Being proactive about your reproductive health is a solid first step toward preparing for that family you’re looking forward to having one day. After all, 40 to 50 percent of infertility cases are attributed to male fertility issues.
Whether you’re looking to start a family next month or next year, you’ve likely put some thought into how you can promote healthy sperm development. If you’re actively trying, you might have even attempted some of the “tricks,” such as switching from briefs to boxers—an idea often touted in glossy magazines.
But do these strategies truly improve your fertility? We turned to Dr. Eric Levens of our Annandale, VA office to shed some important light and actionable steps that could help you increase your knowledge and potentially enhance your fertility.
Q: What are the primary causes of male infertility?
Dr. Levens: While there are many different causes of male infertility, each falls into one of three categories.
1. Sperm production disorders
Your brain sends signals to your testicles, telling them to produce sperm. These signals are sent through hormones—primarily follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
In some cases, however, your testicles are unable to produce sperm, even though they’re receiving the signals from your brain.
In other cases, the signal isn’t strong enough. Though your testicles can produce the sperm, you may lack sufficient FSH or LH hormones to kick them into sperm production mode.
As specialists, the way we handle a sperm production disorder depends on what exactly the problem is. In some cases, we can use medicine to create the ideal hormonal balance. In others, we retrieve sperm from the testicle.
2. Obstructive issues
Obstructive issues, which result in reduced sperm count and often lower seminal volume, occur when sperm is prevented from being ejaculated.
While there can be many causes, obstructive issues are often congenital (present at birth), such as the congenital absence of the vas deferens. Problems of this nature can also result from a failed vasectomy reversal.
Some men, particularly those with diabetes, experience outflow obstruction—also known as retrograde ejaculation. When men have this issue, their semen will flow into the bladder instead of out the urethra during ejaculation.
When a man has an obstruction issue, fertility specialists are commonly able to extract sperm cells from the epididymis. In the case of retrograde ejaculation, we can usually reduce urine acidity using medication, then extract sperm from the urine.
3. Immune system dysfunction
In some cases, your immune system may be fighting against your fertility. Because sperm is naturally antigenic, your body can form antibodies against them. In some cases, a man’s body forms antibodies that attach to sperm, making it more difficult for sperm to move.
When a problem pertaining to your immune system is hindering conception, we are often able to “wash” the sperm, remove the antibodies, and proceed with more advanced reproductive care—like an IVF cycle.
Q: What’s a semen analysis, and when should I have one?
Dr. Levens: A semen analysis is a non-invasive, low-cost test in which we assess your sperm. In a semen analysis, we examine three main things:
- Count – How many sperm you have
- Motility – How well your sperm move
- Morphology – How your sperm are shaped
Because a semen analysis is such a simple test that yields a substantial amount of information, we suggest that couples have this test as part of their primary fertility work-up. In many cases, where patients initiated low-tech treatment such as timed intercourse with Clomid under the care of their OB/GYN or primary care physician—only to have an unsuccessful result—the answer was only revealed after a simple semen analysis. Had that couple started with an early semen analysis they could have saved precious time with other treatment strategies.
The bottom line, if you’ve been having unprotected sex for 1 year with a female partner under 35 or 6 months with a female partner over 35 and she hasn’t yet conceived, it is time to see a fertility specialist for testing of both the male and female.
If you have reason to suspect you may have an issue with your sperm—like if you’ve ever had testicular trauma, erectile dysfunction, or problems ejaculating—consider skipping the wait, regardless of your partner’s age or how long you’ve been trying, and get tested immediately.
When it comes to conception, knowledge is power. And a semen analysis can offer a quick, easy snapshot of your sperm health, providing knowledge that can be crucial to your starting a family.
Q: What can I do to promote healthy sperm development?
Dr. Levens: To have the maximum possible impact on sperm quality, you need to do more than simply eat the “right foods” or add a fertility supplement to your diet.
Whether you’re hoping to become a father soon or planning for future parenthood, here are a few actionable items to help you improve your sperm health.
1. Maintain a healthy weight.
Carrying extra weight can increase testicle temperature and ultimately hinder sperm health. Not to mention, our body’s fat cells produce estrogen, which, when present in abundance, can decrease sperm production.
Since a direct correlation exists between obesity and having fertility issues, weight loss may help men improve sperm quality.
To maintain a weight within the ideal range, we encourage our patients to focus both on maintaining a healthy diet and engaging in moderate physical activity.
2. Stop smoking.
Smoking increases oxidative stress on all body tissue, including sperm. Oxidative stress impacts both sperm motility and sperm morphology.
3. Avoid excessive alcohol consumption.
Drinking excessive alcohol not only impacts your physical health—which can result in sperm issues—but it also commonly causes sexual dysfunction. This dysfunction may impact the frequency with which you are able, or choose, to have sex, therefore making conception harder.
4. Avoid excessive heat.
Your testicles need to be at a lower temperature than the rest of your body—which is why they form outside of your body. Like smoking, excessive heat exposure puts oxidative stress on your sperm.
Further research is needed to know how much heat is truly damaging, however. Though we often hear it, there is no guarantee that switching from briefs to boxers will positively impact sperm count. At the same time, however, making the switch likely won’t hurt.
5. Don’t take testosterone-containing medicines.
Some men who struggle to maintain a healthy libido often receive a testosterone (Low T) prescription from their general physicians as a remedy. While it may seem that increasing your testosterone level will help your sperm, many of the medicines used to do this actually suppress sperm function.
6. Take a vitamin.
Maintaining an ideal vitamin and mineral balance is critical for sperm production. Some research indicates that zinc and folate supplements help promote sperm health.
Shady Grove Fertility is proud to recommend Luminary Vitamins and Theralogix to offer high-quality, evidence-based nutritional supplements patients can trust.
Medical contribution by Eric D. Levens, M.D.
Eric D. Levens, M.D., FACOG, board certified in obstetrics and gynecology and subspecialty board certified in reproductive endocrinology and infertility. Dr. Levens is committed to improving the success of fertility care through active research and national advocacy. He sees SGF patients at the Fairfax, Virginia, office.
