Twenty-six international experts including UdeM's Sarah Kimmins make 10 recommendations on how more men can become fathers and have healthy children.
Infertility now affects one in six couples of reproductive age, according to the World Health Organisation. And about half the time, it's the man who's infertile.
As male infertility is increasing worldwide, Université de Montréal professor Sarah Kimmins and 25 other international experts argue that men have a right to meaningful diagnoses and targeted treatments.
Unfortunately, in most cases, they're not getting them.
A lack of knowledge regarding the causes of male infertility, combined with limited clinical tools, has resulted in treatment for male infertility being female-focused, making women go through burdensome and risky invasive procedures.
In a report published today in the journal Nature Reviews Urology, the 26 scientists led by Moira O’Bryan, dean of science at the University of Melbourne, outline 10 recommendations they say could improve the health of men and their children, and decrease the burden on their female partners.
Kimmins, a researcher at the UdeM-affiliated CHUM Research Centre (CRCHUM), is the report's 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 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 impact men’s fertility.
“As it takes months to make sperm, men should consider adopting a healthy lifestyle well before planning their families,” said Jacquetta Trasler, one of the report’s co-authors and a senior scientist at the Research Institute of the McGill University Health Centre.
Urgent need for better diagnoses and treatment
The typical fertility clinic "is poorly equipped to properly diagnose and treat male reproduction – current methods are based on outdated techniques,” said another co-author, Géraldine Delbès, a researcher at Institut national de la recherche scientifique.
Men are now designated infertile based on family history, physical examination, hormone profiles and a simple semen analysis – techniques that haven't changed in over 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 Trasler.
A personalized medicine approach
Towards that goal, Kimmins and her team have spent years developing a better male fertility diagnostic. It's called HisTurn, and it's the first genomic diagnostic that offers a personalized medicine approach for male infertility.
While HisTurn is currently being clinically validated, it's hoped that its eventual use in fertility clinics will give men an accurate diagnosis that can better orient treatments, saving couples and clinics time and money while improving the treatments' efficiency and success rates.
“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," said O'Bryan.
"Research is needed to understand why, and how this trend can be reversed. Urgent, worldwide action to implement our recommendations is critical."
About this report
“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.