Health : Doctors reveal there is no decline in semen quality among Indians

We hear that now more men are volunteering to get infertility tests done, while also escorting women to report to the specialists. Let us find out what is affecting reproductive health among the Gen Z, and more, as Shikha Duggal writes

The Big news: a recent study has revealed men are not producing as much sperm as they were decades ago! It’s too scared stiff to even hear it for a moment. Sperm count is an imperfect measure of fertility, and some outside researchers said they have reservations about the new analysis. The question being asked around the world is, “What is happening to men’s reproductive health?”

“Poor lifestyle, job stress, vehicle pollution, career demands, less relaxation, stationary work, inappropriate sleep pattern affect reproductive health and quality of sperms. Under pressure alcohol becomes no longer relaxation but addiction, adding to smoking, which in turn affects functionality of supermarket and concentration,” told Dr. N Sapna Lulla, obstetrics and gynaecology from Aster CMI hospital. More research is needed to understand better whether sperm concentrations are declining so dramatically and what might be behind the issue. “Exposure can be raised by preventive health check-ups, pre-pregnancy counseling. To quit smoking and drinking a behavioral complacency is a challenge in men! Inactivity in men is common due to work pressure and attitude issues and gender upbringing,” added the gynaecologist.

Sperm can be difficult to count and characterise accurately, meaning numbers could vary from study to study and over time, depending on how sperm are counted. “Awareness of male health is low among men and hasn’t changed much,” she said, adding, “While acceptance of the men’s health programme is limited, as is low socioeconomic status and literacy! It’s a wake-up call for both men and women as it can hinder personal relationships and productivity and cause mental and financial drain.”

Health experts already cautioned young men between 30 and 45 to lead healthy lifestyles following reports of increased infertility rates in the country.She continued, “Forty percent is related to male disorders due to decreasing supermarket concentration and functionality. Lifestyle and habits affect the supermarket’s quality and functionality! Overweight men with sedentary lifestyles have high oestrogen and low testosterone.These hormonal issues lead to erectile dysfunction and decreased libido too. We have a serious problem on our hands that, if not mitigated, could threaten mankind’s survival! Men can improve their sperm counts by relaxing, quitting smoking, avoiding tight undergarments, excessive hot water baths, gold relaxation, and increasing their intake of vitamin C and antioxidants.”

Researchers noted that this is dismaying in general for both male fertility and men’s health since low sperm counts usually come with an increased risk of chronic disease, testicular cancer, and a decreased lifespan. But here is the big reveal by Dr. P.V. Rao, who is an endocrinologist:“The report from Israel on temporal trends in sperm counts in India was only based on assumptions and not on large population data or even small community-wide data. No Indian samples were collected from India nor tested by the Israeli authors for this publication! The Indian references quoted in the publication did not have any statistically relevant data for the purported meta-regression analysis.

Unfortunately, it caught the attention of the media and projected the wrong message about the reproductive health of Indian men. There have always been reports of a decline in the reproductive health of men worldwide over many decades, which prompted Indian researchers to periodically define baseline semen parameters in Indian men from different regions. The National Institute for Research in Reproductive Health is a premier institute of world standards, and they have been closely watching multiple parameters of reproductive health in Indian men. Apart from ICMR and CSIR institutes of repute, the All India Institute of Medical Sciences in 2006 independently evaluated semen profiles and sperm function parameters in 368 Indian men. These findings were consistent with previously published data from Indian men and did not support the contention of a decrease in sperm quality in Indian men! The real reason could be that there were also a few reports of environmental pollution affecting sperm counts and quality in small numbers of Indian men.

Heavy metal toxicity was also reported to cause low sperm counts and motility defects in 57 Indian welders occupationally exposed to nickel and chromium for 2–21 years by Hyderabad doctors from Owaisi and Mahavir hospitals, with help from IICT and the Indian Institute of Genetics. However, such small reports are not generalised to the total adult population in communities, and such data are not used to describe the health of Indian men, as I believe as a responsible doctor.”

On the other hand, we also spoke to the specialist in this topic, Dr. M. Prasad, who is a senior embryologist at Anutest Tube Baby Center with 30 years of expertise in spermatocyte estimations in Hyderabad! He has not noticed any new changes in the sperm quality and quantity among the men being investigated. However, he mentions that there are now more men volunteering to get tests done, escorting women to report to the specialists! “Earlier, only a few men were accompanying their partners for infertility testing, while blaming women for being childless. With the assistance of other technical experts in Hyderabad infertility clinics, I discovered that an increasing number of men are being counted as infertile, as they are now receiving more men reporting for infertility tests, and at such young ages. In their opinion, there was no increase in the absolute number of men who were infertile. They also admit that they are only familiar with the sperm counts of infertile men and do not have data with them to attribute to all adult men in the general population. Sperm cells are usually only 80% of the total in the lab analysis reports. Even much lower numbers in semen are adequate for fertility. With evolving modern techniques, it is also possible to fertilise an egg with a few sperm cells, both inside or even outside in a “test tube”, widely practised all over the country.”

And, then, Dr. Raman Boddula, another senior endocrinologist at Yashoda Hospital, responded to our queries. “We do not have evidence that semen quality is going down in India. National data from Central Institutes do not support such reports. Overweight, stress, physical inactivity, alcohol, smoking, and drug abuse may be emerging risks affecting reproductive health in other countries as social progress continues.

In a minor way, the same may contribute to the quality of sperm in Indian men, though not significantly. The awareness of early identification of the problem, early testing, and maintaining and improving reproductive health is increasing, at least in urban areas of the country. In underprivileged and lower-income groups, women are considered at fault for being childless. It was taboo for many years to test a man for his deficiencies due to being infertile. After one year of married life, it is necessary to get medical advice and test both partners for infertility! The semen test is the simplest and least expensive of all the tests required. Properly collected, stored, transported, and tested, it will yield limitless information on reproductive health. There is no need for a “wake-up call” in this issue at present. The low semen quality does not warrant any alarming caution.

The problem is not significant in our context. Neither is there an effective medicine for increasing sperm count or improving the quality of sperm, whereas some vitamins like E, anti-oxidants, and co-enzyme Q have some beneficial effects, although not always for everybody. No part of the Indian vegetable plant, the drumstick, has any proven effect on reproductive health!”

“Men should not be affected by stress reduction, abstaining from alcohol and smoking, and losing weight. There may be a few men with pituitary and gonadal hormone deficiencies, and they need medical attention for treating possible hormonal imbalances. If male hormone deficiency is diagnosed, hormone replacement therapy also helps.Pituitary hormones and testosterone are only taken on medical advice. Both may cause harm if taken unnecessarily without the advice of an endocrinologist.”