1. Are cases of male infertility on the rise in India? What are the main reasons for this?
Ans. The cases of male infertility are on a rise in India. Around 30% of infertility cases are attributed to males and an additional 30% cases have both male and female factors for infertility. Smoking and drinking affect the sperm numbers and quality. Unhealthy lifestyles, lack of exercise and excessive stress are the other contributors to poor semen quality. Medical disorders like mumps, uncontrolled diabetes, psychiatric illnesses and anti-psychiatric treatment also affect male fertility. Tuberculosis, sexually transmitted diseases like chlamydia and gonorrhea can lead to obstruction of the tubes that connect to the testes. Some local conditions like hernia, hydrocele & varicocele can also impact male fertility.
2. Are cases of men facing infertility issues because of excessive exercise on the rise? What is the age group and social profile of these men?
Ans. There are cases of male infertility, but only a few of them can be attributed to excessive exercise. There are a few cases where men have been given supplements for body building which probably contain steroids. These men are usually young, highly educated and well-to-do, and very conscious about their bodies. They take anabolic steroids for muscle-building, totally ignoring the unending list of side effects of steroids on their fertility.
3. Men also take steroids to boost up muscles and build those six-packs. Does this trigger infertility? If yes, how?
Ans. Steroids play havoc with spermatogenesis. These steroids are used by professional body builders and recreational athletics. Usually, these steroids are used for long periods (about 4-12 weeks). They can affect the semen parameters drastically and cause male infertility. Erectile dysfunction, loss of libido, enlargement of breasts in males (gynaecomastia), depressed sperm count and quality and deranged liver functions are among the commonest side effects of steroids. Exogenous steroids cause low sperm count (oligozoospermia) or even zero sperms count (azoospermia) and reduce motility of sperms (asthenozoospermia).
4. How and why does excessive exercise cause infertility?
Ans. Exercise, especially endurance exercise, has many positive effects on the body in terms of cardiovascular health, but unfortunately, excess of everything is bad. Systems which are negatively affected by too much exercise are neuro-endocrine, which controls and regulates the reproductive functions. Chronic exposure to excessive endurance exercise training may lead to low basal male hormone and low testosterone levels. This eventually leads to disordered spermatogenesis (making of sperms). A term “exercise hypogonadal-male” has been coined for this condition. A lot of research is going on to delineate the exact mechanism for this.
5. Too much cycling is said to affect sperm production as well. How?
Ans. Cycling has been linked to an increase in infertility and erectile dysfunction due to wide range of repetitive trauma, but this has not been proved beyond doubt by research. Sufficient rest after training sessions for long-term low-to-intensive cycling training, however, is suggested. Bicycling for more than 5 hours per week has been linked to fertility issues. Erectile dysfunction, which is a problem of not getting an erection, has been reported in around 13-24% of bicyclists. Bicycle fit, improper seat type and other factors contribute to various urological and fertility problems associated with bicycling.
6. Does too much exercise enlarge the varicose veins in men? How does this lead to infertility?
Ans. Varicocele is the enlargement of veins in the loose bag of skin surrounding the testes. Varicocele causes low sperm production and affects sperm quality and motility. The risk factors include being overweight.
7. Are there specific intense exercises that affect fertility in men? If yes, what are these?
Ans. Endurance-type exercises, for e.g., marathons or long-distance running, may lead to reduced testosterone levels & high scrotal temperature, both affecting spermatogenesis. Bicycling for more than 5 hours / week has been associated with reduced semen quality.
8. What is the treatment for infertility caused due to excessive exercise?
Ans. Exercise induced infertility is fortunately reversible. However, other causes of infertility should be ruled out and treated according to the etiology cause.
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