Male Infertility

Did you know that the quality of men’s sperm in many Western countries has dropped more than 50% in the past twenty years? – this represents the most dramatic drop of any Western country.  A gathering of international fertility researchers in Brisbane yesterday was told in 2008 that the sperm count carried by the average New Zealand man decreased from about 110 million to 50 million per milliliter between 1987 and 2007. The findings, published in the New Zealand Medical Journal, are based on sperm quality data from 975 men volunteering as anonymous sperm donors. Here is an article aimed at couples who are struggling with low sperm counts, it offers some good advice as well as key hints and tips.

Average Sperm Counts Worldwide

  Year                    Average sperm count (per ml)

  • 1950       100 million
  • 1970         75 million
  • 1990         50 million

John Peek, of Auckland’s Fertility Associates, said “It’s rather dramatic indeed, and one of the largest seen in studies in other parts of the world. If it dropped to the 20 million danger mark, we would definitely be running into trouble,” Dr Peek said. We certainly would then have a major fertility crisis on our hands.

Why the drop in sperm counts?

One of the main theories on sperm quality decline is the drug use, alcohol, smoking, obesity, and chemicals in the environment have all been linked to a drop, and even regular cell-phone use which can damage sperm counts.
In my opinion, some of the main reasons for such dramatic sperm decline in twenty years appears to be both environmental as well as dietary. Lifestyle, diet and nutrition and especially stress are all interfering with men’s sperm production. Why?  He is more likely to want to “escape” and drink or smoke more, and in addition to be more likely to eat on the run and exercise less. And what about the toxic stress today? Artificial sugars, plastics, styrene, and the 70,000 + chemicals in our environment. It has been speculated that many different chemicals are now interfering with both male and female reproductive cycles due to their ability to manipulate and even mimic endocrine (hormone) cycles in the body.

So what are sperm?

Sperm are male reproductive cells manufactured within the male testes that contain the highly specific paternal genetic information to be contributed through the process of fertilisation to the female egg cells.
It is vital for a guy’s sperm to be in good shape if pregnancy is desired. Fertile, healthy sperm are defined not just by the number of sperm (count), but also by sperm concentration, by the way the move (motility), and by healthy morphology (their shape and size). Sperm motility is determined by the percentage of sperm that are moving and their capacity to “swim”. Healthy sperm motility allows sperm to sustain vitality and propel themselves through the uterus right up to the fallopian tube – and ultimately penetrate the surface of the ovum and fertilise the egg.
The production of sperm is continuous and requires approximately 70 – 75 days for maturation for the sperm to mature.  It is most efficient at 34° C (93.2°), so exposure to excessive heat or prolonged fever within 2 to 3 months of evaluation can adversely affect sperm count, motility, and morphology. I have seen guys struggle with low sperm counts that are very much into bike racing (tight Lycra shorts).

Cannabis has been linked with a drop in sperm counts

Cannabis in particular is very much linked with male infertility. Men who smoke marijuana frequently have significantly less seminal fluid, a lower total sperm count and their sperm behave abnormally, all of which may affect fertility adversely, a 2003 study in reproductive physiology at the University at Buffalo in America has shown. This study is the first to assess marijuana’s effects on specific swimming behavior of sperm from marijuana smokers and to compare the results with sperm from men with confirmed fertility. Marijuana contains the cannabinoid drug THC (tetrahydrocannabinol), which is its primary psychoactive chemical, as well as other cannabinoids.
Results of the study were presented (Oct. 13, 2003) at the annual meeting of the American Society of Reproductive Medicine in San Antonio.  “The bottom line is, the active ingredients in marijuana are doing something to sperm, and the numbers are in the direction toward infertility,” said Lani J. Burkman, Ph.D., lead author on the study. Burkman is assistant professor of gynecology/obstetrics and urology and head of the Section on Andrology in the UB School of Medicine and Biomedical Sciences. UB’s andrology laboratory also carries out sophisticated diagnosis for infertile couples. I tell male patients who come to see me with regard to sperm issues that as long as a guy takes care of the things he can prevent – like smoking, drinking, or particularly smoking marijuana – there’s nothing to be concerned about. His sperm count, morphology and motility will all improve in time.

