There has been increasing evidence on the global decline in human sperm quality over the past few decades. In the most recent report, an international study group performed a systematic analysis of the current trends in sperm counts. This comprehensive study involved 42,935 men with semen samples spanning over 40 years. They reported a significant decline of 50– 60% in sperm counts amongst men from North America, Europe, Australia, and New Zealand. This latest finding has sparked even greater concern over the reasons behind the apparent decline in the sperm count of Western men.
The most important semen parameters include:
- Semen Volume
- Sperm Count
- Sperm Motility
- Sperm Morphology
- Sperm DNA Fragmentation.
Following are the few tips to boost Male Fertility:
1. Quit Smoking:
Cigarette smoke contains >7000 chemicals, including highly carcinogenic tobacco-specific compounds. Cigarette smokers have increased exposure to hazardous substances such as tar, nicotine (which is highly addictive), carbon monoxide, and heavy metals (e.g. cadmium and lead)
Moreover, tobacco smoke contains Reactive oxygen species (ROS) at levels that can overcome the inherent antioxidant defenses. Increased seminal levels of ROS in smokers expose sperm to oxidative stress, consequently impairing sperm function and ultimately compromising male fertility.
A large meta-analysis involving males from 26 countries concluded that smoking causes a decline in sperm quality in both fertile and infertile men. Sperm count in male smokers was reported to be typically 13–17% lower than that of non-smokers. Moreover, cigarette smoking has been negatively associated with sperm count, motility, and morphology. The decline in semen quality was found to be more marked in heavy (>20 cigarettes/day) and moderate (10–20 cigarettes/day) smokers compared to mild smokers (1–10 cigarettes/day).
With paternal smoking being a significant risk factor for in-vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI) failure, paternal smoking could perhaps contribute to decreased assisted reproductive technology (ART) success rates as much as maternal smoking or more.
Every additional year following the male partner’s smoking cessation reduces the risk of ART failure by 4%.
2. Restrict Alcohol intake:
An Indian study on the male partners of couples facing primary infertility found that abnormal sperm shape was present in 63% and 72% of males who drank alcohol moderately (40–80 g/day) and heavily (>80 g/day), respectively. None of the heavy alcohol drinkers had normal sperms and most had less sperm count, which is suggestive of progressive testicular damage in relation to increasing daily alcohol intake
Alcohol appears to interfere with the production of various hormones including testosterone. As a result, the production, morphological development, and maturation of sperm could be impaired.
Although the effects of alcohol on male reproductive function are dependent on the intake amount, a threshold amount of alcohol beyond which the risk of male infertility increases has not yet been determined.
3. Moderate exercise:
Physical activity programs improve health and the quality of life, but excessive or exhaustive exercise exposure can lead to negative side effects, with one of the most recently recognized being possible fertility issues in both females and males when training load is elevated and intense, though this is not universally recognized.
Physical activity (exercise) could exert beneficial or detrimental effects depending on the several inherent exercise regimen parameters: type, intensity, volume, objective, or organization. Regrettably, there is still a lack of consensus on these effects.
Recently a European study group performed a 16-week aerobic training program in a treadmill, three sessions per week, consisting of a warm-up (10-15 minutes), 35-50 minutes treadmill exercise (increasing five minutes per four weeks) at a work intensity of 50-65% of peak heart rate (increasing a 5% per four weeks) and cooling-down (5-10 minutes). Favorable improvements in semen parameters, sperm DNA integrity and pregnancy rate were noted in this cohort of infertile patients.
4. Balanced Diet:
Vegetables and fruits, fish and poultry, cereals and low-fat dairy products were amongst the foods positively associated with sperm quality. However, diets consisting of processed meat, full-fat dairy products, alcohol, coffee, and sugar-sweetened beverages were associated with poor semen quality and lower fertility rates
To begin with, the practice of substituting processed red meats with fish may have a positive impact on sperm counts and morphology.
Soy, legumes, soy-based foods, soya beans, oils, and seeds have been shown to adversely affect multiple semen parameters.
A recent systematic review involving 19,967 men found that in most of the studies, semen parameters were affected by cola-containing beverages and caffeine-containing soft drinks, but not by caffeine intake from mainly coffee, tea, and cocoa drinks.
5. Avoid Genital heat stress:
The testes are located outside the body cavity and have a counter-current heat exchange system resulting in temperatures 2- 4-degree Celsius cooler than body core temperature. Genital heat stress resulting from increased scrotal temperature is a substantial risk factor for male infertility.
Prolonged hours of sitting or exposure to radiant heat, varicocele (enlarged veins in the scrotum) and undescended testes (testis in an abnormal position) can all lead to testicular heat stress. Elevated scrotal temperatures lead to sperm growth arrest, oxidative stress, and sperm DNA damage.
The use of polyester-lined athletic undergarment supports, repeated usage of sauna or steam room has been discouraged.
6. Avoid recreational drugs:
Cannabis or commonly referred to as marijuana is the most abused illicit drug globally. Regular marijuana smoking (more than once weekly within the last 3 months) was found to lower sperm concentration and total sperm count amongst young men, and this effect is further exacerbated when marijuana is used in combination with other recreational drugs
7. Watch your weight:
Overweight (Body mass index 25–30) and obese (BMI >30) males are associated with a decrease in sperm quality and a greater risk of infertility. The presence of excess white fat tissue in obese individuals causes increased conversion of testosterone (male sex hormone) to estrogen (female sex hormone). These effects result in secondary hypogonadism (low testosterone) and impaired sperm production.
Obese men who attempt assisted reproductive techniques (ART) have reduced rates of embryo development pregnancy, and live-birth rates.
8. Good sleep:
Either excessive or restricted sleep is associated with a reduction of semen quality suggesting that improper sleep duration may impair semen quality. One of the recent Chinese study involving 796 individuals suggested that 7–7.5 hours/day is the recommended standard for good fertility status. Those who slept for more than 9 hours/d or less than 6.5 hours/d had lower semen parameters.
9. Nutrition supplements:
There are specific effective antioxidant medications to improve sperm health. They include carnitine, vitamin C, glutathione, selenium, and coenzyme Q10. These medications are best taken after an initial consultation with the Andrologist or your primary treating physician.
10. Avoid anabolic steroid intake:
56% of users of anabolic steroids have never revealed their steroid use to a physician. Most steroid abusers are young men in their reproductive years who may be unaware of the reproductive consequences of their actions. Anabolic steroids are commonly taken after visualizing the commercial ads on media to improve sexual pleasure or by the insistence of fitness trainers.
External hormonal steroids stop sperm production by suppressing the hormonal pathways and decreasing the internal testosterone levels.
Low testosterone associated with steroid abuse is usually reversible within 3 to 6 months of discontinuation, but the recovery has been reported to take as many as 3 years and occasionally may be irreversible.
11. Sperm cryopreservation:
This is an option where a person can preserve his sperms prior to chemotherapy or radiotherapy in testis cancer, or if not planning to have children at the moment but wants to have after a few years.
“Do not hesitate to consult an Uro-Andrologist if failure to achieve a clinical pregnancy even after 12 months of regular unprotected sexual intercourse”