ENVIRONMENTAL AND LIFE STYLE DETERMINANTS OF SEMEN QUALITY

Jorma ToppariDepartments of Physiology and Pediatrics

University of Turku

2013

Disclosures• I have received lecture honoraria from Eli Lilly,

Merck Serono, Novo Nordisk Pharma, Ferring, and Pfizer during the last 5 years

• Supported by– EU, Envir. Reprod. Health, Expored, Eden, DEER– Academy of Finland– Pediatric Research Foundation– Sigrid Juselius Foundation– Turku University Hospital– Danish Council for Strategic Research

Seminiferous tubules

SPERMATOGENEESI

Functional cycle of Sertoli cells:

Preferential actions of follicle stimulating hormone and testosterone

Courtesy of R. Sharpe

Courtesy of R. Sharpe

Courtesy of R. Sharpe

Sperm concentration (million/ml)

0

20

40

60

80

100

120

DK France UK FIN

MeanMedian

Jørgensen et al. Hum. Reprod. 2001

Sperm concentration (million/ml)

0

10

20

30

40

50

60

DK N EST FIN

Jørgensen et al., Hum. Reprod. 17:2199, 2002

Sperm concentration (million/ml)

0

20

40

60

80

100

120

DK N EST FIN

FertileYoung

Adjusted for duration of ejaculation abstinence

Young men from the Finnish general population

Sperm concentrations

0

10

20

30

40

50

60

70

80

1979-81 1982-83 1987

Mill

ions

/ml

p=0.024p=0.017

Sperm concentrations according to year of birth

Jørgensen et al 2011, IJA

Adjusted for duration of ejaculation abstinence

Young men from the Finnish general population

Total sperm counts

0

50

100

150

200

250

1979-81 1982-83 1987

Mill

ions

p=0.032

p=0.030

Total sperm counts according to year of birth

Jørgensen et al 2011, IJA

Young men from the Finnish general population

Normal morphology

012

345678

91011

1979-81 1982-83 1987

%

p=0.40

p=0.036

Normal morphology according to year of birth

Jørgensen et al 2011, IJA

Adjusted for duration of ejaculation abstinence

Young men from the Finnish general population

Total nos. of normal spermatozoa

0

5

10

15

20

1979-81 1982-83 1987

Mill

ions

p=0.046

p=0.007

Total nos. of normal sperm according to year of birth

Jørgensen et al 2011, IJA

41

Normal young menSperm conc. (mill/ml)

45

44

55

63 48

676355

62

Jørgensen et al (2002, 2011), Richthoff et al (2000),Punab et al (2002), Tsarev et al (2003),Paasch et al (2008)Fernandez et al (2011)

Probability of pregnancy/cycle

Bonde et al., Lancet 1998

Danish young men 1996-2009

0

2

4

6

8

10

12

14

0>0

-10>1

0-20

>20-3

0>3

0-40

>40-5

0>5

0-60

>60-7

0>7

0-80

>80-9

0>9

0-100

>100

-110

>110

-120

>120

-130

>130

-140

>140

-150

>150

Categories of sperm concentration (mill/ml)

No.

of m

en (%

)

Jørgensen et al.

Intrauterine exposure to smoking

• 2069 young men around Baltic sea

• Data on maternal smoking during pregnancy

• Semen analysis

0

10

20

30

40

50

60

smoking

nosmoking

Sperm conc. mill/ml

Jensen et al., Am. J. Epid. 2004

Smoking

• No effect of own smoking in young men, clear effect by intra-uterine exposure(Jensen et al., Am J Epidemiol. 2004 Jan 1;159(1):49-58)

Alcohol

• Moderate alcohol consumption: no effect(Jensen et al., Alcohol intake and male reproductive health; a cross-sectional study of 8,344 young men and partners of pregnant women from Europe and US; submitted)

• Alcoholics, > 30 g daily for years leads to testicular failure in a subpopulation of men(Pajarinen et al., BMJ. 1997 314:13-8)

Reduced semen quality is associated with:

• High and low BMI (Jensen et al., FertilSteril. 2004 Oct;82(4):863-70)

• Sleep disturbances (Jensen et al., Am J Epidemiol. 2013 May 15;177(10):1027-37)

• High daily intake of saturated fat (Jensen et al., Am J Clin Nutr. 2013 Feb;97(2):411-8)

• High Cola soft drink intake (Jensen et al., Am J Epidemiol. 2010 Apr 15;171(8):883-91)

Reduced semen quality

• High exposure to perfluoroalkyl compounds(Joensen et al., Environ Health Perspect. 2009 Jun;117(6):923-7)

Authors:

Jorma Toppari, FinlandMalene Boas, DenmarkHelena E. Virtanen, FinlandAnnika Adamsson, FinlandKatharina M. Main, DenmarkAnders Juul, DenmarkNiels E. Skakkebaek, Denmark

ISBN 978 92 4 150376 1 WHO

www.who.int/ceh

Funding: NIEHS with WHO

Working group:

• Georg Becher, Norway• Åke Bergman, Sweden (Leader)• Poul Bjerregaard, Denmark• Riana Bornman, South Africa• Ingvar Brandt, Sweden• Jerrold J. Heindel, USA• Taisen Iguchi, Japan• Susan Jobling, England• Karen A. Kidd, Canada• Andreas Kortenkamp, England• Derek C.G. Muir, Canada• Roseline Ochieng, Kenya• Niels E. Skakkebaek, Denmark• Jorma Toppari, Finland• Tracey J. Woodruff, USA• R. Thomas Zoeller, USA

http://www.unep.org/hazardoussubstances/UNEPsWork/EndocrineDisruptingChemicalsEDCs/tabid/79616/Default.aspx

Summary

• Sperm production capacity is developmentally determined and establishedalready at early adulthood

• Intrauterine and childhood environmentimportant determinants

• Adult man can cause harm to spermatogenesis but cannot improve it

Acknowledgments• University of Turku

– Helena Virtanen– Sergey Sadov– Anne-Maarit Suomi– Marko Kaleva– Jaakko Koskenniemi– Antti Perheentupa– Jyrki Suominen– Matti Vierula

• Supported by– EU, Envir. Reprod. Health,

Expored, Eden, DEER– Academy of Finland– Pediatric Research Foundation– Sigrid Juselius Foundation– Turku University Hospital– Danish Council for Strategic

Research

• Rigshospitalet, Copenhagen– Niels E. Skakkebæk– Katharina M. Main– Niels Jorgensen– Tina K. Jensen– Christine Wohlfahrt-Veje