Cedars-Sinai Blog
Optimizing Male Fertility
Complications specific to men's health are the sole cause of or a contributing factor to infertility about 40% of the time.
When couples face fertility struggles, much of the pressure often falls on women to improve their health. But men also have a crucial role and can increase the odds of conception by maintaining healthy sperm.
Among couples struggling with infertility, complications specific to the man's health are the sole cause or a contributing cause about 40% of the time, says Dr. Margareta Pisarska, director of the Cedars-Sinai Fertility and Reproductive Medicine Center. When working with a couple, she carefully considers the reproductive health of both partners.
"The main issues we see in men are related to reduced sperm count, motility—the capacity for the sperm to propel towards the egg—and reduced numbers of normally shaped sperm"
One of the first tests she orders—and probably the most well-known—is sperm analysis.
"The main issues we see in men are related to reduced sperm count, motility—the capacity for the sperm to propel towards the egg—and reduced numbers of normally shaped sperm," Dr. Pisarska says.
Problems with sperm also may indicate underlying health concerns such as high blood pressure, heart issues, skin disorders, vascular problems, and endocrine (gland) disorders.
3 factors doctors look for in sperm analysis
The vaginal canal is built to keep out foreign substances, including sperm—but healthy sperm are structured in a way to survive that environment. While sperm are built to travel in harsh conditions, 3 key factors must be in place to make the journey a success.
Low sperm count (oliozoospermia)
The most common cause of male infertility is low sperm count. Beginning at puberty, sperm is produced in the testes during a process called spermatogenesis. Over 70 days, sperm proliferates and is stored until ejaculation, when the sperm combines with fluids from the prostate gland to create semen. If there is a low number of sperm in the ejaculate, this is referred to as low sperm count, with a healthy number considered to be 20 million sperm per milliliter of semen.
Sexually transmitted diseases, infections, genetics, and some chronic illnesses such as diabetes can lower sperm count. A low sperm count does not always predict infertility. Sperm count should be tested periodically when a couple is trying to conceive.
Low motility (asthenozoospermia)
Sperm "swim" using powerful mitochondria, which provide the energy to propel the sperm forward, and a tail, which controls movement. Doctors can see how well sperm move by magnifying them in a petri dish. If sperm swim erratically or don't move at all, conception may be difficult without medical assistance. A complete lack of motility affects 1 in 5,000 men.
Abnormally shaped sperm (teratozoospermia)
Doctors use the term morphology to refer to abnormalities in the three parts of a spermatozoa: head, where the DNA is stored; midsection, home of the mitochondria; and tail. Each part is essential for egg fertilization; damage to any can affect fertility. Many conditions affecting morphology are genetic, including acephalic sperm, a condition that causes the production of headless sperm, structurally unable to fertilize an egg.
"Among couples struggling with infertility, complications specific to the man's health are the sole cause or a contributing cause about 40% of the time."
Steps to ensure optimal sperm health
- Keep things cool. Sperm is stored in the testes outside of the body, to keep the temperature low. Researchers found that prolonging exposure of the testicles to heat adversely affects sperm count, and that a lower temperature is essential for sperm cells to mature. When trying to conceive, limit time in the spa and sauna.
- Keep things safe. Watch out for sports injuries. Cyclists are advised to use specific seats to make sure they do not damage the testes. For potentially rough physical exposure in sports such as martial arts and football, wear proper athletic support and a cup. But watch out for too much compression, which can lead to numbness.
- Be aware of workplace toxins. The environmental effects on male fertility have come to light recently as scientists learn more about workplace chemicals. Paints, metal, plastic, and certain pesticides have been linked to reduced sperm count and can cause reproductive harm. The Centers for Disease Control and Prevention says harmful substances can enter the body by inhalation, contact with the skin, and ingestion. Wear protective clothing and respiration devices while working in environments exposed to toxins.
- Eat a healthy diet. Aside from being a generally good practice, keeping a healthy weight and eating food rich in antioxidants is important for male fertility. A diet high in fruits and vegetables contains plenty of antioxidants. Be careful with soy. Some studies have shown that soy intake may be a factor for DNA damage in sperm cells.
