Ashok Agarwal, PhD
Director, American Center for Reproductive Medicine
Director, Andrology Center and Reproductive Tissue Bank
Cleveland Clinic Foundation, United States of America
If a men and his female partner are having trouble conceiving, or if his doctor has said that his sperm counts are low, they may wonder what this says about his health in general. How does his health relate to his fertility? The fact is, semen quality — or a lack thereof — directly relates to his health and well-being, so we need to pinpoint what's causing problems even if the patient is not thinking of having children right now. This report by Dr. Ashok Agarwal from the Cleveland Clinic’s American Center for Reproductive Medicine, throws light on a neglected and poorly talked aspect of male infertility – the lifestyle choices and other health conditions.
The general understanding is that whatever is healthy for our body is also healthy for optimal sperm quality. On the other hand, if a man is exposed to something unhealthy — such as a high degree of environmental pollution — poor semen quality and infertility may result.
So how do we know if a man has a problem? “If he is unable to conceive after more than one year of regular unprotected sex or if his partner has repeated miscarriages (and she is not infertile), he should schedule a doctor evaluation,” their infertility could point to three general problem areas.
1. Lifestyle choices
Exposure to high temperatures or other lifestyle factors can cause poor sperm quality. Anything from tight underwear to endocrine-disrupting compounds (from chemicals found in pesticides and some plastic containers, for instance) can impact his health. Here are some examples.
Does he spend a lot of time in hot tubs or saunas? Does he routinely use laptop computer on his lap (and carry his smartphone in his front pants pocket)? Too much exposure to heat (and radiation from cell phones) is unhealthy for his sperm.
Is he significantly underweight (BMI less than 18.5) or overweight (BMI greater than 30)? Does he routinely use legal or illegal drugs that affect fertility? Does he have trouble getting enough sleep? These factors all take a toll on man’s health (and sperm health).
Experts suggest these steps one can take right now to help ensure healthy sperm — and better health in general — if the fertility problem relates to man’s lifestyle:
- Follow a healthy diet/maintain a healthy weight
- Get enough sleep and manage your stress
- Use protection to avoid sexually transmitted diseases
- Get plenty of exercise
- Limit your intake of caffeinated and sugary drinks as well as processed meat
- Don't smoke
- Protect your testes from exposure to heat and chemicals
2. Other health conditions
There are also several other things a low sperm count could say about your health. "However, it is generally difficult to point to a specific sign or symptom that men should look for besides infertility”.
Men may have a problem in their hypothalamus or pituitary gland (these structures help control how ones hormones work). Testicular disease or disorders that affect whether men’s sperm get to the uterus successfully also sometimes cause infertility.
Sperm production is sometimes inefficient, or a blockage or obstruction also may cause issues. It's not a "condition" exactly, but sperm health declines with age, so if a man is 40 years or older, that can have an impact on fertility. With some of these conditions, he may also see signs of hypogonadism (the body does not produce enough of the hormone testosterone), including:
- Loss of concentration
- Decreased sex drive
- Erectile dysfunction
3. Genetic abnormality
Experts say infertility sometimes points to genetic abnormalities such as:
- Klinefelter syndrome: A condition in which a male is born with an extra copy of the X chromosome
- Kallmann syndrome: A rare condition in which puberty either does not start or is not completed
- Cystic fibrosis: A disorder that damages the lungs and digestive system
- Kartagener syndrome: A chronic lung disease
Male should know that he can pass some genetic mutations to his children. So it's important to explore the problem with his doctor so he knows what the chances are of passing it down.
What are the treatment options?
In addition to lifestyle changes, several medical and surgical options are also available, depending on what is causing men’s infertility.
- Antioxidants. These are commonly used to maintain a balance in the body and ensure healthy sperm development.
- Surgery. A common surgical option can correct a varicocele, which occurs when the veins inside the scrotum become dilated. The condition causes blood inside the testis to stagnate and elevates testicular temperature. “This is the most common correctable cause of infertility, occurring in about 40 to 70 percent of infertile men”.
- Reproductive assistance. Patients with a long duration of infertility sometimes opt for assisted reproduction options, which include insemination and in vitro fertilization. “Male infertility and sperm health is a complicated topic”. “If you have any questions or concerns you should contact your doctor (specializing in the treatment of male infertility) to discuss them further.”