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Male Factor Infertility (MFI) accounts for (or contributes to) an estimated 30-50% of infertility cases, and more recent research is linking a surprising number of recurrent miscarriages to sperm related issues. Considering this particularly high percentage of infertility cases due to MFI, and that male factors contribute to recurrent miscarriage, it always surprises me how many couples struggling with infertility that I work with who have either not had the husband's fertility tested, or have had only a simple semen analysis completed. It is not uncommon for me to go over a wife's medical history and discover that she's had an enormous number of tests and procedures completed to assess her fertility. When I ask about her husband, I typically hear either "he hasn't been tested yet" or "they did a semen analysis and he's fine." Occasionally I will find out that the husband has some morphology or motility issues, but these are often brushed off or no treatments for these problems have been recommended.
Just as there are a myriad of factors that contribute to female infertility and/or miscarriage, there are also a number of factors that can affect male fertility. Obesity, alcohol, vaping, tobacco, soda, energy drinks (that's right, energy drinks), and marijuana use, morphology (the size and shape of sperm), motility (how the sperm move), sperm quantity, hormonal problems, and chromosomal abnormalities can all affect male fertility. Additionally, things such as low vitamin D levels in men have been linked to recurrent miscarriage. While a simple semen analysis can assess sperm morphology, motility, and quantity, it cannot analyze sperm for chromosomal problems. When a couple is struggling with infertility, the wife is often the one who undergoes the vast majority of testing and treatments, but given the frequency with which men contribute to infertility and recurrent miscarriage, it's equally important to assess his fertility.
After reading this, you may be tempted to rush right out and have all the male factor tests run (and I wouldn't blame you if you did); however, it's important to understand what treatments are available to see if there are some things that can be tried prior to spending a lot of time and money on often invasive tests. By and large, many issues affecting male fertility can be improved or fixed with lifestyle changes.
Spermatogenesis, the time it takes for sperm to develop and mature, is approximately 72 days (with some degree of variation from man to man). Therefore, it is important for men to consider the 3 months leading up to trying to conceive as an important time to focus on being healthy. The most important lifestyle factors include achieving or maintaining a healthy weight, exercising, and avoiding the following: alcohol, vaping, tobacco, soda, energy drinks, and marijuana. Weight loss (for men overweight) has been shown to improve sperm morphology, motility, quantity, and reduce sperm chromosomal issues such as DNA fragmentation. Avoiding alcohol, vaping, tobacco, soda, energy drinks, and marijuana has also been shown to increase overall sperm health. Interestingly, tobacco use is particularly damaging to sperm DNA and should be avoided.
In addition to modifying lifestyle, vitamins and supplements are also worth considering. Working with a physician to achieve optimal vitamin D levels is important. In studies, CoQ10, L-carnitine, selenium, vitamin C, and vitamin E have been shown to improve sperm quantity, motility, and morphology, and sometimes decrease DNA fragmentation. And as you probably know by now, I'm a lot on the crunchy side, but I always suggest talking to your physician about supplements before starting them.
In some situations, male factor infertility cannot be treated with lifestyle changes, vitamins, or supplements. Sometimes surgery is required or medications such as Clomid are needed. Many NaPRO doctors will also work with men and/or refer them to doctors who can assist them in determining the best course of action to treat their fertility issues. Infertility is a huge cross to bear. While investigating and addressing all avenues (male and female alike) is important, don't forget to also take care of yourselves and your marriage in other ways. As always, we are here to support you. If you are struggling with infertility, contact one of our practitioners today to start charting.
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