In the UK, around 1 in 6 couples have difficulty trying to conceive. What perhaps isn’t so widely known though, is that issues with sperm quality and quantity account for around half of those cases. For any couple trying to conceive, it is imperative to focus as much on the man as the woman.
Assisted fertility treatment naturally focuses on women due to the very nature of the medical interventions. Typically, as long as the man can produce some amount of sperm, then an IVF clinic will proceed with treatment. But, as the figures above might suggest, this type of treatment can’t guarantee success because it doesn’t take into proper account the actual health of the sperm.
Sperm production is a constant cycle and it takes around 100 days for sperm to mature. Any semen analysis result will only ever be a snapshot of the health of the man 100 days prior to the test and will only show certain parameters. If you’re a man who wants to enhance his fertility, you need to start working on improving your sperm health at least 3 months before you start trying to conceive.
The good news is that sperm health, unless there are underlying medical issues, is relatively easy to influence. Below are my top tips in order to maximise sperm health and fertility.
Before looking at any diet/lifestyle advice, it’s important to understand the role of oxidative stress within the body and how this can affect sperm health.
Oxidative stress occurs when there is an imbalance between free radicals, which are produced from the body’s natural metabolic process, and antioxidants, which neutralise and counteract the effects of free radicals. Free radicals are cells which are known to cause damage to other healthy cells in the body, so naturally, when free radicals increase, the amount of damage increases. Sperm are particularly prone to free radical damage.
The most common causes of free radicals are:
- Processed foods, especially those high in poor fats, sugars and additives
- Fried, burnt and BBQ’d food
- Recreational drugs
- Environmental pollution
As with most health issues, nutrition is absolutely key and is one of the biggest influencers in terms of sperm health. A few small changes in your diet can have a huge impact on your chances of success when it comes to conceiving.
For a start, given the Free Radicals list above, it naturally makes sense to reduce all the foods listed on it. But it is also just as important to focus on what you put into your diet as much as what you take out. A diet high in good quality fruit, vegetables and unprocessed meat is essential, not only because of vitamins and minerals, but also because of their antioxidant elements.
Where possible, organic meat and vegetables are best. Generally, meat should be lean and low fat. Saturated fats, as found in red meat and processed meats, are particularly bad for sperm health so these should be limited. Fish is generally very good, especially those higher in Omega 3s, such as Salmon, Mackerel and Trout.
One word of caution on some oily fish, such as Tuna, is to be aware of their high mercury content, which can be bad for the body if you have too much.
Nuts are a particularly good snack and very good for sperm health, particularly Walnuts, Almonds and Pumkin seeds.
Tomato puree is high in a substance called Lycopene, which is a powerful antioxidant and a useful boost to other dietary changes. You can buy it as a supplement or, alternatively, some men take a teaspoon of good quality tomato puree every day.
Protein shakes can be an issue for some men and you should ensure there are no steroids added to the mix you are taking. There is no evidence to suggest protein shakes are bad for sperm but do check the ingredients for additives and sugars / sweeteners which would be detrimental to sperm health. Stay within the recommended dose and definitely avoid anabolic steroids.
For some people, making dietary changes can be hard work and bewildering. If you’re someone who needs help and support, then drop me a line and I can help you find a way. Often it’s about making small changes over a period of time to get the best long-term results, rather than jumping on a crash diet. Please note though, the above advice is general advice and, for some, it may be worth seeing a nutritional therapist for a more detailed plan.
This can sometimes be challenging for couples looking to conceive, as a nice glass of wine or beer can be the preferred way to unwind. Binge drinking should definitely be avoided; however, research has shown that moderate drinking doesn’t have a significant impact on fertility, so the odd glass may actually help rather than harm, especially where stress is concerned.
If you find that cutting out all drinking is too stressful, then that is clearly going to be detrimental! And if you find the occasional drink here or there helps your sanity, then you shouldn’t worry too much about it. The important thing is to keep a sensible check on alcohol intake and if you are happy to cut it out in places, then go with that.
TOBACCO AND RECREATIONAL DRUGS
Unfortunately, there isn’t anything good about tobacco or recreational drugs when it comes to sperm health. Both will increase the level of free radicals and therefore the damage being done to sperm.
