New research presented at the first Joint Congress between the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE) reveals that men with fertility issues have lower blood phosphate levels than average. Additionally, reduced phosphate concentrations in the blood are associated with lower sperm motility in infertile men. These findings could provide valuable insights into male reproductive health and open the door to potential fertility treatments.
Over the past five decades, sperm counts have dropped globally, and sperm quality has significantly declined. Currently, 15% of heterosexual couples experience infertility, with male infertility contributing to about half of all cases. Yet, the exact causes of male infertility remain unclear for many men. Factors such as genetics, lifestyle, nutrition, and hormonal imbalances can all impact fertility, with recent studies also linking vitamin D deficiency to poor semen quality.
In this study, researchers from Copenhagen University Hospital Herlev and Copenhagen University Rigshospitalet analyzed blood and semen samples from 1,242 men with infertility in Denmark. They discovered that 36% of these men had clinically low phosphate levels in their blood, compared to just 2-4% in the general Danish population. Men with moderately low phosphate levels had fewer motile and progressively motile sperm than those with normal phosphate levels. These men also had slightly higher levels of estradiol, a hormone. However, phosphate levels did not affect sperm count.
Dr. Sam Kafai Yahyavi, the lead author, explained, “For the first time, we identified a higher percentage of infertile men with low phosphate levels compared to the general population.” He added that this finding could suggest phosphate plays a role in fertility, possibly offering a new avenue for treatment through phosphate supplementation.
While the study does not prove that low phosphate causes infertility, Dr. Yahyavi emphasized that it highlights a potential connection that could improve the understanding and treatment of male infertility.
In a related study, the team had previously found that phosphate is essential for testicular function in healthy men, as its concentrations in seminal fluid are much higher than in the blood. This suggests phosphate plays a key role in the male reproductive system. In this new research, Dr. Yahyavi and his colleagues studied phosphate transport in both rodents and humans. They found that higher phosphate levels in human semen were linked to higher-quality sperm and increased testosterone levels.
“We believe phosphate levels in the reproductive organs may be crucial for both organ and sperm function,” said Ms. Zhihui Cui, a PhD student at Copenhagen University Herlev Hospital. “We are now focused on identifying regulators of this transport and understanding their influence on male fertility.”
Looking ahead, Dr. Yahyavi expressed excitement about the possibility of manipulating phosphate concentrations to improve fertility. “Our next step is to begin controlled trials using phosphate as an intervention to assess its direct effect on fertility in both men and women,” he said.
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