Male reproductive health is in crisis. Recent evidence of declining sperm counts and increasing male reproductive-system abnormalities reveals that this is a global problem that is rapidly worsening. In many parts of the world, fertility rates have hit rock bottom and the rise in male factor infertility is almost certainly part of the cause.
Do we know what’s driving this problem? Not really. There are a lot of theories, and most likely there are multiple factors contributing to the problem, but we don’t yet have a smoking gun. This lack of understanding can be partly attributed to limited healthcare policies, diminishing research funding, and extremely underdeveloped societal awareness and education.
Enter the Male Reproductive Health Initiative (MRHI); a newly established consortium of globally renown key opinion leaders across research, medicine, funding, and policy agencies who are pushing male reproductive health to the top of the political and public health agenda.
MRHI seeks to raise the awareness of society, policy and funding agencies, and others around four main issues:
- The significance of male reproductive health
- The connection with overall male health and illness
- The role the male has in the health and wellness of his offspring and the next generation, and
- The significant burden that is currently carried by his female partner when seeking diagnosis and treatment for infertility.
In addition, the MRHI aims to increase the participation of men in seeking healthcare, as well as advocate to invigorate policy and funding agencies to support increased research into male reproductive biology.
The MRHI is spearheaded by Dr. Chris De Jonge and Dr. Chris Barratt, two world-renowned andrologists who serve on the World Health Organization (WHO) task force for male fertility. In the course of helping the WHO revise its clinical guidelines for the diagnosis of male infertility, the pair identified several fundamental aspects of men’s reproductive health that still lack sufficient knowledge and data upon which clinical decisions can be made. They have published their findings and recommendations for improving the scientific landscape recently in the journals Human Reproduction and Andrology.
Why should we care? As men, having a poor reproductive health profile not only results in greater healthcare costs but also places the burden of infertility treatment solely on women. Therefore the consequences our lifestyle choices extend beyond just us: men’s health is just as much an issue affecting women’s health as well as the health of our future children.
One such choice in particular is the father’s age-at-conception. Researchers have linked spermatozoa from advanced-paternal-age fathers to increased risk of adverse perinatal effects, including early child mortality, cancer, autism and schizophrenia. This may sound daunting, but the harsh realities remain; the sperm epigenome is uniquely complex and susceptible to environmentally associated modification. High paternal-age, smoking, obesity and pollution (just to name a few), are factors that can artificially age a man’s spermatozoa which will consequently impact the gestating foetus, neonate and child. If action is not taken regarding more routine male reproductive health assessments and lifestyle guidance, then men will continue to die young, suffer with chronic disease and will unwittingly continue to pass down genomic mutations to future generations. By coming together, raising awareness and reducing the toxic masculinity and stigma surrounding infertility we will be able to bridge the gender gap in current healthcare policies and enjoy a much more gender-inclusive reproductive health ecosystem, where male reproductive biology is equally as well researched and funded as female reproductive biology is today.
Dr. De Jonge and Dr. Barratt elegantly state the urgency in this matter in their recent opinion piece in the journal Andrology:
If action is not taken, and swiftly, then men will continue to die younger, suffer longer with chronic disease and will, unwittingly, continue to pass their potentially altered genomic and epigenomic signatures to future generations. Men’s health is global community health!”
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