The specialty of male infertility is growing at a rapid pace. “The field is really interesting and there is always something new,” says Dr. Chris Schrepferman, a Louisville-based urologist. Several new developments come to mind:
There is new evidence that the male partner perhaps contributes to adult or childhood diseases in offspring but this can be overcome. “There are ways that people who have inherited diseases like fibrosis or Huntington’s disease can do fertility treatments that can assure them with 100 percent certainty that their offspring will not have those diseases,” says Schrepferman.
There is also increasing interest in sperm transplants, technically called a germ cell transplant, as a means of preserving fertility in young cancer patients and in offering fertility to the infertile. “There is interest in being able to harvest mature sperm, letting them have their chemotherapy and radiation, and then putting the mature sperm back and hoping it develops,” Schrepferman explains.
The amount of literature on semen quality and diet in general is scarce, but a new study from Harvard University shows that the intake of processed meat is associated with lower semen quality in men. The study also notes a positive association between male fertility and fish consumption; white meat fish, such as cod and halibut, are associated with a higher percentage of normal sperm. On the other hand, salmon, tuna and other dark meat fish are related to a higher overall sperm count.
Meanwhile, the Cleveland Clinic Center for Reproductive Medicine is currently evaluating oxidative stress-induced nuclear DNA damage and its effects on sperm quality and pregnancy outcome. Studies to understand how free radicals cause DNA damage and the possible methods to counteract them are currently being conducted. Right now they are evaluating the role of nutritional supplements in reducing oxidative stress in infertile men and increasing the number of successful pregnancies. The goal is to understand the underlying molecular mechanism of sperm dysfunction and recognize alteration in major proteins in men diagnosed with infertility. This way it will be possible to find potential biomarkers that can be used in the diagnosis of male infertility.
Surgical procedures are becoming easier and less painful to patients. “Advances in microsurgical techniques have let us be able to reconstruct the genital duct to allow more patients to have natural pregnancies, so there can be less in-vitro fertilization for certain patients and it is more affordable with a lower risk of multiple births,” says Schrepferman. He also performs vasectomy reversals with great success: “If someone has a vasectomy and wants to have children again, about 70 percent of them or the majority is managed with vasectomy reversal surgery.”
Male fertility is a small but growing specialty in the United States, so Schrepferman reminds both doctors and patients to consult with someone who has true expertise in this field so that they may take advantage of all that is on the horizon.
By Jamie Lober, Staff Writer