We’ve discussed the overall issues of dealing with infertility on our blog, and we’ve also gone into a bit of detail in the female factors for infertility that we manage more frequently, but today we’re going to take a look at infertility from the male perspective. This is pretty important as male factors can contribute to infertility in at least 45% of cases (roughly 35% male factors alone and another 10% contributing to cases also involving some female factors).
So, what makes for healthy sperm? Essentially, the goal is to have an adequate number of sperm that look and move normally. That number ranges from a minimum of around 15 million per mL of ejaculate to over 200 million per mL. Typically, there is about 2-5mL of semen per ejaculate, so if you do the math, that’s a lot of swimmers to try to fertilize one egg.
If a man’s count is low, what kind of testing is done, and what may be some of the causes? Depending on how low the count is and if there are any concerns noted on either exam or history, testing can involve urinalysis (to look for backward ejaculation), ultrasound (to check for testicular or vas deferens lesions), bloodwork (to look for hormonal causes or genetic issues) and in some cases, even testicular biopsy. That being said, for levels that are only mildly low, skipping to treatment for the low count may be a reasonable option.
How can a man help improve the health of his sperm? Turns out, a man’s overall health can play a big role in his ability to conceive. Maintain fitness by doing exercise of any type (unless you’re over 6 hours per DAY), and particularly resistance training, which has the greatest effect on increasing testosterone. From a dietary standpoint, limiting processed foods and emphasizing whole foods will certainly be beneficial. Also, any food high in zinc such as seafood, legumes, and meats can help with improving fertility.
As always, there are some things to avoid when trying to achieve pregnancy as well. Alcohol intake and should be limited, and men should avoid tobacco and drug use, both while trying for pregnancy and even when not trying. Anything that causes significant increase in heating “his boys” should likewise be avoided. This can include hot tubs, laptops (on the lap), really tight underwear, and saunas. Any prescription medications should be reviewed with his doctor to see if decreased fertility may be a side effect, but please don’t have him stop any prescription without reviewing your medication change with your prescriber. Lastly, some lubricants can be toxic to sperm. Be sure to check the label, and if you are planning to use lubrication, then select one like Pre-Seed that’s approved to not hinder conception.
If my partner has a low sperm count, what can we do about it? One of the simplest approaches involves IUI (intrauterine insemination). This involves collecting your partner’s sperm and have a lab concentrate it for placement directly into the uterus by your provider. Think of this as providing a head start to the sperm to reach the egg by cutting their travel time down to maybe half. For other causes, hormonal treatment may be the next step, or in cases of a lesion in the scrotum, surgery may be required. If all else fails IVF (combining the sperm and egg outside of the body with placement into the woman’s uterus after the embryo begins to develop) may be the best bet.
Discussion of infertility often starts at the ob/gyn office, but depending on the cause, collaboration with either a urologist or a reproductive endocrinologist may be required to achieve successful pregnancy. The journey can sometimes be rather long, but in the end, a healthy pregnancy is definitely worth it. Regardless of how you get there, we wish you all the best in having your most enjoyable pregnancy and cutest baby 😊
Dr. Nick
So, what makes for healthy sperm? Essentially, the goal is to have an adequate number of sperm that look and move normally. That number ranges from a minimum of around 15 million per mL of ejaculate to over 200 million per mL. Typically, there is about 2-5mL of semen per ejaculate, so if you do the math, that’s a lot of swimmers to try to fertilize one egg.
If a man’s count is low, what kind of testing is done, and what may be some of the causes? Depending on how low the count is and if there are any concerns noted on either exam or history, testing can involve urinalysis (to look for backward ejaculation), ultrasound (to check for testicular or vas deferens lesions), bloodwork (to look for hormonal causes or genetic issues) and in some cases, even testicular biopsy. That being said, for levels that are only mildly low, skipping to treatment for the low count may be a reasonable option.
How can a man help improve the health of his sperm? Turns out, a man’s overall health can play a big role in his ability to conceive. Maintain fitness by doing exercise of any type (unless you’re over 6 hours per DAY), and particularly resistance training, which has the greatest effect on increasing testosterone. From a dietary standpoint, limiting processed foods and emphasizing whole foods will certainly be beneficial. Also, any food high in zinc such as seafood, legumes, and meats can help with improving fertility.
As always, there are some things to avoid when trying to achieve pregnancy as well. Alcohol intake and should be limited, and men should avoid tobacco and drug use, both while trying for pregnancy and even when not trying. Anything that causes significant increase in heating “his boys” should likewise be avoided. This can include hot tubs, laptops (on the lap), really tight underwear, and saunas. Any prescription medications should be reviewed with his doctor to see if decreased fertility may be a side effect, but please don’t have him stop any prescription without reviewing your medication change with your prescriber. Lastly, some lubricants can be toxic to sperm. Be sure to check the label, and if you are planning to use lubrication, then select one like Pre-Seed that’s approved to not hinder conception.
If my partner has a low sperm count, what can we do about it? One of the simplest approaches involves IUI (intrauterine insemination). This involves collecting your partner’s sperm and have a lab concentrate it for placement directly into the uterus by your provider. Think of this as providing a head start to the sperm to reach the egg by cutting their travel time down to maybe half. For other causes, hormonal treatment may be the next step, or in cases of a lesion in the scrotum, surgery may be required. If all else fails IVF (combining the sperm and egg outside of the body with placement into the woman’s uterus after the embryo begins to develop) may be the best bet.
Discussion of infertility often starts at the ob/gyn office, but depending on the cause, collaboration with either a urologist or a reproductive endocrinologist may be required to achieve successful pregnancy. The journey can sometimes be rather long, but in the end, a healthy pregnancy is definitely worth it. Regardless of how you get there, we wish you all the best in having your most enjoyable pregnancy and cutest baby 😊
Dr. Nick
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