The role of physical agents’ exposure in male infertility: A critical review


Submitted: September 27, 2022
Accepted: October 24, 2022
Published: February 22, 2023
Abstract Views: 1016
PDF: 414
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Background: A decrease in semen quality is an increasingly widespread pathological condition worldwide. Jobs and lifestyles have changed a lot with the advancement of technology in the last few decades, and a new series of risk factors for male infertility have spread. Objective: This review aims to summarize the current literature on this relationship, evaluating alterations in semen parameters and hormonal profile.

Methods: A deep research was performed through MEDLINE via PubMed, Scopus, and Web of Science on articles regarding the relationship between physical agents and male fertility over the last twenty years. Some physical agents already associated with male infertility, such as heat and radiation, while emerging ones, such as physical exertion, psychological stress and sedentary activities, were newly considered.

Results: Most studies described sperm quality after exposure. Overall sperm impairment was shown after radiation and alteration of specific parameters, such as sperm concentration, were observed after psychological stress and sedentary work. In addition, an association was also reported between physical exertion and hormonal profile, especially pituitary hormones and testosterone.

Conclusions: Although the associations between physical agents and male infertility are suggestive, the level of evidence of the studies is not adequate to define their influence, except for physical exertion. Therefore, new prospective studies are necessary for the validation of the correlation and the possible safeguarding of the exposed working classes.


Sharlip ID, Jarow JP, Belker AM, et al. Best practice policies for male infertility. Fertil Steril. 2002; 77:873-82.

Calverton, Maryland, USA: ORC Macro and the World Health Organization; 2004. World Health Organization. Infecundity, Infertility, and Childlessness in Developing Countries. DHS Comparative Reports No 9.

Carlsen E, Giwercman A, Keiding N, et al. Evidence for decreasing quality of semen during past 50 years. BMJ. 1992; 305:609-13.

Agarwal A, Mulgund A, Hamada A, et al. A unique view on male infertility around the globe. Reprod. Biol. Endocrinol. 2015; 13:37.

Delle Fave RF, Polisini G, Giglioni G, et al. COVID-19 and male fertility: Taking stock of one year after the outbreak began. Arch Ital Urol Androl. 2021; 93:115-119.

Babakhanzadeh E, Nazari M, Sina Ghasemifar S, et al. Some of the Factors Involved in Male Infertility: A Prospective Review. Int J Gen Med. 2020; 13:29-41.

Mustafa M, Sharifa AM, Hadi J, et al. Male and female infertility: causes, and management. IOSR-JDMS 2019; 18:27-32.

Giulioni C, Maurizi V, Castellani D et al. The environmental and occupational influence of pesticides on male fertility: A systematic review of human studies. Andrology. 2022; 10:1250-1271.

Benatta M, Kettache R, Buchholz N, Trinchieri A. The impact of nutrition and lifestyle on male fertility. Arch Ital Urol Androl. 2020; 92,121-131

Fisch H, Goluboff ET. Geographic variations in sperm counts: a potential cause of bias in studies of semen quality. Fertil Steril. 1996; 65:1044-6.

Jensen TK, Bonde JP, Joffe M. The influence of occupational exposure on male reproductive function. Occup Med (Lond). 2006; 56:544-53.

Mieusset R, Bujan L, Mondinat C, et al. Association of scrotal hyperthermia with impaired spermatogenesis in infertile men. Fertil Steril 1987; 48:1006-1011.

Al-Otaibi ST. Male infertility among bakers associated with exposure to high environmental temperature at the workplace. J Taibah Univ Med Sci. 2018; 13:103-107.

Hamerezaee M, Dehghan SF, Golbabaei F, et al. Assessment of Semen Quality among Workers Exposed to Heat Stress: A Cross-Sectional Study in a Steel Industry. Saf Health Work. 2018; 9:232-235.

Shefi S, Tarapore PE, Walsh TJ, et al. Wet heat exposure: a potentially reversible cause of low semen quality in infertile men. Int Braz J Urol. 2007; 33:50-6.

