Semen analysis is traditionally used as part of male fertility assessments, but researchers from the University of Adelaide believe it has the potential to promote healthier lifestyles.
The development of mature sperm cells within the male reproductive organs is a highly sensitive process and can be influenced by various factors. Because of this, the University's School of Biomedicine and Robinson Research Institute's Dr Hannah Lyons and Dr Nicole McPherson believe it could be used to predict long-term health risks.
A traditional analysis measures characteristics including physical volume, pH, sperm concentration, movement, form and viability of sperm samples.
"While not a definitive measure of fertility, the analysis offers a valuable insight into reproductive health, which is an important component of overall health and wellbeing," says Dr McPherson, from the Male Reproductive Life Course Group with the Robinson Research Institute and the Freemasons Centre for Male Health and Wellbeing.
The review, published in the journal Nature Reviews Urology, explores the complexities of male fertility, susceptibility of semen to lifestyle and environmental factors and how the analysis might be used to motivate lifestyle changes and reduce chronic disease risk in men.
"Male fertility is highly influenced by environmental, lifestyle and medical factors, with evidence showing both short-term and long-term interventions like nutritional supplementation and lifestyle changes can improve semen quality and fertility potential," says Dr McPherson.
"Over time, there's been a shift towards men being more involved in the pre-conception and pregnancy journey."
Increased sedentary behaviours as well as technological and medical advances have all led to changes in general life, and in some instances increased prevalence of obesity, chronic exposure to dangerous chemicals, increased prevalence of cancers and chronic diseases which are all associated with male-factor infertility.
"We know changes to the internal environment because of external environmental and lifestyle exposures at any stage of sperm development can result in disrupted production and alterations to semen quality," says Ms Lyons.
"Obesity is associated with a reduction in basic sperm parameters, like concentration, motility, morphology, and increased frequency of infertility.
"It's also linked to an increased risk of cardiovascular disease, and complications of obesity like metabolic syndrome and sleep apnoea can also have an impact on sperm quality too.
"Recreational drug use, high-intensity prolonged exercise, heavy smoking, and drinking can also have an impact."
But, Dr McPherson said, improving lifestyle factors where possible can result in fast and meaningful improvements to a man's reproductive health.
"We do need to be mindful however, that while men are becoming more interested in knowing about their reproductive health, receiving the news of an abnormal semen analysis can be quite traumatic and men usually perceive this news as a profound failure of masculinity, which is often accompanied by overwhelming feelings of guilt and shame," she said.
"It is important that the delivery of this news is met with empathy and respect, and this may help motivate men to initiate lifestyle changes to improve not only their fertility but general health.
"An abnormal semen analysis result is likely to inspire further fertility assessment and delivery of care options by primary care providers but could also be an opportunity for further general health assessment to identify the underlying cause of the poor semen analysis results and catch the beginnings of chronic diseases earlier.
"Incorporating male fertility as an integral part of a broad assessment of male health could change the narrative on how male reproductive health is perceived, increase awareness around its predictions about healthier living and reduce the overall stigma around male infertility.
"Men wanting to start a family are highly motivated and respond well to preconception care advice and lifestyle intervention to improve fertility but also overall health."
