Understanding male infertility

Infertility is defined as the inability of a couple to conceive (fall pregnant) after one year of regular (every 2-3 days), unprotected sex.

For some, conceiving can happen really quickly but for others it may take a while. For most couples it can take up to 12 months so, whilst easier said than done, tryn ot to worry if it takes you a little longer than expected.

Accordingto research (Skoracka et al., 2020), males are solely responsible for up to 50% of cases of infertility and are a contributing factor in 30-40% of cases.

As conceiving requires two partners, one with testes and one with ovaries, it’s important that both partners are tested when looking into reasons for infertility.

If you’ve been unsuccessful in trying to conceive for 12 months, yourself and your partner should be referred for investigations. You will be asked to provide a sperm sample and if the results are abnormal, you will be asked to repeat the test after three months.

There are many factors that could impact a male’s fertility, some are reversible and others not. Fertility (in both partners) could be impacted by genetics, environmental toxins, previous surgeries, age, medications and lifestyle choices.

Sperm disorders

The most common reason for infertility in males is due to a sperm disorder.

Sperm disorders can contain the following:

Quantity - not having enough sperm in your semen.

Motility - your sperm don’t travel as quickly as they should.

Morphology - your sperm are an irregular shape.

It is possible for your results to show that you have an issue with one, two or all three of these factors. If they do, don’t panic. There are lots of changes that you can make to your lifestyle to improve the quality of your sperm.

Lifestyle changes to improve sperm quality

These are some of things that can impact the quality of your sperm:  

Here are some the lifestyle changes associated with a positive impact on sperm quality, which includes quantity, motility and morphology:

There are no specific guidelines around the minimum or maximum amount of alcohol that impacts fertility, however there is a link between the amount you drink and the impact on your fertility. This means the more alcohol you consume, the lower the quality of your sperm. Try to reduce your alcohol intake as much as possible, aim to have alcohol free days during the week and avoid binge drinking.

Both increased stress and lack of sleep have a negative impact on sperm quality. Aim to get 6 - 8 hours of sleep every night, and if you’re struggling to sleep at night try to create a calming bedtime routine which includes avoiding screens for an hour before bed time. Find ways to lower your stress levels like playing a sport or exercising. 

High intakes of processed red meat are linked to lower sperm quality. Aim to have less red meat and instead have oily fish (which is rich in Omegas and good for improving sperm quality) and plant-based meals.

Avoid wearing very tight underwear and/or trousers as this may increase the temperature of your scrotum which negatively impacts sperm quality. Where possible wear light, lose underwear. Avoid sitting down for long periods for time and if in a warm environment try and take breaks where it’s a little cooler.

Antioxidants such as zinc, vitamin c and selenium are all required to produce healthy sperm. Consuming a diet that contains lots of colourful fruits and vegetables will increase your consumption of antioxidants, especially things like green leafy vegetables, berries, and citrus fruits. Aim to include five portions of fruits and vegetables to your daily intake.

Other possible male infertility issues

If your infertility is due to factors other than sperm disorders such as obstructions, functional/ejaculation disorders, or hormonal imbalances then your doctor will discuss the options available to you. These might include surgery, hormonal treatment/medication or assisted reproductive technologies (ART’s) depending on the cause.

Undergoing fertility treatment is not easy for anyone, it may cause additional stress and have a negative impact on your mental health. Although it’s not always easy, it can help to talk someone about what you’re going through. Everyone undergoing fertility investigations and/or treatment should receive additional support and counselling. If you find that you would like some support, please ask your practitioner to refer you to a counselling service. If you don’t feel comfortable doing that there are also support groups for infertility, such as HIMfertility.

References:

Damayanthi Durairajanayagam, Lifestyle causes of male infertility, Arab Journal of Urology, Volume 16, Issue 1, 2018, Pages 0-20, SSN 2090-598X. https://doi.org/10.1016/j.aju.2017.12.004.

https://www.nhs.uk/common-health-questions/mens-health/how-can-i-improve-my-chances-of-becoming-a-dad/

NICE GUIDELINES: https://www.nice.org.uk/guidance/cg156/ifp/chapter/Fertility-problems

Male Infertility Best Practice Policy Committee of the American Urological Association & Practice Committee of the merican Society of Reproductive Medicine. (2006).Report on optimal evaluation of the infertile male. Fertility and Sterility, 86, 02–S209.

Practice Committee of the American Society for Reproductive Medicine in collaboration with the Society for Reproductive Endocrinology and Infertility. (2008). Optimizing natural fertility. Fertility and Sterility, 90(5, suppl), S1–S6.

Skoracka K, Eder P, Łykowska-Szuber L, Dobrowolska A, Krela-Kaźmierczak I. Diet and Nutritional Factors in Male In)fertility-Underestimated Factors. J Clin Med. 020 May 9;9(5):1400. doi: 10.3390/jcm9051400. PMID: 32397485; PMCID: PMC7291266.

Wogatzky, J., Wirleitner, B., Stecher, A. et al. The combination matters - distinct impact of lifestyle factors on sperm quality: a study on semen analysis of 1683 patients according to MSOME criteria. Reprod Biol Endocrinol 10, 115 (2012). ttps://doi.org/10.1186/1477-7827-10-115