Male Fertility: The Other 50%
Although trouble conceiving is often viewed as a female centric issue, male fertility problems are actually involved in about 50% of the cases in which a couple struggles to get pregnant. Both partners contribute half of the genetic material needed to grow a healthy baby, so it makes sense that both partners would need to put in a bit of work to ensure that their contribution is of the highest possible quality. Read on to learn about how male fertility issues can arise and the steps men can take to ensure a successful conception and a healthy pregnancy!
What Makes a Man “Fertile”?
There are many factors that contribute to female fertility and the ability to support a pregnancy but, for men, there is really only one thing that matters – healthy sperm. In most traditional medical settings, sperm health is evaluated based on three factors:
Count/concentration– the number of sperm cells in a single unit of fluid
Motility– how well sperm cells are able to swim
Morphology– the percent of sperm cells in a sample that have a normal shape and appearance
Men who have a large number of efficiently swimming, normal looking sperm in their samples are considered to have excellent fertility potential, while men who have a deficiency in any of these parameters are considered to have diminished fertility potential. While the above factors are certainly very important, there is one more major factor that is often overlooked when assessing sperm health:
DNA quality– the percent of sperm cells in a sample that have healthy vs. damaged DNA
DNA damage can occur as a result of DNA mutations, extra or missing copies of chromosomes, or breaks in a DNA strand (fragmentation). Research suggests that higher levels of DNA damage put couples at risk of both infertility and miscarriage. Because DNA damage is not typically assessed in a standard semen analysis, men may not always be presented with an accurate picture of their sperm health. To assess sperm DNA quality, a special test called Sperm Chromatin Structure Assay (SCSA) would need to be performed.
What Causes Poor Sperm Health?
Problems with sperm health can occur for a variety of reasons, many of which can be improved or corrected with some extra attention to diet and lifestyle factors or, in some cases, medical treatment.
Oxidative stress is a state of imbalance between free radicals and antioxidants that can lead to tissue damage and inflammation in the body. Although the production of free radicals occurs naturally through everyday biochemical processes, it can also be accelerated by things like toxic exposure, poor diet, stress, lack of sleep, etc. Antioxidant nutrients counteract free radicals and prevent tissue damage, but when antioxidant supply is depleted and/or intake from the diet is low, oxidation can get out of hand. Unfortunately, sperm are extremely vulnerable to oxidative stress, especially during the roughly two months it takes them to mature. Oxidative stress impacts sperm motility and energy production and also increases sperm DNA damage.
Contrary to popular belief, men are not infinitely fertile throughout life. Similar to female fertility, male fertility appears to decline after age 35. Men over 45 have twice the level of DNA fragmentation in their sperm compared to men under 30, which has been shown to increase miscarriage risk. Studies have also shown increased likelihood of birth defects and autism with increasing paternal age. This might seem a little doom and gloom for older fathers. However, research also shows that sperm quality can be improved and that older men can achieve results similar to younger men with a few simple changes, such as increasing antioxidant intake.
Obesity has been shown to negatively impact fertility in men in a variety of ways, including altered hormone production, decreased sperm quality, and increased oxidative stress. Obese men have been found to have a higher percentage of DNA damaged sperm and are also significantly more likely to have a lower overall sperm count.
Stress is known to have a negative impact on many aspects of health. Specific to sperm quality, studies have shown that psychological stress affects testosterone production and thus sperm count, motility, and morphology. We also know that stress has a negative impact on inflammation and blood sugar regulation, both of which can increase levels of oxidative stress in the body that lead to sperm DNA damage.
Diets high in processed foods, sugars, and other refined carbohydrates are very problematic for fertility in both men and women. Processed foods contain very few essential nutrients and cannot support the body’s antioxidant needs, which can increase oxidation and sperm damage. Sugars and refined carbohydrates also quickly raise blood glucose, which is known to lead to insulin resistance and increased oxidative stress, both of which are harmful to sperm quality and fertility. Sperm health in men who have already progressed to type 2 diabetes is much poorer than in men with normal glucose levels.
We are all exposed to an incredible number of toxic substances on daily basis and there are several common substances that have been specifically shown to have adverse effects on sperm health. The biggest offenders are endocrine disruptors like BPA, phthalates, lead, and other heavy metals. Endocrine disruptors are chemicals that alter hormone production in the body and can thus affect fertility in a variety of ways. BPA has been shown to decrease sperm concentration, motility, and morphology, while also increasing DNA damage. Phthalates have been shown to reduce testosterone in men and have also been linked to increased inflammation and oxidative stress. Higher levels of lead are associated with lower sperm concentration and increased numbers of abnormal sperm. Commercial lubricants have also been shown to be toxic to sperm by decreasing motility and casing DNA damage.
