[Infertility Topic]Sperm quality declines with age and more and more male infertility

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(Kuala Lumpur News) Infertility is a disease of the reproductive system of male and female couples. It refers to the fact that no contraceptive measures have been taken for more than 1 year, and the sex life is normal but there is no successful pregnancy.

Infertility affects millions of people of reproductive age around the world and has an impact on their families and communities. It is estimated that 48 million couples and 186 million people worldwide suffer from infertility.

Male infertility generally refers to the infertility caused by men’s physiological factors. It is found in the research that the sperm quality of young men around the world has a downward trend, and the sperm density is reduced, and the amount of ejaculation is also decreasing.

Various data also show that the decline in sperm count has become more and more serious over time. Although there is still no clear factor for the decline in sperm count, there are several potential reasons, including increased obesity rates, poor diet and exposure to Environmental toxins, and these three major factors are also the current global health crisis.

Abdul Sugu, director of the National Population and Family Development Agency (LPPKN), pointed out earlier that the increasing male infertility in the country has also exacerbated the problem of infertility among couples. 95% of men are not aware that they may have infertility problems because they can have normal sex. An international study revealed that in the past 20 years, male infertility has gradually increased, and 7% of males worldwide are facing infertility problems.

Decline in fertility after age 40

Dr Helena Lim Yun Hsuen, a specialist consultant in obstetrics and assisted pregnancy, pointed out that taking Malaysia as an example, the infertility of couples directly caused by male infertility increased from 6.9% in 2004 to 8.6% in 2014. 10% to 12%, and this will lead to a population shrinkage in the next generation of the country.

The fertility of normal men will gradually decline after the age of 40 to 45, and the increase in age will cause a decline in the quality of sperm, while reducing the chances of women getting pregnant, and increasing the other half of the pregnancy time, that is, the number of menstrual cycles required for pregnancy. It also increases the risk of miscarriage or death of the fetus.

She said that the older a woman is, the more difficult it is to conceive. It has always been recognized by the medical profession, but in fact, older men are also one of the factors that make the other half difficult to conceive.

Under normal circumstances, when the man is older, the age of the female partner is not too far apart (it is another matter to match the old and the young). Low desire to conceive (or delay family planning).

With age, men’s health status may decline, coupled with the decline of semen quality, the increased probability of deoxyribonucleic acid (DNA) fragmentation in sperm, etc., various factors will have varying degrees of impact on male fertility.

Another point that must be noted is that, according to research, the increase in male age is directly related to the occurrence of birth defects, including chromosomal abnormalities.

Offspring at higher risk of autism

According to research, comparing a 50-year-old man with a 29-year-old man, the offspring of the former are 2.2 times more likely to have autism than the offspring of the latter.

Another report also pointed out that the risk of schizophrenia (commonly known as schizophrenia) will also increase due to the age of the father. Taking the aforementioned age as an example, older male offspring have a higher risk of schizophrenia. The odds will be twice as high as the latter.

A survey in 1976 found that male partners over the age of 45 had to spend five times longer than those under the age of 45 to achieve childbearing. Half are the same age or younger, and the chances of having children will be lower.

In short, whether you are a man or a woman, the older you are, the lower your chances of giving birth. Perhaps in terms of fertility, aging is not only feared by most women (except for those women who are frozen or reversed) ), is also a butcher’s knife for men.

Sperm DNA fragmentation rate is high and difficult to conceive

Another key factor in the reduction of male fertility is the deterioration of sexual function, which is also known as erectile dysfunction (Erectile Dysfunction, ED) or commonly known as impotence.

With age, the chance of erectile dysfunction will also increase, which will greatly affect the frequency of sexual life and sexual function. When the reduction of sexual behavior means that the chance and time of conception of the other half will be affected.

“Erectile dysfunction can directly affect the number of sexual activities. Studies have shown that a man who enters the age of 40 to the age of 70 will have three times the probability of having erectile dysfunction than before the age of 40. Whether it is severe or moderate, its The ratios aren’t that far off.”

Infertility caused by degeneration of sexual function

According to data, men can have sex 6.5 times a month on average before the age of 40, but it will decrease by 1 to 2 times after the age of 50, which has a great relationship with erectile dysfunction.

“Usually men have impotence before the age of 40, which is mostly related to psychological factors or smoking, three high chronic diseases (high blood pressure, hyperlipidemia, and hyperglycemia), while after the age of 40, it is mostly related to physiological factors such as vascular obstruction.”

