Source: Maria Mellor

Male infertility is going critically understudied despite worldwide declines in sperm count, according to a new report from Reuters. While more than half of infertility cases are a result of problems within the potential father, the majority of infertility solutions rely on treating the female and this has led to a very poor understanding of male reproductive health.

Infertility is a growing global problem, with an estimated 1 in 6 couples being affected. One of the factors in this gradual increase is a decreasing sperm count in men from the US, Europe, Australia, and New Zealand. In a study published last year, it was found that the average sperm count in men from these countries had decreased by more than 50% in fewer than 40 years.

At the same time, many of the investigations into infertility focus around female reproductive health instead of male health. Correspondingly, the most common infertility treatments (such as in vitro fertilisation and intracytoplasmic sperm injection) do not attempt to treat a male condition and avoid the problem instead by directly injecting the sperm into an egg. This lack of interest in male reproductive health has meant that we have a very poor understanding of the mechanisms behind male infertility; despite the intense decreases in sperm counts, the causes of this decline are not currently known.

When speaking with Reuters, Allan Pacey, PhD, Senior Lecturer in Andrology at Sheffield University, said that the techniques we use to analyse sperm haven’t changed since they were developed in the 1950s. As a result, the data we use to estimate infertility in men is more reliant on educated assumptions than on data collected in subject specific studies.

“The quality of evidence we have got in this area falls way behind that of other branches of medicine,” Dr Pacey said.

One of the reasons behind our lack of sperm research may be the cost commitment of long term studies. To identify a link between lifestyle factors such as smoking or obesity and sperm counts, researchers would need to follow a large number of participants over many years and this requires extensive grant support. As currently available infertility treatments already get around the problems of low sperm counts, some funding bodies may see such expensive research as superfluous.

Nonetheless, the report highlights the need for greater research in this area, in particular because it seems likely that the number of affected couples will grow other time.

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