In some cases, issues with sperm quality or quantity can be caused by medical conditions, such as infections, blocked tubes, or varicocele (enlarged vein in the scrotum). Treatment is often able to correct or improve these issues and thus improve sperm health and fertility.
How to Improve Sperm Health and Fertility
If you know that sperm quality is an issue for you, don’t panic! There are a number of changes you make in your diet and lifestyle to improve your sperm health and fertility potential. Even if you have no reason to expect an issue with sperm quality, the following actions can help ensure a successful conception and healthy pregnancy.
Adjust Your Diet
To help manage weight, reduce blood sugar issues, and minimize oxidative stress, you should significantly reduce or remove the following foods from your diet:
Processed food and fast food
Soda, sweetened beverages, and energy drinks
Refined carbohydrates (anything made from white flour)
Replace them with lots of antioxidant-rich non-starchy vegetables, and moderate amounts of low sugar fruits, starchy vegetables, legumes, and whole grains (and, of course, plenty of water). Also, make sure you are consuming enough quality proteins and healthy fats to help keep your blood sugar stable and keep you satiated. Purchasing produce and animal products from organic sources will help you avoid endocrine disruptors, hormones, and other toxins that can negatively impact sperm health.
It would also be wise to limit alcohol intake, as heavy consumption is linked to poor sperm quality. Alcohol can also damage sperm by increasing levels of oxidative stress in the body. Heavy alcohol consumption for men is considered more than 3 drinks in a single day or more than 14 drinks in a week. Scientific research has not established a definitive “safe” level of alcohol consumption for male fertility. However, if you know that sperm quality is an issue, less is probably more when it comes to alcohol.
Increase Intake of Antioxidants and Essential Nutrients
In addition to the dietary changes listed above, there are some specific antioxidants and other essential nutrients you need to focus on for sperm health and fertility. These nutrients will help quench free radicals, reduce oxidative stress, and prevent sperm DNA damage. The best food sources for each nutrient are listed but it would also be wise to supplement with these nutrients in the form of a quality multivitamin or antioxidant supplement to ensure you are getting enough. Studies show that men who supplement with antioxidants have significantly better fertility potential than men who do not.
Vitamin C– broccoli, brussels sprouts, citrus fruits
Vitamin E– nuts and seeds, avocado, red palm oil
Folate– leafy greens, liver, legumes, beets, asparagus
Selenium– brazil nuts, seafood, liver, beef
Zinc – red meat, pumpkin seeds, spinach, chickpeas
CoQ10 – beef, chicken, eggs, seafood, strawberries, oranges, broccoli
Get Enough Exercise and Manage Your Stress
To help manage weight and reduce stress, you should focus on getting at least 30 minutes of moderate intensity exercise several times per week. Although too little exercise is definitely problematic, research also shows that too much exercise can lead to increased oxidative stress. Avoid pushing your body too hard or engaging in activities that are physically exhausting or depleting. Respect your body type and fitness level when choosing an exercise routine. Other forms of stress reduction are also important. Be sure to take some time to relax and do something you enjoy for at least 30 minutes per day.
Avoid Exposure to Endocrine Disruptors and Toxins
The most important chemicals to avoid are endocrine disruptors and commercial lubricants. Here is a list of ways to avoid the biggest offenders.
You can avoid BPA by:
Avoiding the use of plastic – particularly for any item that comes into contact with food or drink
Avoiding contact with thermal receipt paper
Reducing/eliminating canned food from your diet or purchasing only BPA-free cans
You can avoid phthalates by:
Looking for shampoo, body wash, shaving cream, deodorant, etc. labelled phthalate-free
Switching to non-toxic, plant-based cleaning products labelled fragrance-free or phthalate-free
Avoiding processed foods, especially those packaged in plastic
You can avoid lead and heavy metals by:
Using a high-quality water filter that removes heavy metals
Keeping your home clean
Avoiding contact with old crumbling paint
Instead of commercial lubricants, you can use:
Coconut oil or other vegetable oil
For a more complete list of chemicals and ways to avoid them, visit the Environmental Working Group website devoted to endocrine disruptors.