Eisenberg ML, Chen Z, Ye A, Buck Louis GM. Relationship between physical occupational exposures and health on semen quality: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertil Steril. 2015; 103:1271-7.

Hajizadeh Maleki B, Tartibian B. Long-term Low-to-Intensive Cycling Training: Impact on Semen Parameters and Seminal Cytokines. Clin J Sport Med. 2015; 25:535-40.

Alessio HM, Hagerman AE, Fulkerson BK, et al. Generation of reactive oxygen species after exhaustive aerobic and isometric exercise. Med Sci Sports Exerc. 2000; 32:1576-81.

Hajizadeh Maleki B, Tartibian B, Eghbali M, et al. Comparison of seminal oxidants and antioxidants in subjects with different levels of physical fitness. Andrology. 2013; 1:607-14.

Pelliccione F, Verratti V, D'Angeli A, et al. Physical exercise at high altitude is associated with a testicular dysfunction leading to reduced sperm concentration but healthy sperm quality. Fertil Steril. 2011; 96:28-33.

Verratti V, Di Giulio C, D'Angeli A, et al. Sperm forward motility is negatively affected by short-term exposure to altitude hypoxia. Andrologia. 2016; 48:800-6.

Safarinejad MR, Azma K, Kolahi AA. The effects of intensive, long-term treadmill running on reproductive hormones, hypothala-mus-pituitary-testis axis, and semen quality: a randomized controlled study. J Endocrinol. 2009; 200:259-71.

Vaamonde D, Da Silva ME, Poblador MS, et al. Reproductive profile of physically active men after exhaustive endurance exercise. Int J Sports Med. 2006; 27:680-9.

Mínguez-Alarcón L, Chavarro JE, Mendiola J, et al. Physical activity is not related to semen quality in young healthy men. Fertil Steril. 2014; 102:1103-9.

Finaud J, Scislowski V, Lac G, et al. Antioxidant status and oxidative stress in professional rugby players: evolution throughout a season. Int J Sports Med. 2006; 27:87-93.

Ascensão A, Rebelo A, Oliveira E, et al. Biochemical impact of a soccer match - analysis of oxidative stress and muscle damage markers throughout recovery. Clin Biochem. 2008; 41:841-51.

Gebreegziabher Y, Marcos E, McKinon W, et al. Sperm characteristics of endurance trained cyclists. Int J Sports Med. 2004; 25:247-51.

Tartibian B, Maleki BH. Correlation between seminal oxidative stress biomarkers and antioxidants with sperm DNA damage in elite athletes and recreationally active men. Clin J Sport Med. 2012; 22:132-9.

Eisenberg ML, Chen Z, Ye A, et al. Relationship between physical occupational exposures and health on semen quality: data from the Longitudinal Investigation of Fertility and the Environment (LIFE) Study. Fertil Steril. 2015; 103:1271-7.

Ash P. The influence of radiation on fertility in man. Br J Radiol. 1980; 53(628):271-8.

Fejes I, Závaczki Z, Szöllosi J, et al. Is there a relationship between cell phone use and semen quality? Arch Androl. 2005; 51:385-93.

Agarwal A, Deepinder F, Sharma RK, et al. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008; 89:124-8.

Møllerløkken OJ, Moen BE. Is fertility reduced among men exposed to radiofrequency fields in the Norwegian Navy?Bioelectromagnetics. 2008; 29:345-52.

Baste V, Riise T, Moen BE. Radiofrequency electromagnetic fields; male infertility and sex ratio of offspring. Eur J Epidemiol. 2008; 23:369-77.

Wdowiak A, Stec M, Raczkiewicz D, et al. Background ionizing radiation and semen parameters of men with reproductive problems. Ann Agric Environ Med. 2020; 27: 43-48.

Green DM, Kawashima T, Stovall M, et al. Fertility of male survivors of childhood cancer: a report from the Childhood Cancer Survivor Study. J Clin Oncol. 2010; 28:332-9.

