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What can make men sterile

15.12.2017

Nicotine, obesity, diabetes, fever and infections, chemotherapy and drugs can all affect the number and mobility of sperm - and thus the fertility of men.

Couples who want to have children often underestimate the extent to which stimulants, illnesses and drugs can affect a man's fertility. At the largest German-speaking congress for fertility medicine, one of the two congress presidents, Prof. Dr. med. Frank-Michael Köhn, in a scientific meeting that not only the number of sperm can be damaged by such influences, but also their mobility and their ability to connect to the egg cell. Another point of attack for such damaging influences can also be the DNA, the genetic material.

High blood pressure, obesity, and diabetes can damage sperm

"Cardiovascular diseases, diabetes and obesity are becoming increasingly important as causes for disorders of male fertility, especially in combination with the increasing age of men in the fertility clinic," says the andrologist. The male hormone testosterone is also converted into estrogen in fat cells so that the risk of testosterone deficiency increases, which can impair the function of the testicles ("hypogonadism"). If the sperm quality is severely impaired, fertilization by natural means can become so unlikely that artificial fertilization is necessary. Overweight and diabetes are often accompanied by high blood pressure, which can negatively affect the production of sperm cells in the seminiferous tubules of the testes.

In addition, scientific interest is increasingly directed towards substances such as beta blockers and calcium channel blockers, common drugs used to treat high blood pressure, as limitations in sperm count and sperm function have been observed after the use of these drugs. For the family planning phase, a change of medication might have to be considered in close consultation with the treating internist, says Köhn. Better yet, by changing your lifestyle, you can eliminate the need for medication. “A body mass index over 25 can be associated with poorer semen quality. There is also evidence that sperm from obese men with a BMI over 30 have poorer results when their wives are assisted by artificial inseminations. "

Incidentally, anabolic steroids that contain male hormones also stop sperm production. This signals to the body that there is sufficient testosterone available. As a result, there is no adequate stimulation of the testes by the pituitary gland, so that the production of sperm cells ceases. The result can be a loss of fertility.

“When assessing male fertility, however, sexual disorders such as erectile dysfunction or orgasm disorders should also be taken into account. Alcohol, drugs and psychotropic drugs can sometimes be the reason why the strength and duration of the erection are no longer sufficient in a man or that sexual desire, orgasm or ejaculation are impaired, "explains Köhn.

DNA damage from nicotine and overheating

The damage that nicotine causes to the sperm is also serious: The number, mobility and shape of the sperm can be disturbed, so that their chances of even getting to the egg cell are considerably limited. In addition, smokers are more likely to find damage to their DNA, the genetic material that they transport. The ability of the sperm to fertilize egg cells can be significantly reduced as a result. Studies from Germany have shown that these consequences of nicotine consumption sometimes only regress two years after the end of nicotine consumption. Overheating due to infections with fever, varicose veins in the scrotum, sedentary work or heated seats can also impair the quality of sperm and the ability to fertilize egg cells. Particularly severe damage to sperm production is caused by chemotherapy, such as those used for cancer or sometimes autoimmune diseases.

Less agile, less successful

Successful conception not only requires a minimum number of genetically intact sperm. The sperm must also be able to move forward sufficiently to reach the egg. So-called circulators or sperm that move slowly forward will not be able to reach the egg cell and fertilize it. Nicotine, obesity, diabetes, fever and infections, chemotherapy and drugs can affect these important properties of sperm in such a way that the chance of fertilization is reduced.

“The good news is that testicular tissue can also recover after harmful influences have ended. You can see this impressively when the sperm counts drop dramatically in the case of a high fever and increase again in the following months after recovery ", says Köhn In addition, the ability to recover in individual cases cannot be predicted. We have also seen patients with long-term abuse of anabolic steroids whose testicles have not resumed their function. "

Sperm analysis only according to the WHO manual

Köhn pointed out that the complete semen analysis is still only possible by trained specialists, even if the computer-assisted semen analysis has made further progress in recent years. So that the results of spermiograms are nevertheless comparable, the "Laboratory Manual of the World Health Organization WHO for the examination and preparation of human ejaculate" must be followed, which very precisely defines every single step of the preparation and evaluation and ensures quality assurance in semen analysis.

Prof. Köhn said: “It is very important that where the couple is cared for with their desire to have children, work is carried out exactly according to the WHO manual. However, the results of the semen analysis can only be correctly assessed in connection with the man's medical history, his physical examination by an andrologist and, if necessary, hormone tests. Limited semen quality is only a symptom and not yet a diagnosis. Just as the general practitioner or internist has to clarify where the symptom 'fever' comes from, andrologists have to look for causes in the case of reduced sperm quality. These can be undescended testicles in childhood, hormonal disorders or infections. The future parents themselves benefit from the fact that the diagnosis is really made precisely, because this will measure future treatment and the assessment of the chances of success. "

Source: DVR Congress 2017