Discovery That Infertile Men Produce Healthy Sperm Reveals Key to Treatment

Sperm are healthy when they're born, but not after they're ejaculated.

Sarah Calvert / University of Sheffield

Historically research in the field of infertility has placed a disproportionate emphasis on the female side of reproduction. That began to change several years ago when something became abundantly clear: There is something wrong with the state of sperm. This sense of alarm grew in 2017 with the publication of a landmark study that said the sperm count in Western men has dropped by 50 percent since 1973.

To keep humankind from succumbing to an “infertility crisis,” public health officials called on scientists to boost our collective knowledge of male infertility. In response, United Kingdom-based scientists have announced a potentially revelatory sperm finding: Saturday at the European Association of Urology Congress, a team presented findings that indicate the sperm taken from the testicles of infertile men are just as a good as the sperm from fertile men.

It’s a new way of thinking about infertility: Concerns often focus on the quality of sperm produced by men scientifically deemed infertile. Experts believe that in all fertility cases, approximately 40 to 50 percent is due to the “male factor.” That could be low sperm concentrations, poor sperm motility, or abnormal morphology.

What this new research brings to the table is the idea that it’s not the sperm itself that’s integrally flawed. It’s more of an issue with the journey it takes from the testicles towards ejaculation.

In the study, which is not yet published or peer reviewed, the scientists examined testicular sperm samples and ejaculated sperm samples belonging to 63 infertile men and 76 fertile men. The infertile men had previously failed a number of fertility treatments.

When the scientists examined all sperm samples for DNA damage, they found that when it came to ejaculated sperm, the sperm DNA damage was much higher in infertile men: 15 percent of fertile men had damage, while the same was true for 40 percent of infertile men. But when they examined the testicular sperm, all of the sperm cells were of similar quality.

Here are some sperm.

Flickr / Iqbal Osman1

“What this means is that the DNA in sperm from the testicles of infertile men are better quality than sperm from their ejaculates,” announced Sheena Lewis, Ph.D., an emeritus professor at Queens University Belfast, on Saturday. “This opens the way to taking sperm directly from the testes of men who have highly fragmented ejaculated DNA and failed cycles of treatment and trying to achieve fertility with these testicular sperms.”

Lewis and her colleagues suspect that the majority of DNA damaged caused by the transit from testicles to ejaculation is caused by oxidative stress, which causes single DNA strands to break but not double-strand breaks. While they can’t yet prove that the sperm damage seen is here is the main cause of fertility — and it’s just a hypothesis that using testicular sperm directly could help improve the chances of pregnancy — they do have some leads on what may cause the oxidative stress. Previous studies indicate that poor diets, smoking, and “sitting at a laptop all day” contribute to oxidative stress, as well as serious diseases like Type 2 Diabetes and Crohn’s disease.

As of now, ejaculated sperm is used in fertility treatments. This study suggests that sperm from the testicles acquired via a biopsy could be the ticket. Further research is needed before men can ask for this, but it’s a step in the right direction. The field of male infertility research is still considered to be lacking in high quality, large-scale studies. Meanwhile, sperm doesn’t seem to be becoming any healthier across populations, and scientists agree that the continuous decline is cause for concern.

Related Tags