While women count their birthdays and measure their mid-cycle temperatures to boost their chances of conception, at least some of a man’s reluctance to see the doctor about fatherhood may come from the commonly held belief that chances of conception are determined by the woman’s health and cycle. After all, men are fertile all their adult lives, right? But there are degrees of fertility, and they are not cast in stone. Lower fertility can make a difference to conception, yet it can often be easily treated.
Rajeev Sood, consultant urologist, Max Healthcare, New Delhi, says he has found that contrary to prevalent beliefs, almost 50% of infertility in a couple is related in some way or the other to the male partner, often due to his lifestyle choices.
He recalls one patient, a Delhi-based chef, who was surprised when tests on his wife showed there was no reason why she could not conceive even though the couple had been trying for two years. Eventually, after great reluctance, he agreed to a sperm analysis, and his sperm was found to be of low quality (sperm quality is assessed in terms of motility, viscosity, pH, shape and structure, which affect the sperm’s ability to reach the egg and fertilize it). Now, the couple is working on their lifestyle to improve chances of conception, as well as considering options such as adoption.
“The state of one’s sperm is a reflection of one’s overall health,” says Dr Sood. “For example, smoking can affect its motility and an active body produces higher quality sperm than an inactive one.”
There are, therefore, many things that can adversely affect a man’s chances of making a baby. “Over the last half century, sperm counts in men have got halved (from 125 million to 60 million). The count has gone low on its own—possibly due to environmental changes—and we further put more lifestyle stress that causes hormonal imbalances, reducing the count further,” says Ajit Saxena, urologist and andrologist, Indraprastha Apollo Hospital, New Delhi.
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If you and your partner have been trying for a baby and have not quite succeeded, don’t panic within a few months of trying. A healthy couple’s chances of conceiving in any given month are 20%. That is, out of a 100 couples trying for a baby, only 20 would be able to conceive in a month. So trying for three-six months is not unusual. If you have been trying unsuccessfully for a year, then you should see the doctor. “A couple can take professional help if they haven’t been able to conceive after one year of unprotected sex,” says Nikita Trehan, gynaecologist and laparoscopic surgeon, Trinity Clinic, New Delhi, noting that in some countries, such as the US, doctors prescribe trying for at least two years before seeking help.
“A famous benchmark report by Pressinger-Sinclair (Richard Pressinger and Wayne Sinclair) put together during his graduate research project in Florida in 1998...cited a 1994 study that indicated that smokers’ sperm counts are on average 13-17% lower than (those of) non-smokers’,” says Dr Sood. “And key indicators of sperm quality, according to the World Health Organization, are all drastically reduced in men who smoke, besides leading to an increase in dead and malformed sperm,” he adds.
Smoking also affects the sperm’s ability to adhere to the egg, which is a prerequisite for conception. It gets worse: “It has also been found that men who smoke have lower sex drives and have sex less frequently than non-smokers,” says Dr Sood. In the UK, public health watchdog Action on Smoking and Health (ASH) and the British Medical Association warned as early as 1999 that smoking increases the risk of erectile dysfunction by about 50% for men in their 30s and 40s, based on various studies in the 1990s. In 1998, Thailand began to print health warnings on cigarette packets that warned of sexual impotence. India has been slow to follow suit.
All is not lost though. “Smoking cessation improves natural fertility as well as the success rates of infertility treatments such as in-vitro fertilization,” Dr Sood says.
Stress is a known cause of poor conception too. And that includes everything from problems at work to demanding interpersonal relationships. “Stress can interfere with certain hormones needed to produce sperm (it leads to the release of adrenalin and other hormones which can restrict blood flow to the testes and inhibit sperm production), besides decreasing sexual activity (which is to say, simply not getting round to sex),” says Dr Sood. “Sperm counts, motility and structure are all altered under stress. And problems such as impotence and difficulties with ejaculation are often caused by emotional distress,” he adds.
“In moderation, alcohol consumption is fine, but excess (more than two small, i.e., 30ml, drinks a day on a regular basis) tends to deplete B vitamins (see Feed your sperm count), as well as contributing to low sperm count and poor quality sperm (and eggs). Alcohol also inhibits absorption of key nutrients such as zinc, which is one of the most important minerals for (ensuring) male fertility,” says Dr Saxena. All couples should eliminate alcohol at least three months before they plan to conceive, in order to give themselves the best possible chance, the fertility experts advise.
Excessive heat can reduce sperm production. Hot baths and saunas, sitting in one place for long periods, tight-fitting underwear can all elevate temperatures just high enough and long enough to suppress sperm production. “Laptop use (with the computer actually on your lap) also may increase the temperature of your testicles, decreasing sperm production,” adds Dr Saxena. Keep the computer on a desk or get a proper laptop stand (see Taking a stand ).
Feed your sperm count
It’s well known that the folic acid supplement can help women. In some cases, simple dietary changes can help the would-be dad too
This powerful antioxidant has been shown to increase fertility. Good food sources are wheatgerm (and wheatgerm oil), sunflower seeds and oil, peanuts, almonds, olives, broccoli, spinach, tomato and papaya.
Besides keeping the cold at bay, it appears to keep sperm from clumping together, making it more motile. Good food sources are citrus fruit, strawberries, ‘amla’ and kiwi fruit.
Not just folic acid (vitamin B9), all B vitamins are essential during the pre-conceptual period. Men too should take a folic acid supplement for at least three months prior to trying for a baby. Try to eat breakfast cereals fortified with folic acid. Vegetarians should take special care with respect to vitamin B12 (cobalamin, which is the one vitamin hardly found in plants but plentiful in animal foods)—a deficiency of B12 may lead to inadequate sperm production.
Anaemia lowers sperm count and causes tiredness, hence low sex drive. So eat plenty of chickpea, bananas, organ meats, wholewheat foods and leafy green vegetables.
Deficiency can reduce male fertility as this mineral is found in high concentrations in sperm. Add nuts and seeds to your diet, including flax, sunflower and sesame seeds.
For men, essential fatty acid supplementation can also be crucial because the semen is rich in prostaglandins (which are produced from fats). Men with poor sperm quality, abnormal sperm, poor motility or low count often show inadequate levels of prostaglandins.
Source: Jyoti Arora, team leader, nutrition and dietetics, Artemis Health Institute, Gurgaon.
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