By Denise Wiesner, DACM, L.Ac
The male partner plays a crucial role in the reproductive process, as their healthy sperm is needed to fertilize eggs and make babies. However, the focus in fertility care often revolves around women’s overall health and what they can do to increase their chances of conception. In reality, 40%-50% of infertility cases in couples are due to male factors.
According to reproductive urologist Dr. Paul Turek, “a man’s fertility potential is now known to be a biomarker of his health.” This article will explore male reproductive health from both an Eastern and Western medicine framework, looking at the causes of male reproductive issues, and how to improve male fertility naturally.
In order to make a baby, a man must:
- Make good-quality sperm to fertilize an egg
- Be able to achieve an erection to ejaculate
If there are difficulties in one or both of these areas, it is advised to see a medical professional, such as a primary care physician or reproductive urologist. For example, if there is no sperm in a man’s ejaculate (also known as azoospermia), then a reproductive urologist can use sperm retrieval procedures to extract sperm from his testicles, and use that sperm for in vitro fertilization (IVF). It’s important to remember that sperm takes about 70-80 days to develop, and sperm counts can fluctuate. If one sample is “bad,” a fertility specialist (ie, reproductive endocrinologist or reproductive urologist) may have the male wait and provide another sample at a later date.
What causes male fertility problems?
Infertility is defined as the failure to conceive after 12 months of regular and unprotected sexual intercourse. When a male is involved in the process of trying to conceive, a semen analysis is typically done to determine if the number, shape, and movement of sperm are all normal. According to reproductive urologist Dr. Philip Werthman, “any infertility evaluation should include a thorough male history and physical examination with two semen analyses.”
Below are a few causes of male fertility problems:
Males may be born with genetic conditions, such as chromosome disorders like Klinefelter’s syndrome, that can affect fertility.
Hormone imbalances, such as those with testosterone or the glands that produce hormones, may play a significant role in male infertility. Low testosterone levels may also affect a man’s desire to have sex and cause other symptoms.
Immune infertility occurs due to the presence of antisperm antibodies. This type of infertility has a low occurrence and is not completely understood.
Chronic illnesses, such as diabetes and autoimmune disorders, are well documented to impact male fertility.
Many infections can affect sperm, including sexually transmitted diseases (STDs). Tissue damage and inflammation caused by bacterial infection may also lead to male infertility by negatively affecting how sperm and testosterone are produced.
The movement and number of sperm tend to decrease with age, which may affect fertility.
Exposure to toxins (eg, pesticides) and metals (eg, lead) can influence sperm. Heat and radiation (from hot tubs, saunas, laptops, and other sources) may also affect the testicles, sperm, and fertility.
Alcohol consumption, cigarette smoking, marijuana intake, and poor diet may affect sperm development.
If the genital tract becomes blocked, semen can’t flow out. The causes could be from a genetic or birth defect. Inflammation and/or infection may also block semen. Scar tissue can form as a result of surgery or trauma, and some men have swollen veins in the scrotum called varicoceles that can heat up sperm and cause them to be nonviable.
Men’s reproductive health also involves their libido (ie, desire to have sex) and their ability to get an erection. Libido and erectile dysfunction are not spoken about often due to stigma and shame around sexuality. Contributing factors for male sexual health are complex and can include cultural, behavioral, biological, and psychological factors. Men may also have performance anxiety during the fertile window (ie, the period of time leading up to and during ovulation when chances of conceiving are optimal). In addition, certain medications, such as those for high blood pressure and selective serotonin reuptake inhibitors (SSRIs), may have an effect on erections and ejaculation.
What is male fertility testing?
There are a few different tests for male fertility, including:
As mentioned above, this test looks at the quantity (volume), shape (morphology), and movement (motility) of sperm. A semen analysis can help determine if a man has a sufficient amount of healthy sperm.
Hormone panel (blood test)
Hormonal imbalances can affect fertility, so it’s important to check for issues.
Sperm DNA fragmentation (SDF) test
This test is sometimes done to gather more in-depth knowledge about sperm quality, especially when there is unexplained infertility, recurrent pregnancy loss (RPL), varicocele, male patients with risk factors (eg, unhealthy lifestyle, exposure to toxins), or after failed fertility treatment.
Natural methods that may improve male fertility
First, it is advisable to always consult a medical professional (eg, primary care physician, reproductive urologist). But it is also known that lifestyle changes may help with male fertility. A recent research study stated that “the quality of human semen has deteriorated by 50%-60% over the last 40 years.”
Thus, some of the below options may be beneficial for those struggling with male fertility:
Try to avoid processed meat, soy foods, potatoes, full-fat dairy, coffee, alcohol, sugar-sweetened beverages, and sweets. Eat a variety of organically grown vegetables of all colors (good for gut health, too!), fruits, nuts and seeds, whole grains, and fish rich in omega-3 fatty acids. Antioxidants are a must! You can also incorporate supplements, such as a prenatal for men containing researched nutrients like zinc, selenium, coenzyme Q10, carnitine, and omega-3 fatty acids. Limit caffeine consumption to 1 cup per day (although research is not conclusive in this area).
Herbs may help with many male infertility issues, and it’s important to have an herbalist (like myself) prescribe herbs based on each individual’s situation. Also, keep in mind that, in Chinese medicine, herbs are often put together in formulas and rarely given individually. Here are some of the herbs recommended to enhance sperm and libido:
- Ashwagandha: this Ayurvedic adaptogenic herb helps calm the nervous system, improves sperm, and helps the body deal with damaging inflammatory effects of stress
- Barrenwort: this herb is traditionally used to improve libido and treat erectile dysfunction as an addition with other herbs
- Cordyceps: this type of fungus has been shown to increase sperm count, normalize immune function, and enhance cellular energy in animals
Please note that this is not medical advice, and you should talk to your healthcare provider before trying any of the options.
Traditional Chinese medicine treats the body, mind, and spirit. Acupuncture is one of its modalities. Acupuncture is a practice of inserting thin, metallic needles into the skin at specific points located on the body. The existing literature shows that acupuncture may effectively help with male infertility.
Moderate exercise is good for fertility. Avoid excessive sitting on a bicycle seat, as it can heat up the testicles and become detrimental to sperm production.
Stress can significantly impact men’s health and fertility by affecting sperm health and production, as well as testosterone levels. Engaging in stress-reducing activities such as yoga, meditation, and deep breathing exercises may help improve male fertility. A yoga-based healthy lifestyle may help with DNA damage of sperm, and meditation may have positive effects on cellular aging.
Avoid exposure to environmental toxins
Exposure to environmental toxins such as pesticides, heavy metals, and radiation can damage sperm DNA and decrease sperm motility and production. Men should eat organically grown foods, if possible, and avoid drinks and food packaged in plastics.
Avoid heat on testicles
It is essential to include men in the discussion around fertility as they are often left out of the equation. As the song by Marvin Gaye and Kim Weston says, “It takes two, baby, It takes two, baby, me and you, just takes two.”