Gandini L, Sgrò P, Lombardo F, et al. Effect of chemo- or radiotherapy on sperm parameters of testicular cancer patients. Hum Reprod. 2006; 21:2882-9.

Bezold G, Gottlöber P, Gall H, Peter RU. Accidental radiation exposure and azoospermia. J Androl. 2000; 21:403-8.

Kumar D, Salian SR, Kalthur G, et al. Semen abnormalities, sperm DNA damage and global hypermethylation in health workers occupationally exposed to ionizing radiation. PLoS One. 2013; 8:e69927.

Kumar D, Salian SR, Kalthur G, et al. Association between sperm DNA integrity and seminal plasma antioxidant levels in health workers occupationally exposed to ionizing radiation. Environ Res. 2014; 132:297-304.

Andreassi MG, Cioppa A, Botto N, et al. Somatic DNA damage in interventional cardiologists: a case-control study. FASEB J. 2005; 19:998-9.

Doyle P, Roman E, Maconochie N, et al. Primary infertility in nuclear industry employees: report from the nuclear industry family study. Occup Environ Med. 2001; 58:535-9.

Gaskins AJ, Mendiola J, Afeiche M, et al. Physical activity and television watching in relation to semen quality in young men. Br J Sports Med. 2015; 49:265-70.

Priskorn L, Jensen TK, Bang AK, et al. Is Sedentary Lifestyle Associated With Testicular Function? A Cross-Sectional Study of 1,210 Men. Am J Epidemiol. 2016; 184:284-94.

Bujan L, Daudin M, Charlet JP, et al. Increase in scrotal tem-perature in car drivers. Hum Reprod. 2000; 15(6):1355-7.

Hjollund NH, Bonde JP, Jensen TK, et al. Diurnal scrotal skin temperature and semen quality. The Danish First Pregnancy Planner Study Team. Int J Androl. 2000; 23:309-18.

Hjollund NH, Storgaard L, Ernst E, et al. Impact of diurnal scrotal temperature on semen quality. Reprod Toxicol. 2002; 16:215-21.

Gill K, Jakubik J, Kups M, et al. The impact of sedentary work on sperm nuclear DNA integrity. Folia Histochem Cytobiol. 2019; 57:15-22.

Jorm AF, Windsor TD, Dear KB, et al. Age group differences in psychological distress: the role of psychosocial risk factors that vary with age. Psychol Med 2005; 35: 1253-1263.

Cui X, Rockett IR, Yang T, et al. Work stress, life stress, and smoking among rural-urban migrant workers in China. BMC Public Health. 2012; 12:979.

Nordkap L, Jensen TK, Hansen ÅM, et al. Psychological stress and testicular function: a cross-sectional study of 1,215 Danish men. Fertil Steril. 2016; 105:174-87.e1-2.

Eskiocak S, Gozen AS, Kilic AS, et al. Association between mental stress & some antioxidant enzymes of seminal plasma. Indian J Med Res. 2005; 122:491-6.

Gollenberg AL, Liu F, Brazil C, et al. Semen quality in fertile men in relation to psychosocial stress. Fertil Steril. 2010; 93:1104-11.

Boivin J, Schmidt L. Infertility-related stress in men and women predicts treatment outcome 1 year later. Fertil Steril. 2005; 83:1745-52.

Zou P, Sun L, Chen Q, et al. Social support modifies an association between work stress and semen quality: Results from 384 Chinese male workers. J Psychosom Res. 2019; 117:65-70.

Janevic T, Kahn LG, Landsbergis P, et al. Effects of work and life stress on semen quality. Fertil Steril. 2014; 102:530-8.

Dahl EV, Herrick JF. A vascular mechanism for maintaining testicular temperature by counter-current exchange. Surg Gynecol Obstet. 1959; 108:697-705.

Glad Sørensen H, Lambrechtsen J, Einer-Jensen N. Efficiency of the countercurrent transfer of heat and 133Xenon between the pampiniform plexus and testicular artery of the bull under in-vitro conditions. Int J Androl. 1991; 14:232-40.