A little caffeine is ok and some argue that coffee has some great health benefits and is strong in antioxidants. As with a lot of this advice, it’s about moderation so 1 – 2 cups of coffee or tea a day won’t be too detrimental to your health.
The testicles are outside of the body for a reason and that reason is to keep them cool. Typically, the testicles need to be around 2 – 3 degrees cooler than core body temperature. Exposure to higher temperatures can cause damage to sperm production.
Common factors around heat include:
- Long use of laptops
- Working in a hot environment
- Long periods sitting
- Hot baths and saunas
- Tight fitting underwear
- Excessive cycling
It’s important that any man looking to improve his fertility does all he can to keep his testicles cool. This means avoiding anything that will make them hot for any period of time, and instead embracing ‘cooling’ actions, such as wearing loose fitting underwear.
In many ways, the jury is still out on the effects mobile phones have on our health. Mobile phones emit Electromagnetic Field (EMF) radiation and some research suggests this can be bad for health and fertility. My view, and that of other experts in the field of fertility, is that phones should not be kept in pockets close to the scrotum because of the potential effects of this radiation. If you’re wanting to do all you can to improve your fertility, then this isn’t too big a step to take just in case!
We all hear how bad stress is for us and, unfortunately, there is some truth in that. Ultimately, stress triggers our very primal instincts of ‘fight or flight’, and when our stress levels are particularly high, we live in a state of high alert, whereby our body suppresses non- essential functions, including reproduction.
Long-term stress has a detrimental effect on many areas of the body, so it’s important to find a way to manage this, whether you are trying to conceive or not. Many complimentary therapies, such as acupuncture, are great at managing and alleviating the harmful effects of stress.
Regular exercise is another great way to help combat the negative effects of stress.
When it comes to choosing what exercise to do, it’s about finding what works for you. For some, higher energy exercise works well; whilst others enjoy calmer restorative exercise. I’m personally an advocate of balancing both. Certainly, activities like yoga, tai chi and pilates are all good for those living busy stressful lives as they allow for some down time and space to relax.
Another important thing for men to consider when it comes to maximising the chances of conception, is body temperature and the clothes worn whilst exercising. If, for example, you’re a keen cyclist and regularly wear lycra shorts, then, as this will have a negative effect on your sperm health, you might want to consider switching cycling for yoga or running for the period during which you are trying to conceive. It’s about balancing what’s best for you whilst considering the impact it has on your sperm health.
Ultimately, all of this comes down to balance. For couples trying to conceive, it can sometimes feel like life has to be put on hold. But, whilst being sensible with diet, exercise and stress management is very important, it’s equally important that these things don’t take over and stop you from enjoying your life. In any case, most of the advice above will help you live a happier and healthier life regardless of whether you’re trying to conceive or not, so it’s probably worth bearing most of it in mind anyway.
FURTHER TESTS AND MEDICAL INVESTIGATIONS
Typically, when a couple present to their GP for fertility issues, the man will be offered a standard semen analysis which looks at 3 important issues:
1. Concentration/Volume (Number of sperm) 2. Motility (are they swimming?)
3. Morphology (are they the right shape?)
Once a man has that result, regardless of whether it’s good or bad, not a lot else happens. If a couple do go for IVF treatment, some clinics will run further tests, whilst some will just continue on to treatment, knowing that as long as there is some sperm they can do something.
A standard semen analysis is a good starting point for men, but there is much more that can and should be investigated. Some clinics are now starting to offer Sperm DNA Fragmentation testing, which looks at the actual DNA damage being done to the sperm. This is a far more comprehensive test which will actually identify the true quality of the sperm. High levels of DNA fragmentation are often behind recurrent miscarriages and failed IVF cycles so it’s important that this gets investigated thoroughly. Further investigations also need to look out for any dormant infections or other medical issues which could also be causing issues despite a lack of symptoms.
Any man with a poor semen analysis or high DNA fragmentation would be strongly advised to see a Urologist in order to have further in depth investigations.
Part of the support I offer to men is to offer the Sperm Comet DNA test via my clinics in Hove and Farnham.