

 

STIs

Some sexually transmitted infections (STI) can cause inflammation of the epididymis, the duct behind the testes, which can cause permanent damage and block the sperm tubes, McLachlan says.

Practising safe sex and using a condom can prevent infections like gonorrhoea, chlamydia, and syphilis.

Young men, if sexually active, should have regular STI checks, especially if they suspect something is wrong. Their general practitioner can order sexual health screens and provide treatment.

McLachlan says STI screens are now low key, very routine, and they can get what they need from a blood and urine test.

“It shouldn’t be an issue, it’s accessible, it’s cheap, and it’s non-confrontational,” McLachlan says.

 

Trauma

Traumatic injuries to the scrotum in young men are a significant cause of damage or loss.

Avoid trauma by taking care when riding motorbikes and working on industrial sites, and wear protective guards when playing sports like cricket.

Treat them with respect, treat them carefully,” says McLachlan.

Experts believe that GPs are at the front line of male reproductive health.

Young men should be vigilant and proactive about seeing their doctor for vaccinations and check-ups.

Men need to address symptoms of poor health and physical changes to their penis and scrotum.

“Most likely there’s nothing to worry about,” McLachlan says.

Visiting the doctor allows for diagnoses and treatment, which may preserve reproductive and general health.