For this week’s blog, we are continuing our concentration on male infertility for National Men’s Health Month. Roughly 30% of couples seeking infertility treatments who don’t achieve pregnancy within the first year of unprotected intercourse are infertile due to an isolated male factor (Thonneau et al., 1991). The reason this number is so high, is because there is a lot of biological variability in the ejaculate that can lead to a male factor diagnosis. Even the intra-individual values in sperm count, motility and morphology parameters are largely variable (Alvarez et al., 2003). This is why our physicians typically require 2-3 semen analyses to most accurately characterize a patient’s semen quality.
For many males presenting at our clinic, the overall quality of their semen is sub-normal; below the reference values of a normal semen analysis, established by the World Health Organization. Even in cases where the diminished semen quality is not caused by a congenital abnormality or genetic disorder, the biological variability in semen quality is still largely uncontrollable. Yet, many male patients and their partners ask us what, if any, steps can be taken to improve their overall semen quality.
Unfortunately there is no wonder drug that will change a sub-normal sample to a normal sample, but listed below are a mix of 5 pre-analytic and post-analytic measures a male can take to maximize his semen quality.
- Collecting a complete sample. During ejaculation the first fractions of semen voided are the most sperm-rich portions of the ejaculate (Kvist et al., 2003). Therefore, losing the first portion of the ejaculate during collection will have more influence on the results of the semen analysis than losing the last portion does.
- The abstinence period. Not all sperm stored in the epididymis are released in each ejaculate (Cooper et al., 1993), some remain since the time of the previous ejaculation. This will influence the overall age and range of the quality of sperm in the ejaculate. This is why it is important for all males presenting for a semen analysis to observe the 2-3 day abstinence period indicated in our collection instructions.
- Consuming essential fatty-acids. Sperm motility is solely nourished by the energy produced from fatty acid synthesis (Cooper et al., 2009). Consuming a balanced diet of red-meat, fish or fish-oil supplements and cashews or almonds can help promote normal sperm motility and progression.
- Over the counter daily vitamin supplements. Spermatids are maturing inside the testis over the 60-70 day period required by spermiogenesis to produce a mature spermatozoon capable of fertilizing an egg. In this time, oxidative stress caused by free radicals in the body can influence the quality of sperm produced (Cooper et al., 2009). Therefore, the anti-oxidative properties of folic acid, vitamin C, vitamin E and beta-carotene contained in most daily supplements may help to reduce the amount of oxidative stress on the maturing sperm.
- Healthy lifestyles. One of the first questions asked at an infertility consultation is regarding a patient’s tobacco use. Studies haves shown a direct correlation between smoking and decreased fecundity in men and women. Moderate alcohol intake; 2-3 drinks a week, won’t decrease your sperm count, but alcohol abuse will. Regular exercise and a balanced diet will help you maintain normal hormone levels and libido.
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