Our mission is to provide as much support to our male clients as we do with our female clients. Each of our locations offers a monthly support group, Circle of Hope. This support group is designed to provide a comfortable environment for all clients, male or female, to discuss the hopes, dreams, struggles that individuals are faced with on a daily basis when pursuing fertility treatments. We welcome you to join us for an evening of sharing thoughts and ideas and learn strategies for managing/coping with infertility.
According to our friends at Resolve, The National Infertility Association, about 11 percent of reproductive-age couples in the United States have trouble conceiving or sustaining a pregnancy. About one-third of these cases are due to male fertility problems, about one-third are related to female fertility problems, and the rest are due to factors involving both you and your partner or to unexplained causes.
When a man is diagnosed with male factor infertility, he is facing an emotional journey. A man often associates his sense of masculinity with the ability to conceive a child. Some men find that low sperm count or poor sperm quality makes them somehow “less of a man” or not as virile. Men may experience profound feelings of guilt, anger, and low self-esteem, which can affect all aspects of their lives. It is essential to recognize that the male partner may be experiencing pain that is not dissimilar from the female whose self-worth and femininity may be centered around motherhood. A couple facing infertility, be it male factor, female factor, a combination or unexplained, need to communicate about what is happening to them.
For prospective fathers, healthy eating helps improve the chances for success. Certain nutrients such as folic acid, vitamins C and E and other antioxidants have been shown to improve the number of sperm produced, and ability of those sperm to fertilize the egg. We recommend that our male patients use antioxidant supplements through Theralogix as a part of an overall health maintenance program.
Nutrition and lifestyle
There is good evidence that diet and lifestyle can have a major impact on a man’s fertility.
Smoking Several studies have linked cigarette smoking to lower sperm count, motility, and morphology.1 Smoking also increases levels of oxidative stress in the semen2 and can lead to sperm DNA damage and genetically abnormal sperm.3 If you’ve tried to quit without success, seek help from your family doctor.
Alcohol Use Excessive alcohol consumption has been shown to impair normal sperm. The evidence regarding moderate alcohol intake is less clear, but most experts agree it’s best to avoid more than one drink per day.
Sexual Activity The likelihood of a woman becoming pregnant is much higher when you have intercourse in the three days immediately leading up to and including ovulation. Some experts call these three days the fertile window. You can determine when the woman ovulates either by using basal temperature charts, or with an over-the-counter ovulation predictor kit.
The frequency of intercourse during the fertile window generally doesn’t matter. Although earlier studies seemed to show that several days of abstinence might increase sperm counts, more recent findings indicate that more frequent intercourse may in fact be better.
Avoid the use of any artificial lubricants such as K-Y Jelly® or Replens® which can be toxic to sperm.
Avoid excessive heat It is well known that the testicles should be cooler than the rest of the body for sperm production to be at its best. The harmful effect of a varicocele on sperm production is believed to result from the extra warming of the area caused by the dilated veins.
While there is no scientific evidence to support the claim that boxer style shorts are better than jockey type, it is important to avoid other sources of heat exposure to the testicles such as hot tubs, laptop computers, high-temperature work areas, or prolonged baths.
Healthful Diet Eating a healthful diet rich in fruits, vegetables, and whole grains can be beneficial for sperm function and male fertility. Drinking enough water to stay well hydrated is also important.
Exercise Moderate exercise may be beneficial. Aim for at least 30 minutes of moderate physical activity (walking, running, cycling, swimming, etc.) on most days of the week.
Caffeine Try to limit coffee or other caffeine containing beverages to one serving per day.
Environmental hazards If your work or hobby brings you into contact with environmental dangers such as pesticides, solvents, organic fumes or radiation exposure, you may be unknowingly affecting your fertility by impairing sperm production.
Harmful nutritional supplements Nutritional supplements that provide hormone-like substances such as DHEA or “andro” can actually impair fertility by stopping sperm production. If you are taking any of these types of supplements, or other products intended to build muscle mass, it’s best to stop.
Medications that Impair Fertility Certain medications or medical treatments can interfere with sperm production. Radiation treatment for cancer can impair testicular function. Many chemotherapy drugs will have a permanent effect on production. Some drugs, such as testosterone replacement therapy, can stop sperm production. This is a temporary effect that should reverse within a few months of stopping the testosterone. Your urologist or fertility specialist should be able to guide you regarding your medication use while you are trying to conceive.
[PubMed Abstract] Kunzle et al. Fertil Steril. 2003; 79(2):287-91.
[PubMed Abstract] Saleh et al. Fertil Steril. 2002; 78(3):491-9.
[PubMed Abstract] Potts et al. Mutation Res. 423 (1-2):103-11.