Agger P. Scrotal and testicular temperature: its relation to sperm count before and after operation for varicocele. Fertil Steril. 1971; 22:286-97.

Santi D, Magnani E, Michelangeli M, et al. Seasonal variation of semen parameters correlates with environmental temperature and air pollution: A big data analysis over 6 years. Environ Pollut. 2018; 235:806-813.

Thonneau P, Bujan L, Multigner L, et al. Occupational heat expo-sure and male fertility: a review. Hum Reprod. 1998; 13:2122-5.

Paul C, Povey JE, Lawrence NJ, et al. Deletion of genes implicated in protecting the integrity of male germ cells has differential effects on the incidence of DNA breaks and germ cell loss. PLoS ONE 2007; 2: e989.

Rockett JC, Mapp FL, Garges JB, et al. Effects of hyperthermia on spermatogenesis, apoptosis, gene expression, and fertility in adult male mice. Biol Reprod 2001; 65:229-239.

Karaca AG, Parker HM, Yeatman JB, et al. The effects of heat stress and sperm quality classification on broiler breeder male fertil-ity and semen ion concentrations. Br Poult Sci. 2002; 43:621-8.

Karaca AG, Parker HM, Yeatman JB, et al. Role of seminal plas-ma in heat stress infertility of broiler breeder males. Poult Sci. 2002; 81:1904-9.

Hajizadeh Maleki B, Tartibian B. Moderate aerobic exercise training for improving reproductive function in infertile patients: A randomized controlled trial. Cytokine. 2017; 92:55-67.

Sun B, Messerlian C, Sun ZH, et al. Physical activity and seden-tary time in relation to semen quality in healthy men screened as potential sperm donors. Hum Reprod. 2019; 34:2330-2339.

Nieman DC, Henson DA, Smith LL, et al. Cytokine changes after a marathon race. J Appl Physiol (1985). 2001; 91:109-14.

Koçak I, Yenisey C, Dündar M, et al. Relationship between seminal plasma interleukin-6 and tumor necrosis factor alpha levels with semen parameters in fertile and infertile men. Urol Res. 2002; 30:263-7.

Aitken RJ, Krausz C. Oxidative stress, DNA damage and the Y chromosome. Reproduction. 2001; 122:497-506.

Martínez P, Proverbio F, Camejo MI. Sperm lipid peroxidation and pro-inflammatory cytokines. Asian J Androl. 2007; 9:102-7.

Zini A, Garrels K, Phang D. Antioxidant activity in the semen of fertile and infertile men. Urology. 2000; 55:922-6.

Clarkson PM, Thompson HS. Antioxidants: what role do they play in physical activity and health? Am J Clin Nutr. 2000; 72(2 Suppl):637S-46S.

Zini A, Fischer MA, Mak V, et al. Catalase-like and superoxide dismutase-like activities in human seminal plasma. Urol Res 2002; 30:321-3.

Vaamonde D, Da Silva-Grigoletto ME, García-Manso JM, et al. Response of semen parameters to three training modalities. Fertil Steril. 2009; 92:1941-6.

Wise LA, Cramer DW, Hornstein MD, et al. Physical activity and semen quality among men attending an infertility clinic. Fertil Steril. 2011; 95:1025-30.

Frauscher F, Klauser A, Stenzl A, et al. US findings in the scro-tum of extreme mountain bikers. Radiology. 2001; 219:427-31.

Józków P, Medras M, Lwow F et al. Associations between physi-cal activity and semen quality in young healthy men. Fertil Steril. 2017; 107:373-378.e2.

Hackney AC. Endurance exercise training and reproductive endocrine dysfunction in men: alterations in the hypothalamic-pitu-itary-testicular axis. Curr Pharm Des. 2001; 7:261-73.

Mikamo K, Kamiguchi Y, Tateno H. Spontaneous and in vitro radiation-induced chromosome aberrations in human spermatozoa: application of a new method. Prog Clin Biol Res. 1990; 340B:447-56.

