PT Health Watch: How stress, excessive exercise contribute to infertility in men and women- Expert

Infertility is a global concern that affects millions of individuals, with Nigeria being no exception. The World Health Organisation (WHO), estimates that approximately 17.5 per cent of the adult population – roughly one in six persons worldwide are affected by infertility.

While there is no current data on infertility rates in Nigeria, it is estimated that between 20 per cent and 30 per cent of married couples are affected by infertility issues.

In Nigeria, the stigma surrounding infertility often leads to social and emotional challenges for affected individuals and couples.

Adding to the challenge is the fact that many fertility issues often have no clear explanation.

However, an expert in infertility management and minimal access to gynaecological surgeries, Lukman Omokanye, stated that chronic stress, excessive exercise and some lifestyle factors can lead to ovulation disorders in women and decreased sperm quality in men.

Hormonal imbalance

Mr Omokanye explained that stress can significantly disrupt the body’s hormonal balance, which in turn impacts fertility.

“When we experience stress, the body produces stress hormones like cortisol, which can suppress the production of reproductive hormones,” he said.

“This disruption can lead to irregular ovulation in women and lower sperm quality in men, both of which can make conception more difficult.”

He further emphasised that lifestyle factors such as obesity, extreme weight loss, and excessive exercise can complicate the process of conception, particularly in women.

“A woman weighing less than 40kg may struggle with conception due to hormonal imbalances. Other factors, such as the woman’s age, can also cause infertility,” he said.

Contributing factors

Mr Omokanye emphasised that ovulation disorders are a leading cause of infertility in women. He pointed out that these disorders can arise from various factors, including Polycystic Ovary Syndrome (PCOS), thyroid dysfunctions, and issues with the pituitary gland, which plays a key role in regulating reproductive hormones.

He noted that for men, low sperm count and poor sperm quality are frequent causes of infertility.
Mr Omokanye explained that low sperm count is often linked to preventable infections, while prolonged heat exposure in the testicles can severely impact sperm production.

“Wearing plastic or leather pants, engaging in long-distance driving, and working with a laptop directly on the thighs generate excessive heat that can damage the testicles. These are factors that are easily avoidable,” he said.

He further explained that for optimal sperm production, the testicles need to remain one to two degrees cooler than the body’s normal temperature.

“In Nigeria, recent studies indicate that combined infertility factors in both men and women have risen from 30 per cent to between 40 per cent and 50 per cent,” he said

“The infertility rate is estimated to affect 20 per cent to 30 per cent of married couples, though the actual number could be higher due to underreporting.”

Age as a factor

Speaking with PT Health Watch, Amanda Adeleye, an expert in reproductive endocrinology, explained that age can significantly impact fertility, particularly in women over the age of 35.

Ms Adeleye noted that as women age, the quality of their eggs deteriorates, which makes conception increasingly difficult.

“By the early to mid-40s, a woman’s chances of conceiving drop to between one and five per cent. While men also experience a decline in semen quality with age, it generally has less of an impact on their ability to conceive,” she explained.

She advised that for women over 35 who are struggling to conceive, a fertility evaluation is recommended after six months of trying.

“There are several diagnostic tests available, including ultrasounds, fallopian tube evaluations, blood tests, and semen analysis, all of which can help identify the underlying causes of infertility,” she said.

Ms Adeleye also highlighted that children born to men over the age of 40 may have a higher risk of developing neurodevelopmental conditions, which adds another layer of consideration for older fathers.

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Treatment options

Ms Adeleye also highlighted several common treatment options for infertility, including ovulation-inducing medications, intrauterine insemination (IUI), and in vitro fertilisation (IVF).

She explained that IUI involves placing sperm directly into the uterine cavity around the time of ovulation to increase the chances of fertilisation. On the other hand, IVF is a more complex procedure that involves stimulating the ovaries to produce multiple eggs, retrieving these eggs, fertilising them in a laboratory, and then implanting the best quality embryo into the uterus.

“Success rates for these treatments are influenced by the underlying cause of infertility, the woman’s age, and the quality of the treatment centre. For instance, in the US, women under 35 have an IVF success rate of around 43 per cent per cycle,” she said.

Mr Omokanye added that IVF success is highly dependent on both the quality of the embryos and sperm health.

“IVF encompasses various infertility treatments and is particularly helpful for women with little to no chance of conceiving naturally. Other assisted reproductive techniques include surrogacy and intracytoplasmic sperm injection (ICSI),” he explained.

He strongly advised couples to seek medical assistance from healthcare facilities rather than relying on traditional remedies, which can often lead to infections and worsen fertility problems.