Kualiti sperma lelaki menurun?

© Provided by Harian Metro SENAMAN memberi manfaat kepada kesihatan kesuburan. hafizithnin@mediaprima.com.my

Kesukaran mendapat cahaya mata bukan sesuatu yang baharu dan malah, kisah pasangan melalui pelbagai cabaran untuk mendapatkan zuriat diimpikan sering kali dipaparkan.

Namun, dalam isu ini terdapat juga segelintir yang melihat kaum hawa sahaja menjadi punca utama ‘kegagalan’ untuk mendapatkan cahaya mata.

Perunding Sakit Puan Fellowship dalam Teknologi Bantuan Reproduktif, Dr Lindy Bak Li Mei berkata, perjalanan dalam ketidaksuburan memerlukan pasangan sama ada lelaki atau wanita untuk menempuhi segala rintangan bersama.

“Ia termasuk dari awal ketika peringkat saringan untuk mengetahui masalah yang berkaitan dengan punca ketidaksuburan.

“Isu punca ketidaksuburan boleh dikatakan disebabkan wanita, lelaki, kedua-duanya (pasangan berkenaan) atau tiada punca yang jelas. Oleh itu, adalah amat penting untuk suami menjalani pemeriksaan bagi menentukan kuantiti dan kualiti sperma,” katanya.

Jelasnya, kajian terkini menunjukkan kualiti sperma lelaki semakin menurun di seluruh dunia. Dalam kalangan negara Asia seperti China, India dan Jepun turut merekodkan penurunan kualiti sperma.

“Malaysia turut tidak terkecuali mencatatkan penurunan dari segi kualiti sperma daripada tahun 2010 hingga 2019 di mana 60 peratus ujian air mani menunjukkan sperma tidak normal.

“Walaupun keputusan ujian air mani tidak normal, ia tidak sama sekali merujuk kepada prestasi lelaki ketika persetubuhan, fizikal badan ataupun keperibadiannya,” katanya.

Tambahnya, namun begitu, stigma yang berkait dengan ketidaksuburan serta masalah sperma boleh menyebabkan lelaki berdepan dengan isu kemurungan ataupun ada yang merasa tercabar hingga menggugat perhubungan suami isteri.

“Terdapat pelbagai faktor yang mempengaruhi kesuburan lelaki dan perubahan gaya hidup yang baik serta pemantauan daripada pakar perubatan dapat membantu dalam merealisasikan impian membina sebuah keluarga,” katanya.

Punca ketidaksuburan lelaki:

1. Gaya hidup

Gaya hidup termasuk pemakanan yang tidak seimbang dan sihat seperti daging proses, minuman berkarbonat serta makanan ringan akan menurunkan kualiti dan jumlah sperma dihasilkan. Selain itu stres, pengambilan alkohol, dadah atau kafein juga mempengaruhi kesuburan lelaki.

2. Berat badan berlebihan dan obesiti

Kajian menunjukkan lelaki yang mempunyai berat badan berlebihan mengalami paras testosteron 24 peratus lebih rendah berbanding lelaki biasa, manakala lelaki obes mempunyai tahap 26 peratus lebih rendah testosteron. Kemungkinan ketidaksuburan lelaki meningkat sebanyak 10 peratus.

Oleh itu, penting untuk menurunkan berat badan bersesuaian dengan indeks jisim tubuh (BMI) sekitar 18.5 hingga 22.9. Pengiraan BMI = Berat badan (kilogram) (Tinggi (meter) x Tinggi (meter)

3. Pemakaian seluar yang ketat

Kajian menunjukkan bahawa lelaki yang sering memakai seluar longgar mempu

nyai jumlah sperma dan kepekatan tinggi berbanding yang memakai seluar ketat.

Malah kajian terdahulu memberi petunjuk bahawa peningkatan haba sekitar skrotum memberi impak negatif kepada testis untuk berfungsi dengan baik.

Oleh itu, elakkan daripada memakai seluar yang ketat semata-mata untuk kelihatan bergaya.

4. Persekitaran dan pekerjaan

Pekerjaan yang terdedah kepada suhu atau persekitaran yang panas turut mempengaruhi pengeluaran kuantiti dan kualiti sperma.

Sebagai contoh, pelumba basikal berkemungkinan terdedah kepada peningkatan haba yang boleh memberi kesan kepada asid deoksiribonukleik (DNA) dan membran sperma.

Pekerjaan yang memerlukan duduk lama di suatu tempat juga akan beri kesan apabila haba di tempat duduk menjejaskan pembentukan sperma.

Aktiviti seperti sauna, jakuzi dan juga mandi dengan air panas boleh meningkatkan lagi kesan oksidatif terhadap sperma.

