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For most men who suffer from infertility due to a low sperm count, the damage was done while they were still in the womb (stock image)

Men who try for paternity get a wealth of lifestyle advice on how to best stimulate fertility – wear loose-fitting underwear, avoid hot baths, sleep well and stay away from junk food.

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It is advice supported by research – including a study in June, led by Harvard University in the US, which found that men (the average age was 19) who ate the most red and processed meats, sugary drinks, and starchy carbohydrates lowest average had sperm counts. On average, these were 25.6 million lower than those who ate the least processed food. (A count of 39 million sperm is normally seen as the minimum required to become pregnant naturally.)

Scientists are now discovering a much more worrying truth. It seems that for most men who suffer from infertility due to a low sperm count, the damage was done decades before – while they were still in the womb.

For most men who suffer from infertility due to a low sperm count, the damage was done while they were still in the womb (stock image)

For most men who suffer from infertility due to a low sperm count, the damage was done while they were still in the womb (stock image)

There is increasing evidence that the delicate processes involved in the formation of their reproductive organs can be disrupted in the first months of pregnancy, causing damage that could harm their chances of becoming a father. In addition, new studies suggest that this not only leads to a decrease in sperm count, but also to a considerably higher risk for men for serious diseases such as cardiovascular disease and later cancer.

Male fertility is clearly in a crisis. An extensive overview of evidence in 2017, based on 7,500 studies, shows that the number of sperm cells among Western men has more than halved in the last 40 years. The authors of the review, from the Hebrew University of Jerusalem in the magazine Human Reproduction Update, warned that the decline & # 39; no evidence of reduction & # 39; demonstrates.

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In the UK, about one in ten men of all ages suffer from infertility (defined as a failed attempt to try a year or more pregnancy), according to research from the London School of Hygiene and Tropical Medicine published in the journal Human Reproduction in 2016.

Other studies indicate that as many as one in five men younger than 35 have a low sperm count.

British infertility experts are now starting to investigate the root causes of this 21st-century plague. Already much of the evidence points to chemical pollutants in the air, water and soil around us as the main culprit.

There are also indications that parents' lifestyle prior to conception can affect the health of their children and even their fertility, and that the problems can be passed on through the sperm or eggs of the parents due to changes in DNA (known as epigenetic changes).

Other studies indicate that no fewer than one in five men under 35 have a low sperm count (stock image)

Other studies indicate that no fewer than one in five men under 35 have a low sperm count (stock image)

Other studies indicate that no fewer than one in five men under 35 have a low sperm count (stock image)

BORN INFERTILE TO GROW?

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Today, scientists are starting to discover how the physical damage caused by these environmental factors or epigenetic changes can begin to develop in the womb.

A leading researcher is Alastair Sutcliffe, professor of general pediatrics at University College London, who studies data from more than 200,000 men in the possession of the Human Fertilization and Embryology Authority. He believes there is a problem of prenatal genetic damage that underlies male infertility.

"Lifestyle will inevitably have some influence on your fertility," he says. & # 39; But I think most problems with these men probably go back to their time in their mother's womb. For whatever reason, they didn't have the right conditions there. & # 39;

This can also have consequences for their health.

& # 39; Between 10 and 15 percent of the male genome (the complete set of a man's DNA) is involved in reproduction & # 39 ;, says Professor Sutcliffe.

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"If you have a problem with the reproductive side of your genome, that's probably a window on what happens to the entire genome of an individual, so infertile men may have other health problems driven by problem genes."

There is indeed evidence that early DNA damage to infertility links to the subsequent serious illnesses of men. For example, last month, a study in the British Medical Journal reported that men with fertility problems later in life run a much higher risk of prostate cancer.

The study of more than 1.2 million men by researchers from the University of Lund in Sweden showed that men who became fathers through fertility treatment (IVF or injection of sperm directly into the egg) were much more likely to develop prostate cancer then men whose children were naturally conceived.

NUMBERS

  • Male sperm cells have more than halved in the last 40 years.
  • In 1973, the average number of sperm in western men was 337.5 million per ejaculate, but by 2011 it had fallen to 137.5 million, according to a review published in 2017 in the journal Human Reproduction Update.

Infertility A RED FLAG FOR DISEASE

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Professor Sutcliffe believes that the risk of diseases such as testicular and prostate cancer in the womb can be caused by the same genetic problems that make men infertile.

