Let’s Talk About Male Fertility

My lifestyle is making me infertile
23rd August 2018
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Let’s Talk About Male Fertility

Male Fertility

Let’s Talk About Male Fertility

By Andreia Trigo BSc MSc Nursing & Beatriz Trigo BSc Psychology

Male fertility is the likely cause in 50% of all infertility cases, mostly related to sperm quality issues. But what is sperm quality? Sperm quality is the ability of the sperm to accomplish fertilisation, either because of low quantity, abnormal shape or abnormal movement.

Male FertilityWHO establishes normal parameters for sperm quality and in the UK, NICE recommends the same ranges:

  • semen volume: 1.5 ml or more
  • pH: 7.2 or more
  • sperm concentration: 15 million spermatozoa per ml or more
  • total sperm number: 39 million spermatozoa per ejaculate or more
  • total motility (percentage of progressive motility and non‑progressive motility): 40% or more motile or 32% or more with progressive motility
  • vitality: 58% or more live spermatozoa
  • sperm morphology (percentage of normal forms): 4% or more.

WHO Sperm Parameters

Male Fertility: Is Sperm Quality Reducing?

Several research papers showed there has been a decline in sperm quality and male fertility worldwide. In a review and meta-analysis published in 2017 found out there has been an average decline in sperm count of 1.4% per year between 1973 and 2011. Even though we know men are becoming less fertile, reasons for this happening are unclear.

How can sperm quality be improved?

  1. Age: The genetic quality of sperm, as well as volume and motility decrease with age, which means that older sperm is less likely to result in a successful pregnancy. It also increases the chances of genetic and chromosomal defects. So for successful pregnancies and healthy babies, we need to start considering parenthood earlier in life.
  2. Heat: sperm are heat-sensitive and cannot endure high temperatures. So some activities to avoid are: sauna, bathing for a long time in hot water, tanning bed sessions for a long-time, placement of a laptop computer over the groin for extended use, and wearing underwear that’s too tight.
  3. Physical trauma: Trauma to the testicles can harm the capillaries that supply the sperm producing tissue. Avoid physical trauma that might affect your fertility. Bicycling, for instance, may cause trauma when overdone; it is associated with nerve entrapment syndromes presenting as genitalia numbness followed by, when in advanced stages, erectile dysfunction. Other less common symptoms include penile thrombosis, torsion of spermatic cord, prostatitis, etc. It is okay to ride a bike if it isn’t a “24/7 activity”.
  4. Medication: some medication can lower sperm quality: SSRI (lower count), antibiotics (lower production), antidepressants, anti-epileptics, propranolol, opioids, calcium channel blockers, statins. Steroids can also reduce sperm quality. Check your medications and discuss with your doctor or nurse if these are affecting your fertility. Your doctor may also prescribe some medication that improves sperm quality, like: clomiphene citrate oral (Serophene), serophene oral, Gonal-f® RFF Redi-ject® (follitropin alfa or gonal-F) or subcutaneous (under the skin) injections, antibiotics (in case of urinary or reproductive tract infection), human chorionic gonadotrophin (hCG) (brand names Choragon and Pregnyl), letrozole or anastrozole, exogenous androgens.
  5. Stress: Long-term stress appears to reduce sperm quality. Chronic psychological stress has been shown to lower semen quality. Relaxation techniques and self-confidence are the two best friends a man could have in this situation. Part of this solution is sleeping well, eating right, balancing work and rest, having hobbies, and understanding that the extent of the relationship goes beyond this single issue. Exercise is a good way of dealing with frustration, sadness and/or stress.
  6. Substance abuse: Tobacco, cannabis, marijuana and cocaine lower sperm quality. Tobacco and alcohol consumption are widely socially acceptable, but its negative effects on fertility have been consistently reported over the last 30 years. More recently, marijuana is starting to increase in popularity too in terms of legality. Impairments in spermatogenesis and sperm parameters, and increased chromosomal defectiveness and oxidative stress have been confirmed as well.
  7. Exercise: Exercise improves blood flow, increases the metabolic, and feeds the secretion of certain hormones.The endurance and resistance training can lead to increased production of testosterone, which betters sperm production and improve fertility. Moderate physical activity 3 times a week can increase sperm volume and concentration.
  8. Diet: what we eat affects the quality of sperm. Evidence suggests that drinking sugared sodas reduces sperm quality; soy products also decrease sperm quality; as well as diets rich in processed meat, potatoes, full-fat dairy products, coffee, alcohol and sugar-sweetened drinks and sweets. On the other hand, Folate (vitamin B9) can protect sperm cells; healthy diets with omega-3 fatty acids (e.g. walnuts and salmon), some antioxidants (e.g. blackberries, strawberries and spinach) and vitamins, and low saturated fatty acids and trans-fatty acids can help with sperm quality.
  9. Timing of ejaculation: Sperm quality (semen volume, sperm concentration, sperm motility) is negatively impacted by frequent ejaculation, but positively affected with the comfort in ejaculating (weather having sex or masturbating, due to psychological factors). A period of time of less than one day reduces sperm count by at least 20%. Longer periods of abstinence also reduce pregnancy rate. The key seems to be an abstinence period of only 1 or 2 days. The afternoon seems to be better for sperm quality than the morning. And if you’re collecting sperm for IVF, intercourse seems to provide 70-120% more sperm, with better motility (movement) and morphology (shape) when compared to masturbation. It also generates 25-45% more volume.
  10. Supplements: even with a healthy diet it can be challenging to reach the required amount of nutrients and vitamins to improve sperm quality, so supplements can be really helpful.
  • CoQ10 (increases sperm count)
  • Alpha-tocopherol (increases sperm count)
  • Carnitine (improves motility and morphology)
  • Vitamin E and C (reduces sperm DNA damage)
  • Zinc (increases sperm count and motility)
  • Vitamin D and calcium (also seem to be related to sperm health)
  • Arginine (increases sperm count and poor motility)
  • Fenugreek (seems to improve sperm count)
  • Ashwagandha (indian ginseng) (increases sperm count)

Even though men produce millions of sperm every day, new sperm takes about 2.5 to 3 months to fully mature. So even though you may make changes in your lifestyle today, you will only have an effect in your sperms’ health in 3 months’ time. So it’s all about implementing change and sticking to it!

If you are trying to conceive and are concerned about male fertility, book a free phone consultation here to help you improve lifestyle for fertility. The consultation is with the awarded Nurse Consultant and NLP Coach Andreia Trigo, creator of the Enhanced Fertility ProgrammeIt’s never too late to start your fertility support plan, why not start today?

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