Is this the beginning of the end?

Early last month (December) The Independent reported that the reproductive health of the average male was in sharp decline, according to the world’s largest study of the quality and concentration of sperm.

Between 1989 and 2005, the UK paper wrote, “the average sperm counts fell by a third in the study of 26,000 men, increasing their risk of infertility. The amount of healthy sperm was also reduced, by a similar proportion”.

The findings, it went on, confirm research over the past 20 years that has shown sperm counts declining in many countries across the world. Reasons ranging from tight underwear to toxins in the environment have been advanced to explain the fall, but still no definitive cause has been found.

DN2 set out to find whether the same situation obtained in Kenya. What we found out is by no means flattering.

Dr Solomon Wasike is a worried man. Three weeks ago, a newly-wedded, 28-year-old man walked into his clinic to ascertain the status of his fertility. His curiosity was triggered by the failure of his wife to conceive one year into their marriage.

A sperm analysis was done and the results were disturbing: the young man had low sperm count that was not sufficient to guarantee a pregnancy. What this effectively meant was that he was infertile.

In recent years, Dr Wasike has seen more cases of low sperm count and poor sperm morphology as more young men agree to take fertility tests.

“What is disturbing is young men consulting us are having sperm problems that we used to see in older men,” says Dr Wasike of Royal Garden Hospital.

“This indicates that, besides natural explanations, lifestyle and environment may be reducing the quality of sperm.”

National statistics or studies on the trends on sperm count and quality among Kenyan men are yet to be compiled, but pockets of data coming from individual doctors and clinics indicate a worrying trend.

Statistics from Nairobi IVF Centre, which is one of the few centres that conduct extensive sperm analysis on hundreds of men, show that low sperm count and poor sperm quality are emerging as major infertility problems among Kenyan men.

Dr Joshua Noreh, who runs the centre, says male sperm problems have been increasing. The average age of the men attending his clinic is 35 years.

Data from his centre shows that over 14 per cent of the men, whose sperm the centre analysed, have low sperm count, up three points from 11 per cent three years ago. This is a condition known as oligospermia where a man has less than 20 million sperm per millilitre in the ejaculate.

Oligospermia is the most frequent factor in male sub-fertility reported at the clinic.

Normal sperm count for a fertile man as defined by World Health Organisation is over this mark. Men with a sperm count of between 10 and 20 million per millilitre sperms cells are classified as having a mild sub-fertile condition. Anything below 10 million is severe form of sub-fertility.

Statistics from Dr Noreh’s IVF Centre also show that the number of men who had azoospermia, where there is a complete absence of sperm in the semen, increased from eight per cent three years ago to 10 per cent in 2012.

Men with this condition have been forced to use donated sperms, with 50 per cent of the cases at the Nairobi IVF centres doing so in order to get a baby.

Equally disquieting is the number of men with sperm motility problems, sperm motility being the ability of sperm to move properly towards an egg. The number of men with this problem increased from 3.5 per cent to five per cent in a span of three years, according the clinic’s statistics. Immotile sperms are those which cannot swim to fertilise an egg.

Fertility experts say that for sperms in a single ejaculate to be considered normal and able to fertilise an egg, 50 per cent of them need to be motile. A progressively motile sperm is known to swim forward in a straight line, while the non-progressive one swims in an abnormal path like in tight circles. If a man has healthy immotile sperms, then IVF is used to help correct the problem.

On proper sperm shape, the number of men with poor sperm shape increased from one per cent three years ago to two per cent. Research has established that sperms can only fertilise an egg if over 14 per cent of them have the normal structure of an oval head and a tail. Sperms without a tail, with large, small, tapered or crooked heads, curled or double tails are less likely to fertilise an egg.

While the poor sperm shape and structure have been attributed to natural causes, recent studies suspect lifestyle changes and the environment could be contributing factors to the problem.

But the falling sperm count and sperm quality in Kenya is not an isolated case. It seems to be a global trend that may make some families extinct if not managed. According to a study published in the recent journal of Human Reproduction involving 26,600 Frenchmen, sperm count fell by a third between 1989 and 2005.

The number of spermatozoa per millilitre went down by 32.3 per cent and that of normally shaped sperm fell by 33.4 per cent.

Dr Noreh fears that lifestyle and environmental factors are progressively cutting down on the men’s sperm count and contributing to poor sperm morphology among men.

“Nowadays, some of the things we look out for in man with low sperm count include his lifestyle or state of health,” he said.

Men should be very cautious about their lifestyle as it has a direct effect on the sperm count. Smoking several cigarettes a day, heavy consumption of alcohol, or eating junk food may increase the chances of losing virility. Men who have had sexually transmitted infections that go untreated for a long time may also experience poor sperm quality.

Studies done elsewhere show that sperms in many men worldwide have dropped by 50 per cent since 1940 due to the type of food they eat, smoking, drinking alcohol, and environmental pollution.

Research shows that smoking over 20 cigarettes a day and heavy drinking of alcohol reduces both the sperm count and the sperm motility.

According to a study of 99 men attending a US fertility clinic, men who said they ate a diet high in saturated fats (chips, humbuggers, hot dogs) had 43 per cent low sperm count and 38 per cent low sperm concentration (number of sperm per unit volume of semen) compared to those eating less fats.

Prof Jill Attaman from Harvard Medical School in Boston, who was the lead researcher, is quoted as saying: “The magnitude of the association is quite dramatic and provides further support for the health efforts to limit consumption of saturated fat given their relation with other health outcomes such as cardiovascular disease.”

Although not proven scientifically, there are also claims that genetically modified organisms (GMOs) and gylphosate, an ingredient in one of the herbicides used in nourishing crops, are too causing low sperm count and quality problems.

“The few patients I have seen with poor sperm quality that I can relate to environment are those who work in farms where they do a lot of spraying using chemicals,” says Dr Wasike.

“Harsh or unfriendly environments, especially those laced with chemicals, affect sperm synthesis, hence result in a low sperm count.”

Men who expose their genitals to high temperatures, such as those who frequent saunas or drive motor vehicles whose seats are located above the engine, are also likely to experience reduced sperm count.

And so are those who use Wi-Fi connected laptops on their laps. It is claimed that the excessive heat generated by the laptops and low-dose radiation from Wi-Fi damages the scrotum, reducing sperm count and quality.

“Optimal spermatogenesis (sperm development) takes place at lower temperatures less than the body temperature of 37 degrees centigrade,” explains Dr Noreh.

“Any excessive heat increases the temperature beyond that level, resulting in poor sperm development and, ultimately, low sperm count.”

Fertility experts have also established that men who eat less fruits and vegetables, take more meat and milk, drink a lot of caffeine, and chew a lot of miraa (khat) are at increased risk of low sperm count and generally compromised sperm quality.

Soya beans too have been shown to contain a lot of natural estrogen, which suppresses the production of testosterone, the hormone responsible for stimulating sperm production.

Doctors now want men with sperm problems to use nutritional supplements, avoid sitting in saunas or bathing with hot water; wear loose underwear, and stop alcohol and miraa consumption if they want to boost the sperm count.