Can Hernia Repair Affect Male Fertility? - Chromatography Explores

Many reports suggest that male fertility is on the decline and sperm quality and quantity are both reducing in the developed world. Several studies have suggested that this could be due to a decrease in sperm motility – sperm do not swim properly and so cannot swim to the egg to fertilise it. Other studies have shown a decrease in sperm concentration in ejaculate.

Other studies suggest that there are environmental reasons why male fertility has decreased. Toxins in the environment and the increased use of plastics are often cited. A recent paper published in the journal European Surgery­ - entitled Phthalates and infertility: an issue in hernia meshes? – has investigated one aspect of this problem. Could plastics in the meshes used to repair hernias be a factor in male infertility?

Hernias – not just for footballers

Hernias occur when an organ pushes through an opening in the muscle wall holding it in place. They are often attributed with footballers and other sportsmen but in fact can happen to anyone. Most hernias occur in the abdomen area between chest and hips, but they can also happen in the upper thigh and groin areas. Although not usually life threatening – they need fixing and sometimes surgery is required.

One of the most common types of hernia is the inguinal hernia which can appear as a lump in your groin or in men as an enlarged scrotum. Sometimes the lump is only visible when you are lifting something and disappears when you lie down. Inguinal hernias occur when fatty tissue or part of your bowel pushes through the groin. In men, just after birth their testes descend through the inguinal canal leaving a weak spot where a hernia can occur.

Mesh in the hole – free from toxins?

One way to fix inguinal hernias is through surgery, although this is usually the last resort if other treatments do not work or the hernia is particularly painful. The lump of tissue or intestine is pushed back through the hole and the wall of the abdomen is strengthened with a mesh. The surgery is performed either through open or keyhole surgery.

In the study referenced above, the researchers investigated the mesh commonly used in repairing inguinal hernias and identified any plasticizers in the mesh. Plasticizers are one of the toxins that have been linked to a reduction in male fertility. Could we be adding to the infertility problem when fixing a hernia?

The researchers analysed mesh samples using gas chromatography-mass spectrometry. The use of GC-MS is discussed in the article, Measurement of Pesticides in Cannabis sativa and Hemp Matrices Using a Gas Chromatograph-Triple Quadrupole Mass Spectrometer. The team did not find any of the targeted plasticizers, including phthalates, in the mesh samples analysed. The authors conclude: implantation of mesh materials affecting male fertility, whether temporarily or not, cannot be explained by the presence of the targeted plasticizers.