Le Guen T, Ragu S, Guirouilh-Barbat J, Lopez BS. Role of the double-strand break repair pathway in the maintenance of genomic stability. Mol Cell Oncol. 2014; 2:e968020.

Vogin G, Foray N. The law of Bergonié and Tribondeau: a nice formula for a first approximation. Int J Radiat Biol. 2013; 89:2-8.

Kesari KK, Agarwal A, Henkel R. Radiations and male fertility. Reprod Biol Endocrinol. 2018; 16:118.

International Commission on Non-Ionizing Radiation Protection (ICNIRP). Guidelines for limiting exposure to time-varying electric, magnetic, and electromagnetic fields (up to 300 GHz). International Commission on Non-Ionizing Radiation Protection. Health Phys. 1998; 74:494-522.

Wdowiak A, Skrzypek M, Stec M, et al. Effect of ionizing radia-tion on the male reproductive system. Ann Agric Environ Med. 2019; 26: 210-216.

Latini G, Dipaola L, Mantovani A, et al. Reproductive effects of low-to-moderate medical radiation exposure. Curr Med Chem. 2012; 19: 6171-6177.

Biedka M, Kuzba-Kryszak T, Nowikiewicz T, et al. Fertility impairment in radiotherapy. Contemp Oncol (Pozn). 2016; 20:199-204.

Paris L, Cordelli E, Eleuteri P, et al. Kinetics of gamma-H2AX induction and removal in bone marrow and testicular cells of mice after X-ray irradiation. Mutagenesis. 2011; 26:563-72.

Chicheportiche A, Bernardino-Sgherri J, de Massy B, et al. Characterization of Spo11-dependent and independent phospho-H2AX foci during meiotic prophase I in the male mouse. J Cell Sci. 2007; 120:1733-42.

Simko M. Cell type specific redox status is responsible for diverse electromagnetic field effects. Curr Med Chem. 2007; 14:1141-52.

de Lamirande E, Eiley D, Gagnon C. Inverse relationship between the induction of human sperm capacitation and spontaneous acrosome reaction by various biological fluids and the superoxide scavenging capacity of these fluids. Int J Androl 1993; 16:258-266.

Kodama H, Kuribayashi Y, Gagnon C: Effect of sperm lipid per-oxidation on fertilization. J Androl 1996; 17:151-157.

Agarwal A, Makker K, Sharma R. Clinical relevance of oxidative stress in male factor infertility: an update. Am J Reprod Immunol. 2008; 59:2-11.

Desai N, Sharma R, Makker K,et al. Physiologic and pathologic levels of reactive oxygen species in neat semen of infertile men. Fertil Steril. 2009; 92:1626-31.

Agarwal A, Deepinder F, Sharma RK, et al. Effect of cell phone usage on semen analysis in men attending infertility clinic: an obser-vational study. Fertil Steril. 2008; 89:124-8.

Zheng H, Olive PL. Influence of oxygen on radiation-induced DNA damage in testicular cells of C3H mice. Int J Radiat Biol. 1997; 71: 275-282.

Rube CE, Zhang S, Miebach N, et al. Protecting the heritable genome: DNA damage response mechanisms in spermatogonial stem cells. DNA Repair. 2011; 10: 159-168.

Schulte RT, Ohl DA, Sigman M, et al. Sperm DNA damage in male infertility: etiologies, assays, and outcomes. J Assist Reprod Genet. 2010; 27: 3-12.

Wang SM, Wang DW, Peng RY, et al. (Effect of electromagnetic pulse irradiation on structure and function of Leydig cells in mice). Zhonghua Nan Ke Xue. 2003; 9:327-30.

Musaev AV, Ismailova LF, Gadzhiev AM. (Influence of (460 MHz) electromagnetic fields on the induced lipid peroxidation in the structures of visual analyzer and hypothalamus in experimental ani-mals). Vopr Kurortol Fizioter Lech Fiz Kult. 2005; (5):17-20.

