A harmonious family is built by both spouses, yet infertility often casts a shadow of misfortune over many households. It is reported that the incidence of infertility in China is approximately 20%. Among infertile couples, male factors account for about 50% of cases, with isolated male factors alone representing a significant 30%. Consequently, male infertility is gaining increasing societal attention.This Saturday marks the 18th World Men's Health Day. On the 24th, the Reproductive Medicine Center of the Third Affiliated Hospital of Sun Yat-sen University launched a free consultation event titled "Focus on Male Reproductive Health and IVF Technology Awareness Week," actively providing patients with scientific knowledge and diagnostic consultations regarding male infertility.(Scene from the Third Affiliated Hospital of Sun Yat-sen University's "Focus on Male Reproductive Health" free clinic) Data indicates a significant decline in male fertility The World Health Organization's 2010 Fifth Edition of the WHO Manual on Human Semen Analysis and Processing shows a decline in all major semen parameters compared to the 1999 Fourth Edition. This signifies a continuous deterioration in semen quality—a key indicator of male fertility.
(Comparison table of WHO semen analysis data, 4th vs. 5th editions)
Dr. Li Xiaoming, attending physician in andrology at the Reproductive Medicine Center of the Third Affiliated Hospital of Sun Yat-sen University, explained in an interview with Public Health Network that comparing the 4th and 5th edition semen analysis data reveals:the reference lower limit for progressive motility sperm has been adjusted from 50% to 32%, and the reference lower limit for normal morphology sperm has significantly decreased from 15% to 4%. "This indicates that semen quality among men in the population has significantly declined, and male fertility is gradually decreasing."
High Temperatures and Prolonged Sitting: Sperm "Killers"
High temperatures and prolonged sitting negatively impact semen quality, emerging as two major factors contributing to male infertility.Dr. Li Xiaoming explained that normal sperm production within the testicles requires a temperature 2-3 degrees lower than normal body temperature to proceed smoothly. Elevated temperatures around the testicles disrupt normal spermatogenesis, and when temperatures exceed 38.5-39 degrees Celsius, testicular function is significantly impaired.
"The scrotum's uneven surface with numerous folds serves precisely to facilitate heat dissipation and lower testicular temperature," Dr. Li stated. Consequently, men engaged in prolonged high-temperature occupations—such as chefs working in hot kitchens—constitute a high-risk group for male infertility. Additionally, frequent hot spring soaks and sauna sessions can impair sperm production within the testes.
Prolonged sitting without exercise is another major cause of infertility among office workers and long-distance drivers. On one hand, sitting impairs the scrotum's heat dissipation function, raising local temperatures and disrupting spermatogenesis. On the other hand, prolonged sitting may also lead to urological conditions like prostatitis, affecting semen liquefaction.
Furthermore, excessive alcohol consumption is known to impair sperm development.Especially spirits with high alcohol content can impair sperm production and maturation, leading to reduced sperm quality. Frequent late nights are also a "fertility killer." They weaken immunity and disrupt endocrine function, causing spermatogenesis disorders that result in lower sperm count, reduced motility, increased abnormal rates, and higher DNA fragmentation.
Dr. Li advises that adopting healthy lifestyle habits is crucial for improving sperm quality, particularly for men preparing for conception. This includes ensuring adequate sleep, avoiding heavy drinking, quitting smoking, engaging in regular exercise, minimizing prolonged sitting, managing stress, and reducing exposure to high temperatures. Dietary choices should include zinc-rich foods like oysters and other seafood.(Dr. Li Xiaoming, Attending Physician in Andrology at the Reproductive Medicine Center of the Third Affiliated Hospital of Sun Yat-sen University, conducting a free clinic) Low semen volume may be linked to infertility According to the fifth edition of the WHO semen analysis guidelines mentioned earlier, a minimum volume of 1.5ml per ejaculation is currently a standard for assessing semen quality. Dr. Li clarified that this is based on a minimum abstinence period of two days prior to ejaculation.If the volume is less than 1.5ml, it likely indicates a problem with semen quality.
"If the volume is below 1.5ml, we first need to confirm whether the abstinence period reached two days. We also ask the patient if the entire semen sample was collected during the ejaculation."Dr. Li Xiaoming explained, "If these two factors are ruled out, further testing is needed to determine if the patient has oligospermia." Common causes of oligospermia include seminal vesicle hypoplasia and ejaculatory duct obstruction. The former may result from congenital developmental abnormalities or certain genetic anomalies, while the latter is often caused by prostatitis, urinary tract infections, or ejaculatory duct cysts.
However, Dr. Li emphasized that male infertility typically lacks obvious external signs, and semen appearance alone can only indicate a potential abnormality. Male infertility is defined as the failure to achieve pregnancy after one year of regular, unprotected intercourse between a couple of reproductive age, where the cause is attributable to the male partner.A routine urological examination is typically the first step in male infertility assessment. Semen analysis remains the most critical laboratory test for diagnosis. Patients with significantly reduced sperm counts require additional evaluation of testicular spermatogenesis through hormonal testing. When necessary, genetic investigations such as chromosomal karyotyping and Y chromosome microdeletion testing may also be performed.
Finally, Dr. Li Xiaoming emphasized that upon discovering male infertility, maintaining a positive mindset is crucial. Actively pursuing appropriate treatment and adopting a healthy lifestyle are essential for couples to build a fulfilling family together.