Cell phones linked to lower sperm counts

Men, beware: Using a hands-free device with a cell phone may affect your fertility if you keep your phone close to your testicles, Cleveland Clinic researchers warn in the journal Fertility and Sterility. (Sept. 19, 2008)
Men who use these hands-free devices tend to carry their cell phones in their pants pocket or clipped to their belts at the waist while in talk mode. As a result, they may be exposing their testicles to damaging radiofrequency electromagnetic waves, explains Ashok Agarwal, PhD, head of the andrology laboratory and the director of the Center for Reproductive Medicine at the Glickman Urologoical and Kidney Institute at the Cleveland Clinic in Ohio.

Naturopathic treatment of male infertility

Naturopathic treatment of male infertility focuses nutrition, lifestyle, dietary supplements and herbs to assist in improving sperm quantity, sperm quality, and overall male reproductive health. Improving diet and making healthy lifestyle choices positively impact male reproductive health, and our clinic has witnessed several successful pregnancies over the years after the male improved his sperm count.

Nutrition

The importance of a healthy diet cannot be overstated. To function properly, the reproductive system requires the proper vitamins and minerals. Remember – it takes around 70 days (about 3 months) for sperm to develop and mature. So, knowing this – if you change your diet and lifestyle for this period of time you should be able to develop healthy sperm. Nutritional deficiencies can impair hormone function, inhibit sperm production, and contribute to the production of abnormal sperm.

  • Eat a natural foods diet that focuses on fresh vegetables, fruits, whole grains, fish, poultry, legumes, nuts, and seeds. Top diet = top sperm production.
  • Drink ½ of body weight in ounces of water daily (e.g., a 75kg man would drink about 1 ½ litres of water a day).
  • Eliminate processed and refined foods (e.g., white flour), junk food, sugars, alcohol, and caffeine. Try to bypass the corner store for a pie and a fizzy drink for lunch. Have something fresh and healthy instead (kebab).
  • Avoid saturated fats and hydrogenated oils (e.g., margarine); use olive oil. Hold the fish and chips, go for an Asian meal instead.
  • Pumpkin seeds are naturally high in zinc and essential fatty acids which are vital to healthy functioning of the male reproductive system. Eat ¼ cup a day of pumpkin seeds to help maintain a healthy reproductive system.
  • Oysters are one of the highest zinc containing foods. Eating a few a week will go a long way towards building good sperm levels.

Lifestyle

  • AVOID cannabis. Several key studies since early 2001 have revealed a major connection between smoking cannabis and a decline in sperm numbers, motility and their shape.
  • Don’t smoke. There is also a close association between tobacco smoking and low sperm count, poor sperm motility, and abnormal sperm.
  • Avoid alcohol. Alcohol consumption is associated with an increased number of defective sperm.
  • Restrict cell-phoneuse. Use a hand held phone and limit the amount of time you speak on a cell phone. Don’t keep a cell phone in your pocket (close to the testicles!).
  • Stress has a major impact on male fertility. Learn to relax and laugh more!
  • Increase your libido. Often overlooked, butthe more sex (and especially the higher the sex drive) the more chances of a woman falling pregnant. Common sense? Try the herb Tribulus.
  • Detoxification is something I am keen on with both males and females pre-conception. Conventional doctors “laugh” at the naturopathic notion of detox. But the happy women who conceive after failed IV attempts are the ones I have seen who have the last laugh after completing a detox. It makes particularly good sense for the guy to detox, especially if he has a history of tobacco and cannabis smoking or chemical exposure behind him.
  • Identify and treat hypothyroidism.  It may increase sperm counts in a man, whether or not they are clinically hypothyroid.
  • Avoid Lycra and other tight fitted under clothing. Sperm matures at about 34 degrees centigrade. This is a few degrees lower than your body’s core temperature. Loose fitted clothing will help to achieve this aim. Try boxers instead of briefs – and avoid that Lycra.

Dietary Supplements

The following nutritional supplements have been shown to increase sperm count and/or motility. Allow 3-4 months for the supplements to work. Best to have in combination with a health diet, as NO supplements can be a substitute for a crappy diet. Get your foundation right first – your diet. The supplements are the “icing on the cake” The ones with an asterisk in my opinion are “must have”.