He explains: "Testicular cancer is an embryonic cancer – meaning it is precipitated during development in the womb. But it will wait until puberty starts to develop.

"The risk was written in the womb very early. Something similar can be true with prostate cancer. & # 39;

As a result, Professor Sutcliffe believes that we & # 39; an obligation & # 39; have to screen men for conditions such as prostate cancer in fertility clinics if it appears that they have a low sperm count. "If their risk of prostate cancer is higher and we can treat their problems before they get serious, we should look for them."

This finding is only one of a growing number of studies linking low sperm counts in men in their 20s and 30s to serious illness in later life.

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In March, researchers from the Johns Hopkins University School of Medicine at Baltimore in the US reported that men with infertility also have a significantly increased risk of non-alcoholic liver fat (NAFLD) – an accumulation of fat in the liver can lead to serious liver damage.

NAFLD is associated with a high risk of other serious conditions such as type 2 diabetes and kidney disease, and is associated with a poor diet, lack of exercise and weight gain.

But it is also possible that some men are born more sensitive than others. The American researchers suggest that male infertility and NAFLD can be caused by the same underlying physiological problems.

Another study by 60,000 infertile men last August, by British and American scientists, found that those who had undergone vasectomies are at greater risk of high blood pressure and heart disease compared to those who had not.

This comparison indicates that low or non-existent sperm counts are not in themselves the cause of men's cardiovascular dangers.

The link between infertility and subsequent poor health has become compellingly powerful, Christopher Barratt, a fertility researcher and professor of reproductive medicine at Dundee University, told Good Health.

"We have looked at infertility for a long time, but only recently have we focused more on general health," he says. "The data on this is getting stronger and suggests that if you have sperm problems, you are likely to have more health problems and a higher risk of premature death."

MED DIET AND EXERCISE GET ME THE RIGHT WAY

Tony Suckling, 39, car salesman, lives in North West London with Melanie, his seven-year-old wife.

Tony Suckling, 39, lives with his seven-year-old wife in North West London

Tony Suckling, 39, lives with his seven-year-old wife in North West London

Tony Suckling, 39, lives with his seven-year-old wife in North West London

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When I discovered that I had poor sperm quality, I was destroyed. We started trying to conceive in 2015, but after a year nothing had happened so the doctor arranged a sperm analysis test.

The normal number of sperm is 15 million to more than 200 million; mine was only 0.5 million and they had an abnormal shape. I felt less like a man and am still very upset now.

I decided to become healthier to see if that helped. I gave up alcohol, takeaway meals and processed food, started exercising three times a week and took pre-conception multivitamins. But in early 2017, another test showed no improvement.

At the suggestion of our doctor, we paid £ 15,000 for one Intracytoplasmic Sperm Injection (ICSI) cycle, where a single sperm is injected into an egg. Two embryos were implanted but failed. We were deeply sad. In 2018, another attempt ended in the same way.

We then saw a nutritionist and a urologist, Jonathan Ramsay, conducting more detailed tests. They discovered that my sperm had a high degree of DNA fragmentation – a sign of subfertility.

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The nutritionist has given us both a gluten-free Mediterranean diet and I take a high concentration of fish oil and a bag of vitamins. The nutritionist also did not recommend products that are supplied in plastic.

In April we invented for the first time naturally, a great surprise. Unfortunately, my wife suffered a miscarriage after eight weeks, which was devastating. A test showed that my sperm count had increased to 17 million and it showed less DNA fragmentation.

We are still trying to become pregnant naturally, but we are not excluding more IVF.

I have sometimes been in a very dark place and only recently have I been able to tell friends about the pain we are experiencing.

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Mr. Suckling said: & # 39; We first started getting pregnant in 2015, but after a year nothing had happened, so the doctor arranged a sperm analysis test & # 39;

HOW WAS PREVIOUS ADVICE?

what should be done with all the advice for men about protecting their fertility by taking precautions such as wearing loose underpants (to prevent overheated testicles killing sperm), removing junk food, and so on?

Allan Pacey, professor of andrology at the University of Sheffield, and the UK's main commentator on male fertility, says that advice can still play a crucial role for some men – but we also have to face that prenatal development now appears play important role in determining male fertility.

Early pregnancy is known to be a vulnerable period for the healthy development of male reproductive organs. Exposure to plastic is involved (see right) and the stress levels of mothers have come to the attention.