Lin Yunxuan pointed out that it is worth noting that aging is only one of the factors of erectile dysfunction, and other physiological factors such as the above-mentioned vascular blockage or psychological factors must also be paid attention to. Therefore, it is important for everyone to pay attention to their own health status, including sexual function. Things that men must always pay attention to. For men who want to be fathers, the impact on sexual function, especially erectile dysfunction, cannot be ignored.

“Male infertility has a direct impact on sperm function parameters, and changes in quality assessed by semen analysis have several common conditions, such as low sperm concentration (oligospermia), low sperm motility (asthenospermia), and abnormal sperm morphology ( Teratospermia), and these conditions can make it difficult for eggs to be fertilized, which, combined with advancing age, can affect semen production and lead to reduced fertility.”

Recent medical literature has pointed out that as a man ages, the probability of his sperm DNA breaking increases, which will affect his fertility and make it difficult for the other half to conceive.

She emphasized that health conditions and environmental factors can also affect male fertility, especially as a man ages, there is an increased risk of disease and exposure to environmental toxins, including germ cell damage, ischemia or The immune response to infection, viral orchitis, and sexually transmitted infections are all affected, and post-inflammatory changes associated with gonococcal or chlamydial infection can cause obstruction of the epitesticular vas deferens and infertility.

Testicle size affects sperm production

“Men with a history of other medical conditions such as Sickle-Cell Anemia (SCA), chronic renal insufficiency, cirrhosis, or malnutrition from any cause may have primary or secondary gonadal dysfunction The decline, combined with the drugs used to treat such chronic diseases, may have an adverse effect on sperm function, such as some antihypertensive drugs (such as spironolactone and calcium channel blockers), H2 blockers, used to treat prostate cancer Antiandrogen (such as flutamide) for cancer, etc., the diseases and drugs mentioned above have a great relationship with male infertility due to long-term reasons.”

In addition, the size of the male testis is related to its sperm production and fertility. For an 80-year-old man, the testicular volume is 31% smaller than that of men aged 18 to 40; Lead to decreased libido, affect erectile function and ejaculation difficulties.

“The last is the COVID-19 epidemic that has been raging since 4 years ago. Up to now, the reason why it affects male fertility is still unknown in the medical community. High levels of the angiotensin-converting enzyme 2 (ACE2) receptor, through which viruses can enter the body, can also affect male infertility.”

quit bad habits Medical Technology Helps You Be a Dad

There are two ways to improve infertility, namely, to correct living habits and medical technology. Taking the former as an example, there are the following:

1/ Pay attention to the sperm temperature

Since the scrotum and testicles are located outside the body, in order to produce high-quality sperm, it must be kept at a temperature slightly lower than body temperature, and tight pants must be reduced.

2/ Stop smoking and reduce alcohol consumption

According to research, excessive drinking can affect sperm quality, and the chemical components in cigarettes are harmful to sperm.

3/ Eliminate drugs

Drugs such as marijuana and cocaine have been shown to damage sperm quality and reduce male fertility.

4/ No drug abuse

Drugs of unknown origin, including some prescription drugs, can have temporary or permanent effects on fertility if abused.

5/ Balanced diet and moderate exercise

Being overweight can affect the quantity and quality of sperm, and a healthy lifestyle such as a balanced diet and exercise can keep sperm in a healthy state.

6/ Reduce stress

In addition to affecting the number of sexual activities, stress can even limit sperm production in severe cases, so attention must be paid.

IUI places sperm in the womb

Lin Yunxuan said that the current medical technology has also made great progress in improving infertility, such as intrauterine insemination (IUI), test-tube baby (IVF) and intracytoplasmic sperm injection (ICSI), etc. The former is a kind of fertility treatment, By placing sperm in a woman’s uterus to facilitate fertilization, it aims to increase the number of sperm reaching the fallopian tubes, thereby increasing the chances of fertilization.

Test-tube baby is to take the eggs from the woman, and then send the eggs to the laboratory to combine with the man’s sperm, and culture them in the test tube, and then transfer the successfully fertilized embryos to the woman’s uterus.

ICSI injects sperm into eggs

As for ICSI, a single sperm is injected into the egg to fertilize the egg. The process is similar to IVF, except that the egg fertilization and cultivation process is carried out in the laboratory. ICSI uses a fine needle to extract sperm and then inject the egg.

“For couples who are unable to conceive due to male infertility issues such as poor sperm quality, ICSI is another option that can be considered, and the pregnancy rate is not much different from IVF.”

She concluded that the problem of male infertility has been paid attention to, and at the same time, there are more and more researches and treatment options for infertility, which also makes men who want to conceive their own children with their partners but suffer from infertility There are more options.

Text He Jianxing Organize Liang Yingxiu

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