  • *Arginine—Take 4000mg per day. Needed to produce sperm. If the sperm count is below 10 million per ml, arginine probably will not provide any benefit.
  • Flaxseed oil—Take 1 tbsp daily. Is a source of essential fatty acids.
  • L-Carnitine—Take 3-4 grams daily. Required for normal sperm function.
  • *Multivitamin-mineral—Buy a high-quality product and take one serving size.
  • Selenium—Take 200 mcg daily. Improves sperm motility.
  • *Vitamin B-12—Take 1000 mcg daily. Vitamin B-12 deficiency reduces sperm motility and sperm count. Even if no deficiency exists, B-12 supplementation may help men with a sperm count of less than 20 million per milliliter or a motility rate of less than 50%. Best taken as injection weekly and see your GP for 6 weeks in a block at least. Get a blood test – if on the low side, just do it.
  • *Vitamin C—Take 500 mg 2 times daily. Vitamin C s an antioxidant and may improve sperm motility, quality and viability in guys, and in male tobacco (and cannabis) smokers in particular.  Vitamin C in addition may protest sperm from the genetic damage that can cause hereditary diseases in offspring.
  • *Vitamin E—Take 400 IUs 2 times daily. Vitamin E is an antioxidant Vitamin E may be essential for the production of sperm and improves sperms’ ability to impregnate. Supplemental Vitamin E (400 – 600 IU per day) may improve the quality, quantity and motility of sperm.
  • *Zinc—30 mg per day: Supplementation with zinc may increase sperm count and/or motility, especially in individuals with low serum testosterone levels. Taper to once a day after 2-3 months. It needs to be balanced with copper, and I recommend you take a multi vitamin daily for this reason.

Herbal Medicine

Herbal medicines rarely have significant side effects when used appropriately and at suggested doses. They are a great way to boost a guy’s sex drive (especially Tribulus). Herbs are a great adjunct therapy to a few supplements and a healthy diet and lifestyle.
Through my research I found the best herbs to be the following:

  • Withania (Astragalus membranaceus) Has been linked to the production of sperm.
  • Korean Ginseng(Panax ginseng) Known as a male tonic (an agent that improves general health) and used to increase testosterone levels and sperm count.
  • Siberian ginseng(Eleutherococcus senticosus) may increase the sperm count.
  • *Tribulus (Tribulus terrestris) may stimulate the production of sperm and may increase the quality and motility of sperm.
  • Saw palmetto(Serenoa repens)—Used for overall male reproductive health.

Conclusion
It IS possible to improve your sperm’s health in as little as 3 months if you are keen. All it takes is to focus on avoiding your obstacles – whether it be smoking, drinking too much, avoiding the “junk” in your diet and eating the right foods, cleaning up your body if you have a good reason to and to understand the reasons and causes of your poor sperm count from the onset. The supplements will certainly assist – but get the groundwork done first. If successful, you will have one blissfully happy (and hopefully pregnant!) lady and the joys of fatherhood to look forward to.

References:

  • Lani J. Burkman, Ph.D., The effects of  THC (tetrahydrocannabinol) on male sperm motility and morphology. (Oct. 13, 2003) at the annual meeting of the American Society of Reproductive Medicine in San Antonio.
  • L.S.Birnbaum, Endocrine effects of prenatal exposure to PCBs, Dioxins, and other Xenobiotics: implications for policy and future research, Environmental health prospectus vol. 102, Number 8, Aug 94 p.676-679.
  • E.Carlsen, A.Giwereman, N.Keiding and N.E.Skakkebaek, (1992). British Medical Journal 305,609-613.
  • R.M.Sharpe, N.E.Skakkeback, Are oestrogens involved in falling sperm counts and disorders of the male reproductive tract? Lancet 341: 1392-1395 (1993).
  • B.Martin and M.Day, New scientist- This week- fresh alarm over threatened sperm, Jan 97 page 5.
  • L.D.Russell and R.N.Peterson (1984), Journal of reproduction and fertility 70, 635- 641.
  • R.B.Land, D.T.Baird and W.R.Carr (1981), Journal of Reproduction and Fertility 62, 131-138.