ENVIRONMENTAL AND LIFE STYLE DETERMINANTS OF SEMEN QUALITY. Jorma Toppari Departments of Physiology and Pediatrics University of Turku

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1 ENVIRONMENTAL AND LIFE STYLE DETERMINANTS OF SEMEN QUALITY Jorma Toppari Departments of Physiology and Pediatrics University of Turku 2013

2 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

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4 Seminiferous tubules

5 SPERMATOGENEESI

6 Functional cycle of Sertoli cells: Preferential actions of follicle stimulating hormone and testosterone

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8 Courtesy of R. Sharpe

9 Courtesy of R. Sharpe

10 Courtesy of R. Sharpe

11 Sperm concentration (million/ml) Mean Median 20 0 DK France UK FIN Jørgensen et al. Hum. Reprod. 2001

12 Sperm concentration (million/ml) DK N EST FIN Jørgensen et al., Hum. Reprod. 17:2199, 2002

13 Sperm concentration (million/ml) Fertile Young 20 0 DK N EST FIN

14 Young men from the Finnish general population 80 Sperm concentrations according to year of birth Sperm concentrations 70 Millions/ml p=0.024 p=0.017 Adjusted for duration of ejaculation abstinence Jørgensen et al 2011, IJA

15 Young men from the Finnish general population 250 Total sperm Total sperm counts counts according to year of birth 200 Millions p=0.030 p=0.032 Adjusted for duration of ejaculation abstinence Jørgensen et al 2011, IJA

16 Young men from the Finnish general population % Normal Normal morphology morphology according to year of birth p=0.40 p=0.036 Jørgensen et al 2011, IJA

17 Young men from the Finnish general population Total nos. of normal sperm according to year of birth Total nos. of normal spermatozoa Millions p=0.046 p=0.007 Adjusted for duration of ejaculation abstinence Jørgensen et al 2011, IJA

18 Normal young men Sperm conc. (mill/ml) 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)

19 Probability of pregnancy/cycle Bonde et al., Lancet 1998

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21 Danish young men >0-10 >10-20 >20-30 >30-40 >40-50 >50-60 >60-70 >70-80 >80-90 > > > > > > >150 Categories of sperm concentration (mill/ml) Jørgensen et al. No. of men (%)

22 Intrauterine exposure to smoking 2069 young men around Baltic sea Data on maternal smoking during pregnancy Semen analysis Sperm conc. mill/ml smoking no smoking Jensen et al., Am. J. Epid. 2004

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

24 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 :13-8)

25 Reduced semen quality is associated with: High and low BMI (Jensen et al., Fertil Steril Oct;82(4):863-70) Sleep disturbances (Jensen et al., Am J Epidemiol May 15;177(10): ) High daily intake of saturated fat (Jensen et al., Am J Clin Nutr Feb;97(2):411-8) High Cola soft drink intake (Jensen et al., Am J Epidemiol Apr 15;171(8):883-91)

26 Reduced semen quality High exposure to perfluoroalkyl compounds (Joensen et al., Environ Health Perspect Jun;117(6):923-7)

27 Authors: Jorma Toppari, Finland Malene Boas, Denmark Helena E. Virtanen, Finland Annika Adamsson, Finland Katharina M. Main, Denmark Anders Juul, Denmark Niels E. Skakkebaek, Denmark ISBN WHO Funding: NIEHS with WHO

28 Working group: UNEPsWork/EndocrineDisruptingChemical sedcs/tabid/79616/default.aspx 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

29 Summary Sperm production capacity is developmentally determined and established already at early adulthood Intrauterine and childhood environment important determinants Adult man can cause harm to spermatogenesis but cannot improve it

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