Environmental and Nutritional Aspect in Male Infertility

Male and female partner of a couple must be standard and fit to have the capacity to procreate. Studies confirm that male sperm counts are declining and environmental factors as pesticides, exogenous estrogen, heavy metals negatively impact spermatogenesis without any obvious anatomical defects. So, a number of nutritional therapies have been shown to improve sperm count and motility as carnitine, arginine, zinc, selenium and vitamin B12. Numerous anitioxidants have prove beneficial in treating male infertility as Vitamin C, Vitamin E, Glutathione and Coenzyme Q10. This article aims to highlight the correction of nutritional imbalances to encourage optimum sperm production and function, when there is idiopathic impaired spermatogenesis. 1. Assistant Professor, Department of Obstetrics and Gynaecology, BSMMU, Dhaka 2. Consultant Surgery, Sadar Hospital, Narayanganj, Dhaka 3. Assistant Professor, Department of Obstetrics and Gynaecology, BSMMU, Dhaka Correspondence : Dr. Hamida Begum, Assistant Professor, Department of Obstetrics and Gynaecology, BSMMU, Dhaka syphilis. Chronic asymptomatic chlamydial infection is found in 28-71% of infertile men.1,5 Causes of declining sperm count: There is a growing body of scientific evidence that sperm parameters have declined considerably over the last 50 years, i.e., mean sperm density from 113 million/ml in 1950 to 56 million/ ml in 2000 (p<0.0001), volume decreased from an average of 3.40 ml to 2.7 ml (p=.027).6,7 This figure clearly showed a 20% drop in volume and 58% decline in sperm production over last 50 years. Three other recent reports also found semen quality has declined among donors over the last 20 years.8-10 These decline in sperm density is relatively recent, so we must suspect a combination of environmental, life style changes and nutritional or dietary factors may be interfering with spermatogenesis.11,12 Environmental Factors: The probable factor responsible for deteriorating sperm quality are i) Environmental risk factors as occupational exposure to various chemicals, heat (sperm production greatly reduces at temp>960F) ,radiation, heavy metals e.g. lead, mercury, exposure to environmental estrogens, pesticides5,11,12, ii) life style risk factors as cigarette smoking, alcohol consumption, chronic stress.13,14 iii) Nutritional deficiency as Vitamins E,C,B12, zinc, selenium and excessive intake of cottonseed oil which contain toxic pesticide residue and chemical gossypol which is toxic to sperm.14,15 . REVIEW ARTICLES J MEDICINE 2009; 10 : 16-19