Antioxidants and Other Nutrients
There is substantial scientific evidence to suggest that certain nutrients may help improve male fertility. A recent Cochrane Review found that antioxidants increased pregnancy and birth rates, and improved sperm motility in subfertile males.1
Vitamins C and E are essential antioxidants that protect the body’s cells from damage from oxidative stress and free radicals. Vitamin C is the most abundant antioxidant in the semen of fertile men, and it contributes to the maintenance of healthy sperm by protecting the sperm’s DNA from free radical damage. Vitamin E is a fat-soluble vitamin that helps protect the sperm’s cell membrane from damage. Vitamin C functions to regenerate vitamin E, thus these vitamins may work together to improve sperm function. Vitamin C has been shown to improve sperm count, motility, and morphology.2 Men with low fertilization rates who took vitamin E supplements for three months showed a significant improvement in fertilization rate.3 Vitamin E supplementation in infertile men resulted in improved sperm motility and increased pregnancy rates versus placebo.4
Selenium is a trace mineral that functions as an antioxidant. Selenium supplements have been shown to increase sperm motility, and a combination of selenium and vitamin E has been shown to decrease damage from free radicals and improve sperm motility in infertile men.5
Lycopene is a potent antioxidant and carotenoid (plant pigment) that is abundant in tomatoes. This phytonutrient is found in high levels in the male testes, and research has shown that lycopene supplementation improves sperm parameters in infertile men.6
L-Carnitine is an amino acid derivative produced by the bodythat functions to transport fat so that it can be broken down for energy. L-carnitine is thought to also have antioxidant properties. L-carnitine’s primary benefit is to provide energy for the sperm, and thereby increase sperm motility.7
Zinc is an essential trace mineral that may play a role in sperm formation, testosterone metabolism, and cell motility. Zinc supplementation has been shown to increase testosterone levels, sperm count, and sperm motility.8
Folic Acid (folate) is a B-vitamin that is necessary for DNA synthesis. Low levels of folic acid have been associated with decreased sperm count and motility In a recent study, the combination of zinc and folic acid resulted in a 74% increase in total normal sperm count in subfertile men.19
Coenzyme Q10 (CoQ10) is a naturally occurring antioxidant that is essential for cellular energy production. It is produced by the body and found in small amounts in some foods. CoQ10 levels are highest during the first 20 years of life, and decline with age. Studies have shown that at least six months of CoQ10 supplementation improves sperm motility in men with unexplained infertility.10,11 In a recent study, CoQ10 increased sperm density, motility, and morphology.12
[PubMed Abstract] Akmal et al. J Medicinal Food. 2006; 9(3):440-2.
[PubMed Abstract] Geva et al. Fertil Steril. 1996; 66(3):430-4.
[PubMed Abstract] Suleiman et al. J Andrology. 1996; 17(5):530-7.
[PubMed Abstract] Keskes-Ammar et al. Arch Androl. 2003 Mar-Apr;49(2):83-94.
[PubMed Abstract] Gupta and Kumar. Int Urol Nephrol. 2002; 34:369-72.
[PubMed Abstract] Lenzi et al. Fertil Steril. 2003; 79(2):292-300.
[PubMed Abstract] Hunt et al. Am J Clin Nutr. 1992; 56(1):148-57.
[PubMed Abstract] Wong et al. Fertil Steril. 2002; 77(3):491-8.
[PubMed Abstract] Balercia et al. Fertil Steril. 2009; 91(5):1785-92.
[PubMed Abstract] Safarinejad. Int Urol Nephrol. 2012; 44(3):689-700.
[PubMed Abstract] Safarinejad et al. J Urol. 2012; 188(2):526-31.
Collecting a Semen Sample
It’s okay to feel a bit uncomfortable about collecting a semen sample for sperm analysis. By and large, men describe the experience as awkward and embarrassing. At CNY Fertility Centers we provide a home like environment for the collection process.
How to Prepare
As part of the fertility workup, you’ll make an appointment to either produce your sample in office or drop it off at the clinic or lab after you produce a sample at home. With sperm, timing is of the essence, so plan accordingly.
You’ll need to refrain from any sexual activity for at least two days, but not more than 5 days before you collect your sample. This means no sex or no ejaculation of any kind, including masturbation. Longer or shorter periods of abstinence may result in a lower sperm count or decreased sperm motility. Samples produced after two days of abstinence will usually have the highest numbers of motile sperm with the greatest forward velocity, when compared to samples produced after shorter or longer abstinence. Some men think saving up all their sperm for the day of their test is what’s preferable, but waiting too long between ejaculates is not ideal. Older sperm begin to die if ejaculations are infrequent and the percentage of live sperm decreases with increasing abstinence.
No smoking, drinking, or drugs during the 10 days preceding you sperm collection (of course, you may want to consider these lifestyle changes even further in advance). Specific things that could affect the quality of your sperm sample include:
Medicines, such as cimetidine (Tagamet), male and female hormones (testosterone, estrogen), sulfasalazine, nitrofurantoin, and some chemotherapy medicines.
Caffeine, alcohol, cocaine, marijuana, and tobacco.
Herbal medicines, such as St. John’s wort and high doses of echinacea.
Collecting the Sample
Masturbation is, most likely, the way you’ll collect your semen specimen. If you have severe male infertility, resulting in few or no sperm in the ejaculate, you may require a surgical procedure such as microsurgical epididymal sperm aspiration or testicular sperm aspiration. Most doctors recommend you ejaculate directly into a provided sample cup and not use a condom. If you must use a condom, your lab will provide a special semen collection condom.
Before collecting a semen sample:
Shower and wash your hands with soap and water.
Refrain from using lubricant, saliva, or any product that may contain spermicidal agents.
Ejaculate directly into the sterile sample cup. Try to capture the first part of the ejaculate and do not attempt to collect any spilled semen.
Cap the container as soon as you have finished. Make sure your name and the time and date of your sample is clearly printed on the cup.
Transporting Your Semen
If you collected your sample in a place other than your clinic, you will need to bring it to the office within one hour after ejaculation because sperm do not have a long life outside of the body and at different temperatures. Delays in delivering semen and exposure to various temperatures will results in lower overall motile sperm count.
Your semen sample should be kept as close to body temperature as possible. The sperm motility value will be inaccurately low if the semen sample gets cold and or if it gets too hot. Keep your specimen container upright in a plastic bag, with the lid securely tightened. The specimen should be kept close to your or your partner’s skin.