With so much sperm per ejaculate, it seems that sperm quality would hardly matter in infertility. A healthy male discharges 50 million sperm in one ejaculation. During sexual intercourse, of all those millions of sperm, only a couple hundred will make it to a mature egg that is ready to be fertilized. But 40% of infertility is from the male, including males who passed the semen analysis tests. The average sperm count today is between 20 and 40 million per milliliter in the Western world, having decreased by 1-2% per year from a substantially higher number decades ago. A study of 26,000 men showed sperm counts plummeting 33% among men in the industrial world between 1989 and 2009. But quality rather than quantity maybe more important.
Studies on declining sperm quality are surprisingly lacking and are often correlations rather than studies that prove causation. That said, most of the suggestions are healthy and easy to implements. Here are some things you can avoid that reduce sperm quality and quantity.
- Heat. Keep that laptop off of your lap, wear boxers instead of briefs, cotton rather than synthetics and let your testicles stay cool. That is why testicles hang outside of the warm torso. Avoid saunas and steam rooms while you are trying to conceive.
- Stress inhibits the production of testosterone (in the Leydig’s cells.) Cortisol also isn’t good for your hormone production or enjoyment of sex.
- Plastics: It is estimated that 93 percent of the US population have bisphenol A (BPA), a chemical that can be found in canned goods, in hard, and polycarbonate water bottles, in their body. Even 40% of receipts from cash registers and your ATM contain BPA. PCBs have been added to plastics, inks, adhesives, paints, and flame retardants. as well as being used as coolants and lubricants in electric equipment. PCBs are in the air and water, and many people are exposed to them through eating certain fish — especially those highest on the food chain. Phthalates are found in toys, food packaging, hoses, and personal care products. Avoid all plastics, not just BPA.
- Gore-tex raincoats, Teflon coating and non-stick pans use perfluoroalkyl acids like perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS), that reduce sperm counts dramatically according to a Danish study.
- Obesity: In a meta analysis of several studies, scientists found that of normal weight men 24 percent had a low sperm count and 2.6 percent had no viable sperm. Among the overweight men, 25.6 percent had a low sperm count and 4.7 percent had no viable sperm. Of the men who were obese, 32.4 percent had a low sperm count and 6.9 percent had no viable sperm. This can be a primary cause or a proxy for obesogens from plastics and pollutants.
- Television watching over 20 hours a week results in 44% less sperm. Of course this is most likely a proxy for lack of exercise. But if you are drinking beer and eating processed foods you are getting a double dose.
- Exercise: Men engaging in exercise like weight lifting or outdoor activities for seven hours or more per week (one hour a day) had 48 percent higher sperm concentrations than men who were engaging in less than one hour per week according to a recent Harvard Study. Men who spent more than an hour and a half each week engaging in physical activity outdoors had a 42 percent higher sperm concentration than those who spent no time outdoors.
- Diet: Ditch the junk food, carbs and dairy. High carbohydrate intake, especially from grains and high dairy intake reduces sperm motility. One serving a day of processed meats can impair sperm count while a serving of fish can improve it. Avoid soy: men who ate soy every other day had 41 million fewer sperm per milliliter than soy avoiders in a recent study. Eat vegetables like kale which are high in zinc and magnesium. Oysters from clean water can help. Folic acid, selenium, and zinc sulfate have been shown to improve sperm counts and sperm function.
- Processed meat and bacon: While a steak is good for your testosterone, bacon, pepperoni and processed meats lower sperm quality. One slice of bacon or a sausage a day lowers sperm count. This is a correlative study and bacon eaters might have poorer exercise and lifestyle features, but eating white fish like cod was correlated with more normal sperm morphology while dark fish like salmon and tuna were associated with higher sperm concentrations.
- Canned food, usually contains BPA. Most food cans are coated with BPA resin, and acidic canned foods like tomatoes are especially risky.
- Beer: contains lots of phytoestrogens from the hops, enough estrogen that female farmworkers get breast distention from harvesting the hops. Wine, OTOH may help in moderation. But in general alcohol is not good for sperm production. It may increase the production of estrogen by the liver, which can lower sperm count. Also, alcohol can potentially poison the sperm-producing cells of the testicles although recent French research questions this.
- Tobacco: Smokers are known to have lower fertility, Specifically smoking causes poor sperm motility and possibly poor morphology
- Weed. Heavy marijuana smokers have been found to have significantly lower sperm counts and sperm that swim in circles instead of towards the egg.
- Pharmaceuticals: There are a number of drugs that affect male fertility, including SSRIs like Prozac, antibiotics like penicillin or tetracycline, statins like Lipitor, calcum channel blockers, steroids, cytotoxic drugs used in cancer treatments, and opiates. Some, like estrogens may be in the water supply, which is why our rivers are full of intersex fish. Ask your pharmacist about fertility-inhibiting side effects of your medications.
- Environmental toxins: There is quite a lot of conflicting evidence about environmental substances that may cause damage to sperm. Of course radiation can cause damage and birth defects. Other substances thought to have a detrimental effect on sperm are some perfumes containing phthalates, some types of pesticides, organic mercury, and polychlorinated biphenyls.
- Personal care products like shampoos, soaps, deodorants and shaving creams which contain phthalates. The Environmental Working Group reports that phthalates are found in toys, food packaging, hoses, raincoats, shower curtains, vinyl flooring, wall coverings, lubricants, adhesives, detergents, perfumes, nail polish, hair spray and shampoo.
- Sex toys made with soft plastics like jellies because they contain phthalates. Use silicone, glass, metal or stone instead.
- Excessive ejaculation and conversely, prolonged abstinence: Both are known to affect the number and quality of sperm. Intercourse every 2 to 3 days helps ensure optimal sperm count and health. You can save it up a night or two before her ovulation, but not more.
- Late night sex is less effective than morning sex. You have more sperm and it is more vigorous in the morning.
- Male pelvic floor exercises (kegels) improve sexual function and significantly can reduce erectile dysfunction.
In Chinese medicine we look at the functionality of the Kidney and Liver meridians for fertility and for obstacles like Phlegm stagnation that can reduce sperm concentration or mobility. Yin and yang deficiency can also play a role in male infertility, operating on hormones. Depending on the pattern a man may get specific acupuncture formulas and appropriate herbal medicine. Acupuncture reduces inflammation, increases sperm motility, improves semen parameters, modulates the immune system, and improves sexual and ejaculatory dysfunction in male infertility. Herbs can tonify yang and yin or remove obstacles to fertility. In a study of 37 individual herbs and seven herb decoctions used in the treatment of male factor infertility, 30 showed strong to weak anti-estrogenic activity. This means that appropriate herbal formulas can affect the success of fertility.
However don’t discount the effect of passion. Especially if a couple has been trying to conceive for a while the act of sex can become programmed and mechanical. Avoid making sex a function merely of the calender- love, desire and joy, along with an herbal aphrodisiac (and chocolate) may boost your chances while cementing your relationship.