In 2017, a study from the Hebrew University of Jerusalem caused international shockwaves when it revealed that sperm counts in the western world had more than halved between 1973 and 2011. The concentration of sperm in men’s ejaculate had dropped by an average of 1.4% a year, leading to an overall drop of 52%.
The change had happened within a single generation. This led a lot of researchers to believe that the overall drop was lifestyle dependent, down to the increased prevalence of sedentary lifestyles, poor diet, drinking, smoking and obesity.
Fortunately, lifestyle factors such as these are well within the control of most men, and through relatively simple changes sperm counts can drastically improve. However, many men are completely unaware of any problems with their sperm count in the first place. Until you know it’s affecting you directly, a 52% decrease in male fertility over 40 years just sounds like another statistic.
Me CASA su CASA
Enter ExSeed, a mail-order computer assisted sperm analysis (CASA) kit which can be operated via a smartphone. Using a vast database of semen samples, it gives users an analysis of their sperm’s motility, volume and concentration.
The ExSeed device can be used many times, and comes with consumables for five different tests. Users will need to do two tests to have statistically significant results, as per World Health Organisation (WHO) guidelines, with the extra three thrown in for users who plan to keep checking on their sperm count in future. Simply collect a sperm sample, input it into the ExSeed device on a glass slide and hook the device up to your smartphone.
The device analyses the sample in just a few seconds and streams the results to its corresponding app. After a user completes the required tests, the platform can offer them personalised advice on how to improve their sperm count and quality, typically through lifestyle changes like improved diet and exercise.
The company claims the results from its CASA technology are 96% accurate, compared to laboratory results. The company is currently under evaluation with the British Standards Institution (BSI) to become officially recognised as a medical device.
“Historically speaking, the male side of infertility has been grossly neglected,” says ExSeed CEO and co-founder Morten Ulsted. “It’s kind of crazy, because you have a situation where 40% of all infertility actually has male-related factors, yet doctors and clinics have almost solely focused on women.”
It’s true that the impetus is usually put on women in conversations about fertility and conception, rather than men. The femtech market is expected to be worth $50bn by 2025, and a huge number of femtech companies are focused on fertility. Meanwhile, clinicians have yet to develop a male contraceptive pill, let alone a male fertility tech market to rival the female one.
Ulsted says: “I think ExSeed finally empowers men to actually take an active approach and participate in the process.”
A different lifestyle
Around a third of ExSeed users will find that their sperm quality is at the low to moderate end of the spectrum. This stands to reason – ExSeed users are, by and large, men who are already concerned about their fertility and therefore more likely to have a problem. But when the NHS reports that one in seven couples in the UK are failing to conceive naturally, it’s hard not to sit up and take notice.
It isn’t just self-inflicted lifestyle factors suspected to be behind the drastic drop in sperm quality. Contact with certain chemicals and pollutants has also been blamed for the decline, and avoiding exposure isn’t always an option.
“There’s been a lot of talk about the effect of chemicals on the development of the testicles of a baby, even whilst it’s still in the womb,” Ulsted says. “The argument here is that chemical compounds affect our hormone levels, messing with our testosterone and oestrogen balances. You also have micro exposures of adult men to BPA and plastics in tablets – even chemicals in sunscreen are under suspicion.”
Despite this, only 12% of all NHS Clinical Commissioning Groups (CCGs) are complying with current National Institute for Health and Care Excellence (NICE) guidelines, which recommend that all eligible couples should have access to 3 full cycles of in-vitro fertilisation (IVF).
Ulsted says: “Some CCGs have entirely written fertility out of their budget. If you’re in Essex or Croydon, some CCGs have literally nothing for infertility, both on the male and female side. So people will actively start looking for other solutions, like ExSeed.”
Of course, simply following ExSeed’s advice and eating more greens won’t make up for any underlying medical causes of male infertility. But in cases where lifestyle changes are what’s needed, becoming aware of them earlier has the potential to save struggling couples thousands in unnecessary and expensive fertility treatments further down the line.