In May, an Australian study of 643 20-year-old men in the journal Human Reproduction warned that men whose mothers had had three or more stressful life events in the first 18 weeks of pregnancy had on average 38 percent less sperm than adults.

Professor Pacey told Good Health: "I think the biggest factor is what happens before a man was born – regarding how his testicles were developed. This is determined by how well that first trimester of pregnancy went for him.

"How that pregnancy manifested in a man is determined by the size of his testicles, because that is a consequence of how they developed in the womb. If you have larger testicles, you produce more sperm – and the greater the chance that they will produce a baby.

"If your testicles are small, that's probably a problem."

Professor Pacey says that clinics can precisely measure the size of the testicle, but adds: "For people at home, it is best to measure the testicle in the scrotum against a lychee. This size is approximately the minimum volume required for help without fertility. Slightly smaller can cause problems. & # 39;

The significance of this is that & # 39; for men who are looking for a family in their late 20s and early 30s, their fertility is almost completely set & he says.

"The major problem that is not being published is that it has not been proven that lifestyle changes make a difference to actually becoming a father to children. If they make a difference, it is relatively small. & # 39;

He explains honestly: "The only thing men can do with lifestyle changes is to protect and promote the testicular function with which they were born. It is about risk reduction.

& # 39; If you have small testicles, your risk of infertility is greater and you have more risk of protecting yourself against it. For example, a 10 percent reduction in testicular efficiency will have a much greater fertility effect on a man with small testicles than a man with large.

& # 39; On the other hand, if men adopt good health habits, it can help their health later in life. & # 39;

So although & # 39; take care of your swimmers & # 39; can appeal to the natural desire of men to protect their fertility, it can also help to keep them healthier in old age. And where is the evil in it?

IS PLASTIC POLLUTION TO DEBTS?

British experts blame the male fertility crisis on boys who suffer developmental damage in their mother's womb – and blame chemical pollutants in our environment.

Phthalates are considered a major culprit. These are added to plastics to increase their durability and have become ubiquitous.

In 2015, Shanna Swan, a professor of reproductive epidemiology at the Icahn School of Medicine at Mount Sinai, New York, discovered that mothers with high blood phthalate levels in the first trimester of pregnancy were much more likely to have sons with significantly reduced anogenital distance (AGD) – measured between the anus and the bottom of the scrotum.

The researchers, written in the journal Human Reproduction, said that a shorter distance is linked to low sperm counts later in life.

Phthalates are added to plastics to increase their durability and have become ubiquitous (stock image)

Phthalates are added to plastics to increase their durability and have become ubiquitous (stock image)

Phthalates are added to plastics to increase their durability and have become ubiquitous (stock image)

In another study, last year, midwives at the University of Western Australia compared the fertility of 900 men aged 20-22 with data from their mother's blood samples when they were pregnant.

Men whose mothers had many phthalates between the 18th and 34th weeks of pregnancy usually had small testicles and subsequently a low sperm count, the researchers reported in the journal Frontiers In Endocrinology.

Another important pollutant appears to be perfluorooctane sulfonic acid (PFOS), used as a stain repellent and used to be an important ingredient in substance protectors. It is called "forever chemical" because it will be present in the environment for decades, often in drinking water.

According to a study, common painkillers during pregnancy can also influence the future fertility of a baby boy (stock image)

According to a study, common painkillers during pregnancy can also influence the future fertility of a baby boy (stock image)

According to a study, common painkillers during pregnancy can also influence the future fertility of a baby boy (stock image)

Studies in mice (reported in 2017 in the journal Environmental Science & Technology) have shown that pregnant women who were exposed to low doses of PFOS gave birth to male puppies that grew up with low sperm counts and testosterone.

Common painkillers used during pregnancy can also affect the future fertility of a baby boy, according to a study last year led by Dr. Rod Mitchell, a pediatric endocrinologist consultant at the University of Edinburgh.

When samples of human fetal testicles were exposed to paracetamol and ibuprofen for a week, there were 25 percent fewer testicular germ cells – the cells that give rise to sperm.

The study also tested the effects of painkillers on mice with human fetal testicular tissue grafts. After a day of treatment with paracetamol, the number of sperm-producing cells had fallen by 17 percent. After a week there were almost a third fewer cells.

For a better note, a study in the journal Scientific Reports last month suggests that taking folic acid during pregnancy can help protect baby boys from testicular damage caused by environmental pollutants.

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