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June 5, 2009
Research on infertility
Sperm quality decreases a lot in 10 years.
CYNTHIA RAMSAY
The decrease in sperm concentrations and motility among fertile sperm donors in Israel is alarming.
This is the conclusion of a recent investigation conducted by the Reproductive Endocrinology and Infertility Unit, Department of Obstetrics and Gynecology, at Hadassah Hebrew University Hospital, Mt. Scopus, in Jerusalem. The research team was Drs. Ruth Har-Nir, Vered Ben-Shoshan, Caryn Greenfield, Ido Eldar, Yuval Bdolah, Arye Hurwitz and Ronit Haimov-Kochman. The study compared sperm donated recently versus 10 years ago in the Hadassah Mt. Scopus sperm bank.
"This is a global trend and it has been going on for the last few decades. Our finding is not very new, it's just the rate [of decline] that's striking," said Haimov-Kochman, who will be coming to Vancouver in September for the Best of Hebrew University Stretch your Mind series.
"We have three parameters to evaluate the quality of sperm," the doctor explained in a phone interview with the Jewish Independent. "We look at the concentration of the sperm cells and we look at their motility because they have an intrinsic motility, this is a special cell, and there's another parameter of morphology ... how the sperm looks. This is a more arbitrary criterion, so we use the first two criteria of concentration and motility – they are very basic – to say something about the quality of sperm."
Haimov-Kochman explained, "In our study, we investigated a very special group of men. These are the semen donors in Jerusalem in our sperm bank. These are the men that are young and healthy, non-smokers and usually having an academic degree, which says something about their socioeconomic status. So these are men in the optimum of sperm quality and, in this special group, we see the decrease in sperm quality and this is what was so alarming.
"When we look in the IDF unit, for example, in my hospital, Hadassah Mt. Scopus, and we compare historically what's going on, the percentage of male infertility as the cause for the infertility of a couple is much, much higher than in previous years. We actually see the trend in the population of infertile men going on for the last two decades."
Hadassah Mt. Scopus treats a diverse group of people, given its location, said Haimov-Kochman. "What I'm saying is that the population we treat is very heterogeneous, it's Israelis and Palestinians and Arabs and Muslims and Christians and Jews and everybody." This is why, she said, the topic of one of her talks at the Sept. 12-13 Stretch your Mind series will be Infertility Management in a Multicultural Society.
She said she is concerned about the possibility – which has yet to be proven but of which there are signs – that the population in East Jerusalem has the highest rate of male infertility in Israel, up to 85-90 per cent. "This is very alarming," she said, "and nobody pays attention."
During the last decade in Israel, the prevalence of malformations of the male reproductive system, as well as testicular cancer, has been increasing. Since it's not just about sperm quality, said Haimov-Kochman, "That's what brought me to think about some environmental causes that may be in action here. I cannot specify one cause. It can be estrogen in the water. There is evidence of hormones in cow milk – this is something we know for sure. There may be ... radiation from the cellular phone.
"There are many speculations. We don't know. There must be a place for investigations. These investigations should be funded by the Israeli Ministry of Health and Ecology. That's the main thing, to prompt those who give the money to fund research to get direction."
Since Haimov-Kochman first presented her findings, she said she has had a lot of response.
"I was very happy that, two days after my presentation, I got an e-mail from the Ministry of Health and they actually invited me to speak in front of the team and to try and construct a policy. I may be asking for funding as well in order to find the reasons. That makes me very glad that they took it seriously."
Haimov-Kochman has been a specialist in reproductive endocrinology since 2004 and her main area of research is in vitro fertilization (IVF) techniques and male and female infertility, so the sperm quality study was part of her clinical research. She did her fellowship in San Francisco in 2003 and then returned to Israel as part of the IVF unit.
"IVF is an evolving subject," said Haimov-Kochman about her interest in the subject. "Research nowadays is going to be the practice tomorrow in IVF. I don't think there's [another] such interesting field that is so advancing. It's jumping from stage to stage. The way we treat people now is very different from what we did even 10 years ago, so the progress is tremendous with IVF. This specialty enables me to be both an investigator and a clinical doctor."
Also at the Stretch Your Mind conference hosted by Vancouver's Canadian Friends of Hebrew University of Jerusalem at King David High School, Haimov-Kochman said she is going to "present another very interesting study, about the selection of the human embryo after IVF.... This is something that I hope is going to help us in selecting the best embryo and this will probably decrease the twin and triplet pregnancy in IVF."
When asked about the ethical issues involved in such work, Haimon-Kochman said, "Ethical issues are part of what we're doing on an everyday basis, [in] your discussions with the infertile couple and on the broader basis, when you select an embryo or you study a new technique and the implementation of the new technique on your patient. Ethical discussions are a part of our life in the IVF unit."
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