Can X-rays Cause Male Infertility?
Written by Ben Bunting: BA(Hons), PGCert.
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Infertility can be defined as the inability to conceive even after engaging in unprotected sex several times for at least 1 year.
Those couples who cannot get pregnant, 50% of the time male partners are a cause. Male infertility can be observed due to any condition that might affect:
- Sperm production
- Sperm function
- Sperm delivery
The issues that might result in the above problems are:
- Chronic health issues.
- Injury
- Bad lifestyle choices
- Hormonal issues
- Radiation
- Genetic defects
In this article we shall cover the following areas:
- Raditation and fertility
- X-rays and infertility
- Conclusion
Radiation and fertility
Here, we are going to discuss the role of radiation on male fertility. Males might be exposed to radiation in the following circumstances:
- For medical purposes like diagnostic X-rays or radiation therapy for cancer.
- Employment such as someone working at a nuclear plant or as a radiologist at a hosptial.
The radiation through many types of research and a lot of study work has been found to affect male fertility in mainly two ways:
- It impairs the process of spermatogenesis
- It affects the Leydig cells that produce testosterone.
The degree of injury caused by radiation largely depends on the volume, target, dose, specifically targeted cells, and fraction size of the radiation.
Spermatogenesis
The radiation affects spermatogenesis which is a dynamic process of cell division and differentiation through which spermatogonia changes into spermatozoa. [1]
The differentiated cells are more sensitive to radiation and hence the damage is greater.
Through research, we know that irradiation directly affects spermatozoa which are the motile, main cell in males, causing fertilization in females.
This decreases the number of sperm in males and affects their ability to fertilize enough that they can be categorized as sterile. [2]
However, depending on the radiation dose, this effect reverses in some months and sperm count has been seen to restore its original numbers in the majority of cases.
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After radiation doses of 1-2Gy, the loss in the number of sperms has been seen to reverse in 10-24 months, for people exposed to radiation up to 4-6Gy the recovery period was noted to be 5 years and more. [3]
Exceptions are there. The higher the dose of radiation, the longer time it will take to reverse the damage caused.
Recovery is a slow process but if the radiation is persistent with a dosage above 4Gy the reversal is not possible and permanent sterility may be caused.
Leydig cells
The second effect of radiation on males is the damage it causes to the Leydig cells in the testes. [4]
They produce the male hormone testosterone which is the main male hormone that regulates the sexual characteristics as well as production and delivery of sperm in males.
These cells are more affected in prepubertal time than after maturation, however, the adverse effects are still very much there.
A high dosage of irradiation may affect the Leydig cell causing hypogonadism in males.
This condition manifests itself as diminishing secondary male characteristics like body hair and gynecomastia along with the deterioration of testes and reduction in libido. [5]
This causes fertility issues in males and may render them infertile.
Do X-rays cause infertility in males?
Establishing the effects of irradiation, it is very impertinent to understand that going for a diagnostic x-ray once or twice may not be as harmful and potent enough to cause any risk to fertility in males. [6]
The image areas are protected, and having an x-ray is the equivalent to a few days of background radiation, so it is safe to go for an x-ray.
The amount of radiation used for the x-ray is so less than the risk of sterility is null.
However, the person in charge of taking the x-ray might be at risk of excessive radiation exposure as they spend long hours working with radiation.
They are advised to not be careless and carry out proper safety protocols to save themselves from unnecessary radiation exposure.
More research is being conducted to understand the relationship between irradiation and male fertility and how to regulate the gonadal function.
Conclusion
People exposed to irradiation in their work environment or due to any medical reasons should get a checkup done periodically to catch any abnormality in its initial period.
They should be properly guided about the precautionary measures they can take and the effects of radiation on their fertility so they can make necessary informed decisions.
Refrences:
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Fukunaga, H., Butterworth, K.T., Yokoya, A., Ogawa, T. and Prise, K.M. (2017). Low-dose radiation-induced risk in spermatogenesis. International Journal of Radiation Biology, 93(12), pp.1291–1298. Available at: https://www.tandfonline.com/doi/abs/10.1080/09553002.2017.1355579
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www.cancer.gov. (2017). Male Fertility Issues and Cancer - Side Effects - National Cancer Institute. [online] Available at: https://www.cancer.gov/about-cancer/treatment/side-effects/fertility-men.
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Biedka, M., Kuźba-Kryszak, T., Nowikiewicz, T. and Żyromska, A. (2016). Fertility impairment in radiotherapy. Contemporary Oncology, [online] 20(3), pp.199–204. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5013679/.
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Shalet, S.M., Horner, A., Ahmed, S.R. and Morris-Jones, P.H. (1985). Leydig cell damage after testicular irradiation for lymphoblastic leukaemia. Medical and Pediatric Oncology, [online] 13(2), pp.65–68. Available at: https://pubmed.ncbi.nlm.nih.gov/3920486/ [Accessed 21 Feb. 2022].
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Daniell, H.W., Clark, J.C., Pereira, S.E., Niazi, Z.A., Ferguson, D.W., Dunn, S.R., Figueroa, M.L. and Stratte, P.T. (2001). Hypogonadism following prostate-bed radiation therapy for prostate carcinoma. Cancer, [online] 91(10), pp.1889–1895. Available at: https://pubmed.ncbi.nlm.nih.gov/11346871/ [Accessed 21 Feb. 2022].
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NHS Choices (2018). X-ray. [online] NHS. Available at: https://www.nhs.uk/conditions/X-ray/.