The latest report on global fertility by the United Nations Population Fund (UNFPA) says infertility is a key barrier to reproductive autonomy for almost 13 per cent of Indians. Studies also show that among the approximately 28 million people in the country who face infertility, male-factor infertility accounts for 40-50 per cent of the cases.
Despite such a significant proportion, male fertility remains under-discussed and underdiagnosed, with little to no awareness beyond sperm count. This leaves no room to acknowledge the complex causes and possible solutions to the condition. Dr Vaani Mehta, fertility specialist at Birla Fertility and IVF, Chandigarh, lists the lesser-known factors impacting male fertility:
Genetics: Genetic abnormalities are often left out of discussions when talking about infertility even though they can be significant contributors. One such example would be microdeletions in the Y chromosome, particularly in the Azoospermia Factor or AzF gene. If any part of AzF is deleted or mutated, it can disrupt the entire process of spermatogenesis and lead to a severely low sperm count or even complete absence of sperm in semen, resulting in infertility.
Sexual dysfunction: Sexual dysfunction that affects fertility can manifest in many ways, with symptoms such as erectile dysfunction, problems relating to ejaculation and even low libido. In a 2023 study by the American Society for Reproductive Medicine, a projected 322 million men around the world were to be impacted by sexual dysfunction in 2025. Despite its impact, male sexual dysfunction is often underdiagnosed or undertreated. Recognising such symptoms early and addressing them through medical, psychological or lifestyle changes can significantly improve chances of natural conception.
Unhealthy lifestyle: Unhealthy lifestyle is another big factor that impacts male infertility. Several factors, such as obesity, diet or nutrition, stress, smoking and alcohol use, affect not just sperm count but also motility, morphology and sperm DNA.
Stress and emotional wellbeing: Our societal construct pressures men to curb their emotions, which leads to underlying stress and loneliness. Couple this with the stress and pressure to conceive and it negatively impacts their emotional health. It is essential for men and couples to put emotional wellbeing in focus and regulate stress to ease their fertility journey.
Comorbidities: Underlying health issues, such as diabetes and hypertension, can also have a major impact on male fertility. High blood sugar levels can reduce sperm mobility, damage sperm DNA and hamper sperm morphology. Similarly, hypertension can affect blood flow to reproductive organs and even impact hormone regulation.
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