What Does a Low Sperm Count in Men Mean for Fertility?
A recently published study highlighted a problem that has been obvious to people in the fertility field for many years, low sperm count in men in western countries. According to studies, sperm counts among men in the west have more than halved in the past 40 years and are currently falling by an average of 1.4% a year. No wonder problems with sperm are a component of 30% of infertility cases in the west.
It’s interesting that this is not a problem in developing nations as many developing nations have more pollution in their air and water than developed nations. There are several theories that link the rise in infertility to polluted environments but pollution might affect women more than men. Since there haven’t been any definitive studies yet, this is still speculative.
What we do know is that people in the west are starting their families later so the window to deal with infertility issues is smaller. In 2014, the average age of a woman giving birth for the first time in the US was 26.3 and 52% of all live births in the UK were to mothers aged 30 and over (67% of fathers fell into this age group). More and more people plan on starting their families after they finish school, have good jobs and stable relationships. This is a wonderful thing for society but it means that the majority of people with fertility problems, male and female, don’t find out until they’re over 30.
Since problems with ovulation and egg quality are the most common fertility issues, the woman is usually the focus of the initial intervention. Sperm quality is part of initial fertility testing but it’s assumed that, as long as there are some viable sperm, the sperm will be usable. While 30% of the men tested have some sperm problems, the majority of the sperm can be salvaged using sperm washing, a process that separates the sperm from the ejaculate fluid.
Once the sperm are separated out the strongest, normally formed sperm are gather and used to inseminate the woman either through IUI or IVF. If there are very few viable sperm a treatment called Intracytoplasmic Sperm Injection (ICSI) is used. In ICSI one healthy sperm is injected into an egg instead of the sperm trying to penetrate the shell of the egg. After 3-5 days of incubation the fertilized egg is then transferred into the womb using IVF. At some fertility agencies half of the IVF cycles involve ICSI. Of course, fertility services are expensive and not everyone can afford high end fertility interventions like IVF and ICSI.
While it is one way around the low sperm count dilemma for some lucky parents, it isn’t an answer for the population as a whole. Hopefully now that information about declining sperm count is out there, science will start looking into the causes so this trend can be reversed.