Oyewopo AO, Olaniyi SK, Oyewopo CI, Jimoh AT. Radiofrequency electromagnetic radiation from cell phone causes defective testicular function in male Wistar rats. Andrologia. 2017; 49(10).

Agarwal A, Desai NR, Makker K, et al. Effects of radiofrequency electromagnetic waves (RF-EMW) from cellular phones on human ejac-ulated semen: an in vitro pilot study. Fertil Steril. 2009; 92:1318-25.

Hjollund NH, Storgaard L, Ernst E, et al. The relation between daily activities and scrotal temperature. Reprod Toxicol. 2002; 16:209-14.

Foucaut AM, Faure C, Julia C, et al. Sedentary behavior, phys-ical inactivity and body composition in relation to idiopathic infertil-ity among men and women. PLoS One. 2019; 14:e0210770.

Gaskins AJ, Afeiche MC, Hauser R, et al. Paternal physical and sedentary activities in relation to semen quality and reproductive out-comes among couples from a fertility center. Hum Reprod. 2014; 29:2575-82.

Vaamonde D, Da Silva-Grigoletto ME, García-Manso JM, et al. Physically active men show better semen parameters and hormone values than sedentary men. Eur J Appl Physiol. 2012; 112:3267-73.

Kotitschke A, Sadie-Van Gijsen H, Avenant C, et al. Genomic and nongenomic cross talk between the gonadotropin-releasing hor-mone receptor and glucocorticoid receptor signaling pathways. Mol Endocrinol. 2009; 23:1726-45.

Gunnar M, Quevedo K. The neurobiology of stress and devel-opment. Annu Rev Psychol 2007; 58: 145-173.

Hardy MP, Gao HB, Dong Q, et al. Stress hormone and male reproductive function. Cell Tissue Res. 2005; 322:147-53.

Klimek M, Pabian W, Tomaszewska B, et al. Levels of plasma ACTH in men from infertile couples. Neuro Endocrinol Lett. 2005; 26:347-50.

Romeo R, Pellitteri R, Russo A et al. Catecholaminergic pheno-type of human Leydig cells. Ital J Anat Embryol 2004; 109: 45-54.

Retana-Marquez S, Bonilla-Jaime H, Vazquez-Palacios G et al. Changes in masculine sexual behavior, corticosterone and testos-terone in response to acute and chronic stress in male rats. Horm Behav 2003; 44: 327-337.

Fenchel D, Levkovitz Y, Vainer E, et al. Beyond the HPA-axis: The role of the gonadal steroid hormone receptors in modulating stress-related responses in an animal model of PTSD. Eur Neuropsychopharmacol. 2015; 25:944-57.

Nirupama M, Devaki M, Nirupama R, et al. Chronic intermit-tent stress-induced alterations in the spermatogenesis and antioxi-dant status of the testis are irreversible in albino rat. J Physiol Biochem. 2013; 69:59-68.

El-Haggar S, El-Ashmawy S, Attia A, et al. Beta-endorphin in serum and seminal plasma in infertile men. Asian J Androl. 2006; 8:709-12.

Niederberger C. Re: Regulation of male fertility by the opioid system. J Urol. 2012; 187:238-9.

Xiong X, Zhang L, Fan M, et al. b-Endorphin Induction by Psychological Stress Promotes Leydig Cell Apoptosis through p38 MAPK Pathway in Male Rats. Cells. 2019; 8:1265

Hajizadeh Maleki B, Tartibian B. Resistance exercise modulates male factor infertility through anti-inflammatory and antioxidative mechanisms in infertile men: A RCT. Life Sci. 2018; 203:150-160.

Rosety MA, Díaz A, Rosety JM, et al. Exercise improved semen quality and reproductive hormone levels in sedentary obese adults. Nutr Hosp 2017; 34:608-612

Giulioni, C., Maurizi, V., & Galosi, A. B. (2023). The role of physical agents’ exposure in male infertility: A critical review. Archivio Italiano Di Urologia E Andrologia, 95(1). https://doi.org/10.4081/aiua.2023.10890

Downloads

Download data is not yet available.

Citations