Abu Dhabi, UAEFriday 6 December 2019

Men unaware of lifestyle-related fertility risk, say UAE doctors

Doctors say obesity and smoking are key factors in increase in those who struggle to start families

Pankaj Shrivastav, director of Conceive Gynaecology and Fertility Hospital in Dubai and Sharjah. Satish Kumar / The National
Pankaj Shrivastav, director of Conceive Gynaecology and Fertility Hospital in Dubai and Sharjah. Satish Kumar / The National

Men wishing to have children must avoid damaging lifestyles that limit their chances of conception, say experts.

Sperm counts are on the decline globally, according to UAE doctors who say they are treating more infertile men than ever.

Obesity is one of the main factors, but radiation from work environments, smoking and sitting down for long periods are also affecting reproductive health.

A trend towards steroid use in gyms is also having a damaging effect on sperm quality, the experts said.

“I’m not convinced male infertility is more of an issue here than elsewhere, but we are seeing more incidence of male infertility and suboptimal sperm motility in our clinics,” said Dr Pankaj Shrivastav, director of Conceive Gynaecology and Fertility Hospital in Dubai and Sharjah.

“Men are more aware of their own fertility today but they would rather take three months of hormone injections than cut down on their smoking.”

Men who smoke have decreased sperm concentration, and their sperm has increased DNA damage, reduced motility (swimming ability) and is less likely to be shaped normally than that of nonsmokers. Despite the decrease of tobacco smoking in the UAE, a growing trend towards e-cigarettes is unlikely to halt the decline in fertility, doctors said.

Dr Shrivastav said switching to e-cigarettes is also damaging to sperm.

“Smoking and alcohol remain a major issue in fertility, but we are seeing new trends like steroid use, and increased shisha and medwahk consumption that also destroys sperm,” he said.

“Men need to understand the damage they are doing.

“Some people think e-cigarettes are a better alternative, but they still deliver nicotine that has a severe impact on sperm production.”

The quality of a nation’s anti-tobacco policies are graded by the World Health Organisation, and include economic measures and health interventions such as antismoking programmes. A top A rating is offered to nations with the most stringent antismoking policies, with the UAE categorised as a C nation in 2017.

The WHO reports about 8 per cent of couples in C-category countries experience infertility, compared with about 10 to 15 per cent in industrialised nations.

Male infertility is recorded in between 30 to 35 per cent of all cases.

Temperature and radiation exposure can also hinder sperm production and is responsible for about half of male infertility cases seen by Dr Muthanna Alrawi, a consultant urologist at Canadian Specialist Hospital, Dubai.

“Men who I see often assume their wives are infertile and the reason why they have not conceived,” he said.

“They are often surprised when I ask if they have been checked too. It is important to ensure we offer the correct treatment.” In his 12 years working with infertile patients, Dr Alrawi has seen increasing numbers of men presenting with low sperm quality. His findings lend weight to the discussion over the impact of modern lifestyles.

“It is important for men to know we can harvest sperm and improve its quality, even in men who produce a very low sperm count,” he said.

“There are treatments available, so men affected should not give up hope.

“Every three months there is a new generation of sperm. The testicles are like a factory, so things can always improve in most cases.”

Cases can be managed with a minimally invasive procedure, using microscopic testicular sperm extraction.

Patients are also put on a hormone treatment plan to increase testosterone levels to improve their sperm production.

It can help improve the quality of sperm to make them stronger and more likely to be effective in fertility.

The procedure costs about Dh10,000, but is not typically covered by health insurance.

Sperm extracted can be frozen and used for in vitro fertilisation.

“It is a problem in the UAE that male infertility is not covered by health insurance, as it can be an expensive process,” Dr Alrawi said.

“Lifestyle, living environment and basic genetics play an important role in sperm production, especially on their motility.

“Smoking is damaging to sperm and one of the more common reasons for infertility in men in this region.”

Updated: July 6, 2019 07:42 PM