Lauri M. Aesoph NDMost people take it for granted that they’ll have children one day. In fact, most people are so confident they can conceive, they use birth control until they’re ready for parenthood. Yet 10 to 15 percent of all couples are infertile; half the time it’s due fully or partly to the man.
If you think you or your partner is infertile, first have a physical exam done by your doctor. A semen analysis or “sperm count” is also useful. This test will tell you a number of things including the movement, number and shape of your sperm. You’ll also learn your total semen volume, thickness and how well it liquifies. Armed with this knowledge, sort through the following lifestyle and nutritional options that might solve help your problem.
Causes
Just as women’s health care is called gynecology (gyne means woman in Greek), andrology (andro means man) refers to the study and care of male reproduction and infertility. Unfortunately for men, until 20 years ago male infertility was relegated to urology or urinary complaints. Finally in 1976 the American Society of Andrology was formed, spotlighting male health concerns.
Male infertility encompasses four main areas: sperm production and maturation, speed (motility), ejaculation, and deposition of semen into the vagina. The normal ejaculation releases 1/2 to 1 teaspoon of semen containing anywhere from 40 to 500 million sperm. If illness, injury or congenital malformations interfere with a man’s reproductive tract, from the testes that produce sperm and testosterone to the epididymis that stores the maturing sperm, infertility is possible.
If impotence is the problem, drugs, chronic illness, prostatitis or diabetes may be responsible. Infection of a man’s reproductive system, including mumps or sexually transmitted diseases, can impair sperm production. Even a high fever can temporarily halt sperm. Other conditions to watch for are hydrocele (a small sac of fluid in the scrotum), varicocele (like a varicose vein, but in the genital area), undescended testicles and failure to ejaculate normally.
Recently, E. Carlsen and his associates evaluated 61 studies from 1938 to 1991 and reported that sperm counts have dropped by half during this time while semen volume is 20 percent less (British Medical Journal, 1992, volume 305). Carlsen says such a dramatic decline is likely due to lifestyle or environmental factors such as pollutants and toxic chemical exposure.
Since publishing this information, Carlsen has been challenged by Geary Olsen, PhD (Fertility and Sterility, 1995, vol 63). While Olsen may have a valid point, it’s interesting to note that he and several of his co-authors work for Dow Chemical, while others, with the exception of one, are employed by Shell Oil.
Other studies also point to the adverse effects of toxic substances on male fertility. R.K. Dikshit from B.J. Medical College in India discovered that industrial employees working long hours in poorly ventilated, hot, chemically infested conditions were twice as likely to have sperm counts lower than 20 million/ml than office workers (Infertility, 1987, vol 10). Organic farmers had higher sperm density compared to other workers in a study done by Annette Abell of the University Hospital of Aarhus in Denmark (The Lancet, 1994, vol 343).
Richard Sharpe, PhD from the Centre for Reproductive Biology in England says in utero exposure to estrogen (other than the mother’s) might explain declining sperm counts and other male disorders like testicular cancer. DES (diethylstilbestrol), a synthetic estrogen given to women to prevent miscarriage and famous for causing vaginal cancer and other problems in daughters of women who took the drug during pregnancy, is also linked to diminished sperm counts in sons. Estrogen or estrogen-like compounds are also found in soy products, dairy, and dioxin and other chemicals (The Lancet, 1993, vol 341).
Nutrients
Fertility and health in general benefit from a diet based on fresh fruits and vegetables, whole grains, low fat protein (skinless poultry, fish, legumes and beans) and clean water. But research from around the globe reveals that specific nutrients also help sperm. One recurring rationale is that many of these vitamins and minerals are antioxidants, substances that protect sperm from toxic damage.
Nicotine and other by-products of cigarette smoke reduce sperm count, speed and morphology by 20 percent (Archives of Andrology, 1995, vol 34). Men who work around lead, pesticides and other chemicals are affected even more. When Earl Dawson, PhD from the University of Texas in Galveston gave 75 heavy smokers vitamin C, their sperm quality increased; the more vitamin C they received, the more they improved.
Other antioxidants showing promise for male infertility are vitamin E, coenzyme Q10 (professional experience), selenium, zinc and glutathione. Glutathione, produced in the body with vitamin C supplementation, helped several infertile men in Italy (Human Reproduction, 1993, vol 10). One sign of vitamin E deficiency in men is slow moving sperm (Nutrition Reviews, 1988, vol 46).
When Coon-Nam Ong from the National University of Singapore checked over 200 men for trace elements, he found higher sperm density was associated with increased zinc and selenium levels. Cadmium on the other hand, a by-product of cigarette smoke, went hand in hand with low semen volume (Reproductive Toxicology, 1993, vol 7) and sperm density (International Journal of Fertility, 1994, vol 39).
