Information » Diseases » Male Infertility
Sperm counts are falling. This should be a concern to us all, but it is a more immediate problem if you are trying to have children. Many couples who have trouble getting pregnant are not sure what to do about it. A great deal of emotional stress can be created by issues of blame, conflicting values and uncertainty about what is going wrong and what to do about it. Infertility is much easier to identify in men than in women, and it is possible to treat it simply and safely.
Many research studies have documented the slow, steady decline in sperm counts. The one that is quoted most often was published in 1992 in the prestigious British Medical Journal. The authors reviewed 61 studies of 14,947 men from 1938 to 1991. In that time, average sperm concentrations fell from 113 million to 66 million (sperm per milliliter of semen). This has been confirmed in many studies, suggesting that young men are less fertile than older ones. Very disturbing.
Although sperm counts are not a perfect measure of fertility, they are the best first test and provide a good estimate. It is also possible to test for anti-sperm antibodies in the blood, and specialized fertility centres can test semen for things like fructose levels, acidity, infections and white blood cell counts. This being said, if your sperm count is low you should definitely try to find out why – and do something about it.
It is well known that there are genetic causes of male infertility, caused by mutations of the Y chromosome. These are not very common, and should only be suspected if your sperm concentration is less than 10 million/mL. (The World Health Organization defines abnormal as sperm concentration less than 20 million/mL, normal motility less than 50% and normal morphology less than 30%.)
Environmental factors are much more common. These include things like heat, chemicals, heavy metals and radiation, but heat is the one that most people know about. Sperm develop and mature over 70 days, and they are damaged if the testicles are exposed to high heat during this time.
Research suggests that it is probably not worthwhile to switch to boxer shorts. In a study of 21 men who were given tight briefs to wear for one year, the temperature of their testicles rose by 1 degree Celsius – as expected – but their sperm counts did not change at all. Hot baths, saunas and Jacuzzis are another story – this wet heat can raise temperatures much more and lower sperm counts a great deal. This was confirmed by a study of men with low sperm counts who took regular hot baths or saunas at least once per week. When they avoided these activities for several months, their counts rose dramatically - by almost 500 percent.
Cell phone use has been linked to infertility in a few studies. It is well known that other kinds of radiation can damage sperm, so it is logical to think that the electromagnetic radiation from cell phones might be harmful. The studies are still very sketchy, though, so it is still too early to say for certain. Use the speakerphone function whenever possible.
There seem to be toxic chemicals in food, plastics, cosmetics and many other modern conveniences. A few have made headlines because they are known to disrupt hormones, but there are thousands of others that we just don’t know enough about. They are hard to avoid, but a few simple changes to your lifestyle are worth considering. Avoid processed foods containing ingredients you cannot pronounce. Eat organic fruits and vegetables when possible. Don’t drink bottled water and don’t store food in plastic containers. Keep cosmetics to a minimum and breathe fresh air whenever possible.
Heavy metals are known to damage sperm. Lead and cadmium have been found in semen, and they even affect the success of in vitro fertilization. The research is conflicting here, but this is because routine blood tests are only useful for recent exposures. We conduct specialized tests at the Centre using chelating substances to measure the amount of lead that is stored in body tissues. A series of IV treatments is used to remove excess metals from your body. These have improved sperm counts in our patients.
There are a few supplements that have improved sperm counts and fertility in research studies. The one with the most potential is carnitine. This is a molecule that brings fatty acids into mitochondria, which is how our cells get energy. Scientists thought it might be important when they found very high levels of carnitine in the epididymis, which is where sperm mature. A few studies have found L-carnitine or L-acetyl carnitine to be helpful. The largest was a double-blind study done in Italy, where 60 men took it for a few months and their sperm counts improved significantly.
Free radicals and oxidative stress are wellness buzzwords because they seem to damage every part of us. Sperm are particularly vulnerable because most of our natural antioxidants are not found in semen. One exception is coenzyme Q10, which has also been studied in disorders of the heart and brain. Many researchers have found low levels of CoQ10 in infertile animals and humans. In a small clinical trial of 22 men, supplementation almost doubled sperm concentration. This was confirmed in a larger study of 60 men. Another antioxidant that has been shown to improve male fertility is astaxanthin. This is a carotenoid found in salmon and other seafood, and is similar to vitamin E but much more powerful. In a study of 30 infertile men given 16mg of astaxanthin or placebo for three months, 55% of the men treated were able to achieve pregnancy, compared to 11% in the placebo group.
Finally, Zinc deficiency is common in infertile men. This has been documented in a few studies, and one good clinical trial has found that taking extra zinc can improve sperm counts. The researchers divided 102 men into four groups and gave them zinc, folic acid, both or a placebo. The real benefit seemed to come from zinc, and it raised sperm counts by 74%.
With every heartbeat, 1200 sperm are born. Evolution has decided that producing an enormous number of sperm is the best way to ensure our survival. Although our modern world presents challenges to couples that want to have a baby, there are alternatives to high-tech fertility treatments. These natural approaches do not simply make you more fertile; they make you more healthy.