Male Extinction

Good-bye males.  Brave New World, women only.





The infertility timebomb: Are men facing rapid extinction?


By Tamara Sturtz
Last updated at 8:19 AM on 10th May 2010
Daily Mail.co.uk


One in five men could suffer from fertility problems. And scientists have warned that it's just going to get worse...

There's a crisis brewing, but it has nothing to do with the economic deficit or the current political uncertainty. Scientists are warning that rising levels of male infertility have become so perilous that it is a serious 'public health issue'. And some go even further.

Professor Niels Skakkebaek, of the University of Copenhagen, describes the issue 'as important as global warming'. Last week, one science writer even suggested, in starkly terrifying terms, that if scientists from Mars were to study the male reproductive system, they would possibly conclude that man was destined for rapid extinction.

And if it continues, this trend could indicate men are on a path to becoming completely infertile within a few generations.

Reports claim that as many as one in five healthy young men between the ages of 18 and 25 produce abnormal sperm counts.


Only 5 to 15 per cent of their sperm is good enough to be classed as 'normal' under World Health organisation rules - proving that infertility is not just a female problem. Indeed, among those experiencing difficulty with conception, a male fertility problem is considered important in about 40 per cent of couples.

But women trying to get pregnant are facing another astonishing claim: that the core problems of male fertility - while they may be exacerbated by environmental issues - start in the womb.

'Sperm counts are declining and there is mounting evidence that the problem starts even before birth,' says Dr Gillian Lockwood, medical director of Midland Fertility Services.

She cites growing evidence that although the process of sperm production - known as spermatogenesis - starts in adolescence, the crucial preparations are made in the few months before and after birth.

Factors such as women eating a lot of beef during pregnancy - which means they have consumed a diet rich in polycyclic aromatic hydrocarbons (PAHs) that are potentially damaging chemicals - to the issue of obesity during pregnancy and a woman's exposure to smoke, pesticides, traffic fumes, plastics and even soya beans are all thought to have a bearing on a male foetus's future fertility.


Experts talk of a 'window' of testicular development that begins in the growing foetus and ends in the first six months of life. Problems in this period mean that the baby boy may never be able to produce babies of his own.

It's a theory that Karl Tonks, a clinical skills trainer, is particularly interested in. Karl, 47, and his teaching assistant wife Lorraine, 41, consider themselves among the lucky ones: they have two healthy children, despite Karl's low sperm count. Their twins Ben and Kira, now 12, were born as a result of arduous and expensive IVF.
 
Like many men, Karl was given no particular reason for his low sperm count. The news that it would be impossible for him to have a child came as a shock.


'We'd been trying for a baby since we got married. I had no idea there was a problem, and there was never a reason given. It was just one of those things.'

Was it, though? Karl admits that he always wondered if the fact that his mother took Thalidomide while pregnant with him could have had any influence on his infertility.

'My mother took Thalidomide for morning sickness. When the scandal broke in 1962, GPs offered free abortions, but my mother was too far gone by two weeks.'

Unlike the majority of Thalidomide babies, Karl was born seemingly healthy. But he has suffered from asthma since birth.

'Since the infertility was diagnosed, I started questioning whether there were underlying problems caused by the drug. My younger brother doesn't have any fertility problems. Nobody has done research into "normal" Thalidomide babies.'

Lorraine and Karl illustrate perfectly the toll that difficulties in conceiving can take on a marriage. Karl confesses that, so distraught were they - 'eight years of thinking of nothing else' is how he puts it - that at one stage he suggested they should divorce. But Lorraine says: 'I just couldn't even think of it.'

After a series of failed intracytoplasmic sperm injection (ICSI) attempts, where Karl's sperm was placed in Lorraine's uterus, the couple moved on to IVF.

The treatment involved intracytoplasmic sperm injection (ICSI), a procedure where a single sperm is injected into the egg. Even though a single healthy sperm could not be found, Karl was able to have testicular sperm extraction (TESE), which involves passing a needle into the testis to remove a piece of tissue, from which developing sperm were taken.

Incredibly, that resulted in eight fertilised embryos. In April 1998 their twins, Ben and Kira, were born. Their father drove down the street shouting: 'I'm a dad!'

Like Lorraine and Karl, Ed Farmer, 41, an IT specialist, and his wife, Rebecca, also 41, are still left guessing as to the causes of Ed's infertility.

'We were told that Ed had practically zero per cent sperm,' says Rebecca.

But after seven years of tests and treatment, they are no closer to knowing why.

'It was a terrible shock and desperately disappointing to be facing the possibility of IVF,' explains Ed.

Their fertility consultant recommended ICSI. Both Ed and Rebecca were 33, and their hopes were high, especially after several healthy sperm were retrieved using TESE.

'We believed our consultant when he said: "Let's make you a baby",' says Ed.

But treatment failed and they were told to consider using donor sperm. However, they went through two more cycles of treatment.

'We wanted to give it everything we could,' explains Ed. By this time, they were both 35.

'We had to make some major decisions', says Rebecca. It was putting a huge strain on their relationship, and they had withdrawn from their friends and family.

'We felt it was us against the world,' says Rebecca. 'We were so fed up of everyone around us having babies and not understanding what we were going through. Comments such as "At least you have a lovely husband and a nice house" weren't helpful. We even considered moving abroad.'

Rebecca threw herself into researching multiple IVF and ICSI failure on the internet, and concluded that not all clinics are the same.


Ed says: 'It was important for me to see an andrologist, somebody who specialises in male infertility. But they are not readily available in the UK.'

'We looked at it very rationally and were prepared to spend £15,000,' says Rebecca.

Research had been carried out in the U.S. in hormonal therapy for men with fertility problems. After remortgaging their home, Ed and Rebecca went to New York.

'I had the first proper examination throughout all our treatment,' says Ed.

He was put on Clomid, the hormone that women are given when they don't ovulate regularly, followed by ICSI. Although this created only one embryo, it resulted in the birth of their beautiful daughter, Ruby, now three.

Ed and Rebecca wanted a sibling for Ruby. After another cycle of treatment in New York, their twins, Tom and Rose, were born two days before Rebecca's 40th birthday.

Ed and Rebecca are very proud parents and thrilled that they defied the odds. But they are also angry.

' So many men are denied the opportunity to become biological fathers through an apparent lack of investigation into male infertility,' says Rebecca.

'We have met couples who have gone through many failed cycles of treatment at great financial and emotional cost, who have gone on to have "miracle babies" abroad, after being dismissed by UK clinics. It is so sad that the country that invented IVF should have failed to progress much beyond the expensive and impersonal production line of treatment that is currently on offer.'

Meanwhile, Lorraine and Karl Tonks are following the latest research with interest. It suggests that if their son Ben is to have fertility problems of his own, it may be too late to do anything about it. This concerns Karl.

'I worry that I may have passed my infertility on to my son. He has asthma, but as there are no adult ICSI children yet, we probably won't know for another few years.

'I will encourage him to get his fertility checked when he is old enough.'

Lorraine, however, points out that there are drawbacks to knowing too much, too soon.

'On the one hand, if we'd known earlier that there was no chance of us getting pregnant naturally, then we'd have saved a lot of time and heartache, seeking help sooner. On the other hand, can I honestly say that we would have ended up married had I known Karl couldn't have children? Who knows? It's very tricky.'

It will get even trickier as more efforts are made to unravel the mystery of male sperm production, a mystery to which 'Mother', whether she likes it or not, seems to hold the key.






















genetics