Men! It Takes TWO to Make a Healthy Baby!
When it comes to infertility men contribute to about 50-60% of the cases – meaning they are either the sole cause or half of the equation.
First things first, if you are in your mid-thirties (or just suspect that something is off) and are attempting pregnancy – don’t wait, go to your doctor to get an evaluation. Because if the scope is larger than nutritional intervention and lifestyle medicine, there may be treatable or reversible procedures available. If your evaluation reveals that you are dealing with poor sperm quality, low testosterone and/or other hormonal imbalances like insulin dysregulation … then it’s time we talk!
Because of the biology and nature of sperm, meaning that men ejaculate millions of sperm each time they have an orgasm, they do not experience “infertility” the way women do. More often than not, men are dealing with “sub-fertility” – less than optimal sperm count and sperm health reducing your chances of achieving pregnancy with each attempt during your partner’s fertile window. But this doesn’t mean you can’t achieve pregnancy, even with a reduced count, pregnancy is still obtainable.
HOWEVER, just because it’s POSSIBLE, doesn’t mean you SHOULD. Because low sperm count can indicate that your sperm isn’t healthy. Additionally, even if you have a high sperm count, if most of those sperm are misshapen, can’t swim properly, or carry damaged DNA – then fertility is ultimately “lowered” anyway aka “subfertility.” So, what we are talking about today and the parameter that really matters to the health of your child (for their entire lifetime) is sperm quality.
You may be thinking, “I need to improve my T” (aka testosterone levels) to improve my sperm quality. And although testosterone plays a role in spermatogenesis (the production of mature sperm), it’s a minor player. You do want optimal testosterone levels though to ensure you have a good sex drive. Optimal levels of T also reduce your chances for erectile dysfunction, reduced spontaneous erection and delayed ejaculation – all of which in some way play into natural spontaneous conception.
In summary, it goes deeper than sperm count and T levels…
When it comes to attempting pregnancy what you really want to focus on is sperm quality by way of decreasing your levels of sperm DNA fragmentation (SDF). Let me explain why you want to improve your reduce levels of SDF before attempting conception and why you want to go beyond conventional methods of testing sperm quality.
In conventional methods of sperm evaluations your doctor or fertility clinic will run a sperm analysis that will look at sperm concentration per ejaculate, motility, morphology and count. However, this is not sufficient to investigate male sub-fertility. That’s because you can have a normal sperm analysis but still have high levels of SDF.
This all leads me to the brass tax of this article… The current best method to test the quality of your sperm and your overall ability to conceive a healthy embryo is sperm DNA fragmentation (SDF).
Sperm DNA fragmentation is essentially the amount of damaged DNA within each sperm. DNA is considered damaged when the strands or chains are broken (no need to worry about these details unless you’re a scientist).
What is important, is that all men have some amount of damage to their sperm DNA. But it is when you have higher levels of damage (aka SDF) that your chances of achieving a pregnancy go down and chances for miscarriage go up. And this remains true even if the woman is carrying good quality eggs. That means that the quality you bring to the fertility table is EQUALLY as important as what she is brining.
A recent study looking at rates of SDF and the success of assisted reproductive technology showed that sperm that had an SDF of >30% could still achieve fertilization (the making of an embryo) of those that had less SDF (<30%) at about the same rate. However, embryo quality and implantation (the attachment of the embryo to the uterine lining – essential to pregnancy) were significantly decreased and miscarriage rates were significantly increased.
Again, back to the aforementioned point – just because you can doesn’t mean you should …. At least not without testing and/or taking the steps and time to improve sperm quality prior to trying to conceive.
In simple terms, what this comes down to (that is in your control anyway), the DNA in your sperm is being attacked by too many free radicals (oxidative stress). Oxidative stress (OS) is a result of too many free radicals being produced in the body (whether from internal or external causes) and not enough antioxidants to stop them from doing damage to your cells.
But don’t just look at this as an isolated “sperm” problem. If the DNA in your sperm are being attacked and your body is prohibited from, quite literally the one thing that it was put on this planet to do…reproduce, then you can assure that your system at large is also under attack. And it was a blessing that you got the canary in the coal mine warning before your health blew up.
As a side FYI: oxidative stress has now been shown to play a role significant role in many diseases including atherosclerosis, arthritis, vasculitis, heart diseases, stroke, intestinal ischemia, emphysema, gastric ulcers, hypertension, and neurological disorders like Alzheimer's disease, Parkinson's disease, muscular dystrophy – and this list is NOT exhaustive.
What are some things that affect your sperm DNA fragmentation?
Smoking
Drug abuse
Poor diet
Hormonal Imbalances
Advancing age
SDF increases with age and will double between the ages of 20 and 60 years
Infection
Urinary tract infections or other STDs
Testicular Cancer – and possibly others
Lifestyle Factors
Sedentary behaviors, obesity, diabetes – which all contribute to increased scrotal temperature, hormonal imbalance and chronic systemic
Environmental toxins
Exposure to heavy metals such as lead, cadmium, synthetic insecticide, and organophosphorus pesticides can cause DNA damage
Radiation
Electromagnetic waves, particularly from cell phones, increase mitochondrial ROS production and DNA adduct formation causing DNA damage
The list is long … and confusing – but there is low hanging fruit here and I am here to help.
Low hanging fruit examples: don’t keep your phone in your pants pocket, get a proper amount of exercise to correct too much body weight, get restful sleep every night, eat a diet rich in nutrients and low in processed food, assess where you many be coming into contact with heavy metals and pesticides (do you spray your lawn all the time, is your water filter, do you try to eat organic food, etc).
And this all may sound simple, but trust me – after years of practice with clients and the reason I have a job in the first place – is that what is out of your normal daily scope can be challenging to incorporate. With time, understanding and an open mind, I can help you get there.
Lastly – why does this really, really matter??
Studies have shown that when men achieve pregnancy with low quality sperm, their children are at higher risk of things like …. (the list is not exhaustive)
Autosomal dominant genetic diseases like
Huntington's disease
Marfan syndrome
Achondroplasia
Neurodevelopmental disorders
Autism
Bipolar disease
Spontaneous schizophrenia
Brass Tax….
Quality matters, from both sides of the baby making bed. If your wife/partner is going to spend the time to improve her health prior to conception, it is wise to take the time and do the same. Do you want to buy the car that has been put through rigorous safety and performance tests or the one that says “buy here, pay here, as is?” You get the point.
Now back to the good news…
Due to the biological fact that sperm take about 74 days to mature – a man’s time to improved fertility can be very quick! Of course it depends on what is the root cause of the problem, some health issues take more time to resolve than others.
By working together, we can use several tests that will give us feedback on your fertility, your oxidative stress levels and where the vulnerabilities lie in your system and diet. After we find these areas of opportunity we will give you a roadmap to improved fertility, improved personal health and improved health for your future offspring for life!
I look forward to working together
In fertile health,
Madison Milmiester, MS, M.ED, RD
References:
1. https://www.yalemedicine.org/conditions/male-infertility
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4. Whittaker, J & Wu, K (2021) Low-fat diets and testosterone in men: Systematic review and meta-analysis of intervention studies. The Journal of Steroid Biochemistry and Molecular Biology. doi.org/10.1016/j.jsbmb.2021.105878.
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