Impact of high and low cholesterol on male infertility

Impact of high and low cholesterol on male infertility

In the previous article, we explained about cholesterol in general. Here, we would like to focus on how cholesterol affects male fertility.

Cholesterol is required for the production of sperm. However, abnormal cholesterol levels could affect the volume of seminal fluid, sperm count and morphology, leading to reduced male fertility.

Mature sperm production is the work of the testes. Homeostasis has been described as the “relatively stable equilibrium between interdependent elements.” Cholesterol homeostasis is a result of many complex processes which occur in the liver. This cholesterol homeostasis is very important for testicular functions, such as the following:
Steroidogenesis – is the process for biosynthesis (production of molecules in living cells) from cholesterol to steroid hormones, using the testes and adrenal glands.
Sertoli cells – these are important cells essential for production of male sperm. They assist in the process from immature male sex cells to become spermatozoa with motility.
Germ cell differentiation – Sertoli cells also provide growth nutrients for germ cell survival and differentiation. The germ cells differentiate to produce male and female gametes (mature male or female germ cells which are able to join together to form a fertilized egg).
Hence, any alteration in the concentration levels of plasma (total) cholesterol can negatively affect the male reproductive function. High cholesterol has been linked to male infertility.

LDL: High levels of LDL – the “bad” cholesterol leads to plaque building in the arteries and clogging of blood vessels. The impact on the blood flow can affect fertility as well. Also, high LDL has a derogatory effect on hormone levels as well. When the body does not produce a sufficient amount of certain hormones, it could lead to infertility. If the hormone activity is abnormal, the sperm will not attach or survive.

Testosterone: Low testosterone does not directly cause infertility. Testosterone is required for sperm production but other hormones are also involved. However, low levels of testosterone could result in less production of sperm. Studies have shown that high cholesterol is linked with decreased testosterone levels.

Dyslipidemia: This is caused when the LDL and triglycerides levels are very high and the HDL level is too low. Dyslipidemia leads to oxidative stress, which is known to affect sperm DNA quality.

Oxidative stress: High oxidative stress causes changes in the membranes of the sperm cells which affect morphology and motility and can cause damage to their DNA. Sperm are rich in PUFA (polyunsaturated fatty acids) which is required for healthy sperm production, increasing motility and improving development of testes and spermatogenesis. However, they can be negatively affected by oxidative stress causing cell damage.

On the contrary, sperm require ROS (reactive oxidative stress) to complete their maturation determining the integrity level of paternal DNA as well as other important steps in the fertilization process.
While some physicians may advise a PUFA-based supplementation to the diet to help sperm disorders, it is important that an antioxidant supplementation is provided as well, to make it effective.

Conclusion: While cholesterol is essential for the production of normal sperm, too high or too low cholesterol can have negative effects on fertility. While research is still ongoing on this subject, it is best, for general health as well, to keep cholesterol (both LDL and HDL) at a normal level. At the same time, if there is a plan to start a family or experiencing difficulties in conception, it is wise to have a semen analysis done.

At Andrology Center, we carry out semen analysis and DFI (sperm DNA fragmentation index) tests. These provide an accurate account of sperm quality and information on the level of sperm DNA integrity. We are proud to state that we are the only authorised laboratory in India to provide the authentic SCSA (sperm chromatin structure assay) test. With high tech equipment and standardized reporting formats, accurate diagnosis can be made which will help the fertility specialist to recommend the right ART treatment to the couple.