Worldwide fertility crisis: Why men really need a hand from science

Montreal, October 13, 2023—Infertility now affects one in six couples of reproductive age according to the World Health Organisation. About half the time, it originates from men. As male infertility is increasing worldwide, researcher Sarah Kimmins and 25 international experts highlights that men have a right to meaningful diagnoses and targeted treatments.

Unfortunately, these are currently unavailable in most cases.

The lack of knowledge regarding the causes of male infertility and in combination with limited clinical tools, has resulted in female focussed treatment—burdensome and risky invasive procedures—for male infertility.

In a consensus report published in the journal Nature Reviews Urology, the consortium of 25 scientists led by Moira O’Bryan, Dean of Science at the University of Melbourne, reveal 10 recommendations that could improve the health of men and their children, and decrease the burden on their female partners.

Université de Montréal Professor Sarah Kimmins, a researcher at the CHUM Research Centre (CRCHUM), weighs in the report as the first author and a world-leading expert in male fertility and gene-environment interactions.

Lifestyle and Environment Play a Key Role

“The rapid decline in male fertility cannot be explained by genetics, and studies indicate that environmental factors are a driving force, said Sarah Kimmins. These include increased exposure to hormone-disrupting chemicals that exist in our daily lives and persist in the environment.”

“Other factors include the rise in overweight and obese men, poor diet, stress, cannabis use, alcohol and smoking or vaping. Unfortunately, men are generally unaware of these factors.”

One of the key recommendations of the report is to increase public awareness through public health campaigns around these lifestyle choices that are hazards to men’s fertility.

“As it takes months to make sperm, men should consider adopting a healthy lifestyle well before planning their families,” said Dr. Jacquetta Trasler, study’s co-author and senior scientist at the Research Institute of the McGill University Health Centre.

Urgent Need for Better Diagnoses and Treatment

“The clinic is poorly equipped to properly diagnose and treat male reproduction. Current methods are based on outdated techniques,” said Géraldine Delbès, study’s co-author and researcher at Institut national de la recherche scientifique.

Men are currently designated infertile based on family history, physical examination, hormone profiles and a simple semen analysis that has not changed for more than 50 years.

“As health professionals, going forward, we need more funding of research that will allow us to offer men sensitive and accurate tests of sperm health,” said Dr. Trasler.

A Personalized Medicine Approach

Towards that goal Sarah Kimmins and her team have devoted years of research to develop a better male fertility diagnostic.

Aptly named HisTurn, it will be the first genomic diagnostic that offers a personalized medicine approach for male infertility.

While HisTurn is currently being clinically validated the goal is that it’s eventual use in fertility clinics will give men an accurate diagnosis that can better guide treatment, saving couples and clinics time and money, while improving the efficiency and success rates of fertility treatment.

“Decreasing semen quality and increasing frequency of testicular cancer and congenital defects in the urogenital system indicate that, globally, male reproductive health has declined over recent decades. Research is needed to understand why, and how this trend can be reversed. Urgent, worldwide action to implement our recommendations is critical,” states Moira O’Bryan.

Science writing: Bruno Geoffroy

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About the 10 recommendations

1. Governments, healthcare systems, insurance companies, and the public should understand and acknowledge that male infertility is a common, serious medical condition and patients have a right to meaningful diagnoses and targeted treatments;
2. Establish a global network of registries and biobanks containing standardized clinical and lifestyle information, and tissue from fertile and infertile men, their partners, and children. Link it to national healthcare data systems;
3. Implement protocols and incentives to standardize collection of de-identified tissue and clinical/lifestyle data;
4. Fund more international, collaborative research to understand the interactions and impacts of genetic, lifestyle, and environmental factors on male fertility in diverse populations;
5. Integrate genomic sequencing into diagnosis of male infertility;  
6. Develop additional diagnostic tests to improve diagnosis and cause of male infertility. 
7. Rigorously test the impact on male fertility of compounds—especially endocrine-disrupting chemicals—in products, the workplace, and the environment. Implement regulations and policies and develop safe alternatives;
8. Rigorously test strategies for medically assisted reproduction before they are integrated into clinical practice;
9. Public education campaigns to promote discussion of male infertility and engagement in health seeking;
10. Improved training for healthcare workers to promote male reproductive health across the lifespan. 

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About the study

“Frequency, morbidity and equity—the case for increased research on male fertility,” by Sarah Kimmins et al., was published online Oct. 12, 2023, in Nature Reviews Urology.

The paper’s 26 authors are world leaders in andrology, gynaecology, urology, cellular biology, endocrinology, environmental hazards, pathology, reproductive medicine, medically assisted reproduction, oncology, genetics, paediatrics, pharmacology, and therapeutics.

About the CRCHUM

The CHUM Research Centre (CRCHUM) is one of North America’s leading hospital research centres. It strives to improve the health of adults through a continuum of research spanning disciplines such as basic science, clinical research and population health. More than 2,150 people work at the CRCHUM, including nearly 500 researchers and nearly 650 students and postdoctoral fellows. crchum.com

About Université de Montréal

Deeply rooted in Montréal and dedicated to its international mission, Université de Montréal is one of the top universities in the French-speaking world. Founded in 1878, Université de Montréal today has 13 faculties and schools, and together with its two affiliated schools, HEC Montréal and Polytechnique Montréal, constitutes the largest centre of higher education and research in Quebec and one of the major centres in North America. It brings together 2,300 professors and researchers and has close to 67,000 students. umontreal.ca