‘Why Nigerian men are battling low sperm production’

Poorly treated sexually transmitted infections, prolonged sitting around heat sources exposing the scrotum and testes to hot temperatures, smoking, and alcohol consumption are factors contributing to low sperm concentration in Nigerian men, experts have said.

They also identified obesity, marijuana use, some medications, diabetes, thyroid diseases and complications from surgeries or injuries as possible contributors to poor sperm production and sperm quality.

The experts explained that the problem of poor sperm concentration in men may go unnoticed until couples experience difficulty conceiving.

PUNCH Healthwise reports that the growing use of computers, digital tools and automated systems in Nigerian workplaces means more employees spend long hours seated, contributing to increasingly sedentary lifestyles among Nigerian workers.

Meanwhile, experts have linked sedentary lifestyles to different health problems.

Around 17.5 percent of the adult population – roughly one in six worldwide – experience infertility, according to a new World Health Organisation report.

Also, the Association for Fertility and Reproductive Health says there are about 12 million infertile persons in Nigeria, which is almost 10 percent of the total population.

With male factors contributing about 40% to 50% of all infertility cases among couples, experts are now raising concern about low sperm concentration in Nigeria.

Speaking exclusively to PUNCH Healthwise, a Professor of Obstetrics and Gynaecology at the University of Uyo, Akwa Ibom State, Aniekan Abasiattai, said factors affecting the production and transportation of sperm cells could reduce their quantity and quality, thereby affecting a man’s fertility.

He explained that sperm cells are produced in the testes and transported through tubes before being released through the penis during ejaculation.

According to him, sperm concentration refers to the number of sperm cells in a man’s semen, while motility is their ability to move actively.

Abasiattai said a man should have at least 15 million sperm cells per millilitre of semen, adding that a concentration below that level was classified as low sperm concentration.

“It is usually referred to as low sperm count, but the correct term is low sperm concentration. Also, about 50 per cent of the sperm cells are supposed to be active. When fewer than 50 per cent are active, that is what we refer to as low sperm motility. Motility means movement,” he said.

The don noted that evidence indicated a decline in the quantity and quality of sperm cells globally, particularly in developing countries, while the male contribution to infertility among couples was increasing.

He said, “There is clear evidence that the quantity and quality of sperm cells worldwide are declining, particularly in the developing world, including Africa and Nigeria.”

Abasiattai added that the male factor could account for as much as 40 per cent of cases in which couples experienced difficulty conceiving.

He explained that low sperm concentration did not necessarily mean that a man was producing fewer sperm cells, adding that the problem could also arise when the passage through which sperm cells travelled is affected.

“When a man has low sperm concentration, I usually like to classify the causes or contributing factors broadly into two. One is a problem with sperm production,” he said.

He added that any condition affecting sperm production or transportation could influence the number and quality of sperm cells released during ejaculation.

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On lifestyle and environmental factors, Abasiattai identified alcohol consumption, cigarette smoking and marijuana use as possible contributors to poor sperm parameters.

He also warned that excessive heat around the testes could interfere with sperm production, explaining that sperm cells require a temperature range of between 32 and 34 degrees Celsius to develop properly.

The consultant gynaecologist said long-distance drivers who sat for extended periods and wore tight clothing could be exposed to excessive heat around the testes, while conditions such as varicose veins and large inguinoscrotal hernias could also raise testicular temperature.

He further identified certain medications, including some used in treating hypertension, as possible causes of impaired sperm production, alongside medical conditions such as diabetes mellitus and thyroid diseases.

Abasiattai said surgeries and trauma could also affect sperm transportation, citing cases in which the spermatic cord of men was damaged during hernia operations performed by quacks.

However, he described poorly treated infections, particularly sexually transmitted infections, as a significant factor affecting male fertility in Nigeria.

He explained that infections such as urethritis could cause discharge from the opening of the penis and pain in the urethra, adding that some men failed to seek proper treatment.

The specialists said some patients resorted to buying mixtures of antibiotics from medicine dealers without completing appropriate treatment courses, potentially allowing infections to persist and damage the sperm-producing mechanism of the testes.

The don stressed that men with low sperm concentration might not experience any obvious symptoms, meaning the condition could remain undetected until a couple sought medical attention for difficulty conceiving.

“Usually, there are no signs. It is in the course of a couple experiencing a delay in achieving pregnancy or difficulty conceiving that the test is done and the diagnosis is made,” he said.

Abasiattai advised men experiencing fertility challenges to seek specialist care and undergo seminal fluid analysis, which helps determine the quantity and quality of sperm cells.

He said further investigations could include hormone tests to establish whether hormonal problems were affecting sperm production, as well as testicular ultrasound scans where conditions such as varicose veins were suspected.

The gynaecologist noted that treatment depended on the underlying cause, adding that advances in assisted conception, particularly in vitro fertilisation, had improved the management of infertility involving both men and women.

He explained that even in cases of azoospermia, where no sperm cells were found in a man’s ejaculate, medical procedures could sometimes be used to retrieve sperm directly from the testes for IVF.

Corroborating Abasiattai, a Consultant Obstetrician and Gynaecologist at the Federal Medical Centre, Abeokuta, Ogun State, Dr Olanrewaju Jimoh, also identified prolonged exposure to heat as a factor that could damage testicular tissue and suppress sperm production.

Jimoh advised men to avoid placing laptop computers directly on their laps or thighs because heat from the devices could expose the scrotum to elevated temperatures.

He also urged men whose jobs involved prolonged sitting around heat sources, particularly long-distance truck and trailer drivers, to take frequent breaks, stand up, and allow their bodies to cool down.

On medical care, the consultant gynaecologist recommended routine reproductive health evaluations, noting that previous testicular or pelvic infections, including mumps orchitis, tuberculosis, and sexually transmitted infections, could permanently affect testicular tissue or cause structural blockages.

Jimoh further advised men who had undergone pelvic or groin surgeries, including hernia repairs, to have their testicular function assessed because surgical scarring could sometimes affect sperm transportation or the blood supply to the testes.