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Abstract
Objective: To examine the potential effects of lifestyle factors on male reproductive health. Evidence of a global decline in human sperm quality over recent decades has been accumulating. Environmental, occupational, and modifiable lifestyle factors may contribute to this decline. This review focuses on key lifestyle factors that are associated with male infertility such as smoking cigarettes, alcohol intake, use of illicit drugs, obesity, psychological stress, advanced paternal age, dietary practices, and coffee consumption. Other factors such as testicular heat stress, intense cycling training, lack of sleep and exposure to electromagnetic radiation from mobile phone use are briefly discussed.
Materials and method: A comprehensive literature search was performed to identify and synthesise all relevant information, mainly from within the last decade, on the major lifestyle factors associated with male infertility and semen quality. Database searches were limited to reports published in English only. A manual search of bibliographies of the reports retrieved was conducted to identify additional relevant articles.
Results: In all, 1012 articles were identified from the database search and after reviewing the titles and abstract of the reports, 104 articles met the inclusion criteria. Of these, 30 reports were excluded as the full-text could not be retrieved and the abstract did not have relevant data. The remaining 74 reports were reviewed for data on association between a particular lifestyle factor and male infertility and were included in the present review.
Conclusion: The major lifestyle factors discussed in the present review are amongst the multiple potential risk factors that could impair male fertility. However, their negative impact may well be mostly overcome by behaviour modification and better lifestyle choices. Greater awareness and recognition of the possible impact of these lifestyle factors are important amongst couples seeking conception.
Abbreviations:
- AAS
- anabolic–androgenic steroids
- APA
- advanced paternal age
- ASIH
- anabolic steroid-induced hypogonadism
- ART
- assisted reproductive technology
- BMI
- body mass index
- Chk1
- checkpoint kinase 1
- ECS
- endogenous cannabinoid system
- GnIH
- gonadotropin-inhibitory hormone
- HADS
- Hospital Anxiety and Depression Score
- HPA
- hypothalamus–pituitary–adrenal
- HPG
- hypothalamus–pituitary–gonadal
- IVF
- in vitro fertilisation
- ICSI
- intracytoplasmic sperm injection
- IUI
- intrauterine insemination
- MMP
- mitochondrial membrane potential
- ROS
- reactive oxygen species
- SOD
- superoxide dismutase
Notes
Peer review under responsibility of Arab Association of Urology.