Written by: Dr. Aaron Styer, board-certified reproductive endocrinology and fertility specialist at CCRM Fertility Boston
Have you and your partner been struggling for months (or even years) to get pregnant? While often couples assume the problem stems from the female partner, the possibility of male infertility is just as likely. There are numerous reasons why male infertility occurs, including structural issues that prevent the sperm from reaching the egg, genetic conditions, infection, and environmental and lifestyle factors.
For both men and women, infertility is when pregnancy doesn’t happen after a year (or more) of unprotected sex. About 30% of the time, infertility is due to concerns in the man. Another 30% of fertility issues are due to a factor in the woman, and 30% of the time, it’s both. In about half of men with infertility, no cause is found.
While some causes of male fertility are genetic or structural and require help from a fertility doctor, here are things you can do on your own to improve your wellness and fertility. If you and your partner have been trying for more than a year (if the woman is less than 35 years old) or more than 6 months ( if the woman is 35 years of age or older) and haven’t had a successful pregnancy, it’s time to talk with a fertility specialist.
What determines sperm health?
For pregnancy to occur, sperm needs to fertilize an egg. This means the testes need to make sperm, the sperm needs to travel out of the penis and into the female reproductive tract by ejaculation. If there is a concern with any part of this process, it can make pregnancy more difficult to achieve.
To have healthy sperm, there needs to be the following:
- An adequate amount or concentration of sperm. Greater than 15 million sperm per milliliter is considered normal.
- Good motility, or how well sperm move. If more than 35% of your sperm are moving, your motility is considered normal.
- Normal morphology, or sperm shape. Sperm should have a smooth, oval-shaped head and a normal tail. Normal results are when 4% or more of the sperm have normal shaped heads, according to the Kruger morphology test. When sperm have a morphology below 4%, the risk of infertility may increase.
Approaches to Improve Men’s Fertility
Here are six things you can do to optimize your fertility.
1. Exercise regularly
Getting regular exercise isn’t just good for your heart, it can also benefit your fertility. Some studies show that getting regular physical activity can increase testosterone levels and boost sperm quality.
Focus on weight-lifting and running as opposed to walking—these activities are good for helping the testes produce sperm at the highest level possible. If you’re trying to conceive, you may want to limit how much you ride a bicycle as this can actually lower sperm counts, because the scrotum can become compressed, leading to overheating and trauma.
2. Limit alcohol
When it comes to consuming alcohol while you’re trying to conceive, the research isn’t as clear. Some studies show an occasional drink doesn’t have an impact on sperm count or quality. Even drinking in moderation may not have an effect on fertility.
Long-term, heavy drinking, however, does seem to harm your fertility, causing lower sperm counts, lower testosterone, and can disrupt reproductive hormone balance.
3. Take vitamin C
Most people know vitamin C can help keep your immune system healthy, especially during cold and flu season, but this vitamin which is found naturally in citrus fruits, tomatoes, and bell peppers, can also help your fertility.
Vitamin C is an antioxidant, so it can help heal cell damage caused by oxidative stress in the body. Since high amounts of oxidative stress may negatively impact fertility, taking vitamin C might help to reduce these effects. Taking 1,000 mg twice a day is recommended
4. Get enough vitamin D
Another vitamin that might have a positive effect on testosterone levels is also known as the “sunshine vitamin.” Your body uses vitamin D to absorb calcium and build healthy bones. It also plays an important role in both male and female fertility.
Taking 2,000 IU to 3,000 IU of vitamin D3 daily for a year may optimize and may improve. Make sure to talk with your doctor about how much vitamin D is recommended for you.
5. Minimize stress
Daily stress may have an adverse effect on sperm quality. It may also cause increased levels of cortisol, known as the stress hormone, which may interfere with testosterone production. Stress can also directly impact sexual performance and libido. This can lead to erectile dysfunction concerns, which can cause a vicious cycle of anxiety about sex and the inability to perform.
6. Get enough zinc
Zinc is a mineral responsible for the healthy growth of cells, balancing testosterone levels, and strengthening the immune system. If you’re low on zinc, it may be affecting your testosterone levels and sperm quality. Those who use smoking tobacco might have even lower levels regardless of fertility status. Taking a zinc supplement may help to optimize sperm production and testosterone levels.
What causes male fertility problems?
There are several reasons why you may have fertility concerns. These can include:
- Varicoceles
- Problems with the testicles or ejaculation
- Hormone imbalances
- Genetic conditions such as Klinefelter’s syndrome or cystic fibrosis
- Cancer treatments (e.g. prior chemotherapy or radiation)
- Environmental factors
- Infections
Testing for Male Fertility
One of the most common tests for infertility is a semen analysis. This test can check for concerns with sperm, including:
- Total semen volume
- Sperm concentration, or the amount of sperm in each milliliter of semen
- Motility and morphology
You may also have a blood test to check hormone levels. Depending on these results, your doctor may refer you to a specialist such as a urologist for further testing. These can include:
- Semen culture: This may be done to see if there’s inflammation or infection that’s affecting semen.
- Genetic testing: This may be appropriate if there’s a concern for a genetic cause of infertility. These tests can also check for problems with chromosomes within the sperm that could be affecting fertility.
If you’re concerned about your fertility, don’t hesitate to talk with a CCRM Fertility specialist. Make an appointment today.