Because the prostate gland is rich in zinc and magnesium, these two minerals have long been considered important treatments for prostatic and other male complaints. Zinc, a cadmium antagonist and necessary for protein synthesis, is one part of a comprehensive fertility program (Urology, 1987, vol 29). Orhan Deger from the Ataturk University in Turkey found infertile men had about half the semen magnesium as fertile men (Magnesium, 1988, vol 7).
Carnitine, the nutrient that’s not sure if it’s a vitamin or not, is concentrated in the epididymis and spermatozoa. When levels drop too low due to inadequate precursors (lysine and methionine) or cofactors (vitamins B6 and C, niacin, iron), poor absorption, high fat diet, drugs or disease, sperm production and speed fall also (Andrologia, 1994, vol 26). If you plan to take this nutrient, use only the L-carnitine form not the DL or D types.
Finally, two members of the B-complex family have shown potential in infertility treatment. Folic acid is needed for synthesis of the genetic material, DNA. When Giorgio Bentlivoglio, MD of the University of Genova supplemented Italian men with folinic acid, folic acid’s active form, for three months their sperm numbers and motility increased (Fertility and Sterility, 1993, vol 60). Vitamin B12 may also improve sperm count (Infertility, 1984, vol 7).
Stress
Stress used to be blamed for half of all infertility cases. While there’s no doubt that daily pressures impact health including fertility, only five percent are now attributed directly to stress. Besides emotional tensions, stress includes reaction to surgery, long standing immobility, physical demands and even foods, like excessive sugar and salt.
During the past decade, a link has been drawn between immunity and psychological states. That same connection, called neuroendocrinology, has been made between reproduction and emotions. Stress creates a familiar scenario: fast beating heart, sweating, rapid breathing. The reproductive system isn’t immune to this body-wide reaction. Adrenalin, for example, can decrease blood flow to a man’s testes.
In a review article by A.V. McGrady from the Medical College of Ohio in Toledo, there are several incidence showing how mild to serious emotional pressure affects male fertility. Students at an officer-candidate school had lower testosterone levels when stress rose. Spermatogenesis, or sperm formation, almost came to a standstill in prisoners who were sentenced to death and then kept waiting. Even long-term infertility treatment can impair a man’s fertility.
In addition, unabated fatigue, worry about family and business and other pressures may dampen a man’s fertility, libido, sexual performance and general interest in a relationship (Archives of Andrology, 1984, vol 13).
Drugs and Other Considerations
If you’re concerned about fertility, look at any drugs you’re taking be they prescription, over-the-counter or recreational. Like other chemicals, many drugs reduce sperm quality and quantity.
If you’re on a long-term prescription, ask your doctor the effects of your medication on fertility. If you want to do your own research, find a copy of the Physician’s Desk Reference, an annual publication that lists all prescription drugs and describes their use and side effects. When you’re having X-rays for diagnostic reasons (including dental) or treatment, make sure your genital area is covered with a lead apron. If the technician or doctor doesn’t offer you one, request it.
One-third of men of reproductive age smoke cigarettes. Passive smoke affects even more men. The harmful substances emitted by cigarette smoke include not only nicotine and carbon and monoxide, but products that cause cancer and hurt your sperm (and therefore your baby). Tobacco’s by-products wind their way to the testes, disrupting sperm production and function. They effect sperms’ attachment and penetration of the egg (Archives of Andrology, 1995, vol 34). Even impotence tends to be higher in smokers versus nonsmokers (American Journal of Epidemiology, 1994, vol 140).
Like cigarettes, cocaine use hurts both sperm development and any baby that may result. Ricardo Yazigi, MD from the Washington University School of Medicine in St. Louis found that sperm may actually transport cocaine to the egg (Journal of the American Medical Association, 1991, vol 266). A Yale study headed by Michael Bracken, PhD discovered that cocaine use was associated with slower and more abnormal sperm as well as lower sperm counts and concentrations (Fertility and Sterility, 1990, vol 53).
Because sperm production is thwarted by heat, unintentional warming of the testicles can decrease the fertility of an otherwise normal man. Some couples become pregnant after just a few simple, cooling precautions. If parenthood eludes you, consider avoiding hot tubs, saunas, long hot baths (tepid baths and showers are OK), wearing tight underwear (trade your jockeys in for boxers), athletic supporters and tight pants. Like most male treatments, do this for at least three months to allow new sperm to form and mature (Fertility and Sterility, 1986, vol 46 and professional experience).
There are so many conservative natural approaches to consider when faced with infertility before launching into expensive, complex treatments. While they may involve changes in how you eat or live, difficult for most of us, the results can be very rewarding.
Did You Know?
Unlike most creatures, human reproductive behavior isn’t dictated by seasons…or is it? In Houston, at the University of Texas Health Center, Wilie Tjoa, MD, PhD found out that sperm counts and concentrations fluctuated throughout the year. Sperm quantity peaked between February and March, and sank to its lowest during September (Fertility and Sterility, 1982, vol 38).
Maryon Stewart
Jim Strohecker
Tom Ferguson MD