5. Radiasi

Pendedahan elektromagnet radiasi daripada telefon bimbit yang diletakkan di dalam kocek seluar memberi kesan kepada kesuburan lelaki kerana kajian mendapati sperma yang dihasilkan mempunyai kualiti rendah.

6. Jangkitan kuman atau beguk

Jangkitan kuman di testis boleh menyebabkan ketidaksuburan bagi lelaki, terutamanya penyakit beguk. Beguk yang disebabkan virus Paramyxovirus biasanya membabitkan kelenjar parotid tetapi boleh merebak ke bahagian testis. Ini akan mengganggu kualiti sperma dan mempunyai risiko kecil untuk kesan jangka masa panjang.

7. Sistem reproduktif lelaki tidak sempurna (sama ada sejak dilahirkan, masalah rembesan endokrin, disebabkan trauma ataupun jangkitan kuman).

a. Ketiadaan vas deferens (tiub panjang yang menyalurkan sperma)

Sperma tidak boleh keluar melalui pancutan air mani. Ini menyebabkan air mani tidak mengandungi sperma apabila dianalisis.

b. Air mani tidak dapat dikeluarkan disebabkan vas deferens tersumbat dan mengalir balik ke dalam pundi kencing.

c. Paras hormon testosteron rendah akan menyebabkan lelaki ejakulasi pramatang dan lemah libido.

d. Salur darah pada testis timbul. Keadaan ini boleh mengakibatkan aliran darah tidak lancar dan boleh merosakkan epidimis dan mengurangkan jumlah sperma.

8. Usia

Kadar keguguran juga adalah lebih tinggi sekiranya pasangan wanita berjaya hamil dengan lelaki yang sudah berusia.

Pemantauan rapi daripada doktor diperlukan supaya risiko keguguran dapat dikurangkan. Penambahan usia juga mungkin mengundang penyakit yang lain seperti tekanan darah tinggi, kencing manis dan jantung yang sec

ara tidak langsung memberi kesan kepada kesihatan.

Dr. Lindy berkata, bagi pasangan lelaki, kualiti dan kuantiti sperma amat penting agar persenyawaan dengan telur isteri boleh berlaku untuk membentuk menjadi embrio atau janin.

Jelasnya, mengikut piawaian daripada Pertubuhan Kesihatan Dunia (WHO) 2010, analisis normal untuk sperma merangkumi aspek:

• Isipadu air mani antara 1.5 hingga 5 mililiter

• Kuantiti sperma antara 39 hingga 928 juta

• Pergerakan sperma (motility) 32 hingga 81 peratus

• Bilangan sperma berbentuk normal (morphology) 4 hingga 48 peratus

“Semua faktor di atas akan diambil kira ketika melakukan analisis ke atas air mani dan jika ada di antara isu itu berada kurang daripada garis panduan berkenaan, pemeriksaan lanjutan daripada pakar diperlukan agar dapat ditangani sebaik mungkin,” katanya.

Jelasnya, bergantung kepada hasil pemeriksaan lanjut, antara rawatan yang mungkin disarankan doktor adalah:

Pembedahan – jika vas deferens tersumbat atau tiada, pengambilan sperma melalui suntikan di testis atau epididimis boleh dilakukan termasuk pembedahan kecil biopsy tisu dari testis.

Antibiotik – jika terdapat jangkitan bakteria yang menyebabkan kurang jumlah sperma.

Ubat-ubatan yang lain – untuk mengatasi isu ejakulasi pramatang atau ereksi.

Rawatan hormon untuk mereka dengan masalah rembesan hormon dari otak.

Ubat-ubat vitamin seperti vitamin E, B12, D dan C oenzyme Q10, zinc, folic acid, gluthatione, selenium, carnitine dan arginine juga boleh membantu pembentukan sperma yang sihat dan banyak.

Katanya, doktor juga mungkin akan menyarankan pasangan untuk mencuba kaedah rawatan kesuburan iaitu:

• intrauterine insemination (IUI) atau permanian berhadas.

• in vitro fertilization (IVF) atau bayi tabung uji.

• IVF dengan bantuan intracytoplasmic sperminjection (ICSI).

Jelasnya, bagi mereka dengan bacaan BMI melebihi 30, lebih banyak ubat-ubatan diperlukan untuk membantu pesakit dalam menangani isu kesuburan dan kadar kejayaan kehamilan juga sukar untuk dijangkakan.

“Sedikit penurunan bacaan BMI memberikan impak yang besar kepada tubuh dan kecenderungan untuk hamil sama ada secara normal atau menerusi rawatan kesuburan menjadi lebih baik,” katanya.

Nasihatnya, jika keputusan ujian air mani tidak berada di paras yang memuaskan, berbincang dengan doktor dengan segera untuk mendapatkan nasihat berkenaan rawatan dan cadangan perubahan cara hidup supaya dapat meningkatkan lagi peluang untuk hamil.

© New Straits Times Press (M) Bhd

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