Desperate to be a dad? You’re sadly not alone. The NHS say that around one in seven couples will struggle to get pregnant. And while IVF is routinely offered to treat women, men are less likely to receive treatment for their own problems, despite a shocking decline in male fertility in the past 40 years.
The average sperm count among men in the West has more than halved in a generation and continues to fall each year, according to studies carried out on both sides of the Atlantic.
The good news is that men can future-proof their own fertility - and optimise their health and vitality at the same time. Leading nutrition and wellness expert Gideon Remfry explains how.
A male fertility crisis?
The subject of male health sometimes gets lost within the big picture of fertility. But with one in seven couples struggling to get pregnant, it’s a subject we should be taking more seriously. Men’s reproductive health seems to have declined by as much as 60% over the last 50 years. And although environmental pollutants, obesity, diet and later age of trying to conceive have all been proposed as a cause, no one has a definitive answer as to why.
A comprehensive and global review including 185 studies, counted semen samples from a total of 42,935 men between 1973–2011. The results showed a 50–60% decline in male reproductive health, concluding that “research on causes and implications were urgently needed.”
What sperm counts can tell us about male fertility
Sperm are men’s reproductive cells. If you’re worried about your fertility, your doctor may offer you a semen analysis. This tells you how many sperm per millilitre (ml) of semen you’re producing, but also includes other factors that may affect the sperms’ ability to fertilise the female egg, such as the size and shape; how well and fast they can swim; and whether you have low PH levels.
Sperm counts are hugely individual. In fact, the World Health Organisation’s suggested averages range between 40 million and 300 million sperm per ml. Interestingly, the WHO also imply that having low or high sperm numbers does not necessarily correspond with the ability to conceive - what appears to be more important for fertility is the combined ‘quality’ of the sperm. The NHS recognise a low sperm count as when a man has fewer than 15 million sperm per ml of semen.
Factors that affect male fertility
Male fertility can be affected by hormonal imbalance, as seen in medical conditions such as hypogonadism where low amounts of free testosterone can be a cause. Fertility can also be impacted by medications, including some antibiotics and antidepressants, or there may be genetic, structural or functional issues within the testicles themselves
But while medical, medications and testicular health all affect men’s reproductive health, there are also multiple, modifiable lifestyle factors that can be addressed. These include smoking, obesity, alcohol use, recreational drug taking, depression, anabolic steroid use, physical stress, genital infections, emotional stress and even your occupation.
Could your body’s own antioxidants help increase your fertility?
Most of us are aware that the natural antioxidants found in the foods we eat (such as the polyphenols in plants) are great for our health. What’s less well known is that our bodies also have an in-built antioxidant system which produces powerful antioxidants like superoxide dismutase (SOD) and glutathione peroxidase (GPX).
We can eat antioxidants and take steps that help us up-regulate our bodies’ own antioxidants, both of which create a cellular protective reserve known as our total antioxidant capacity, or TAC. Our TAC is our defence mechanism against the oxidative damage caused by mental and physical stress (oxidative stress).
This is important because oxidative stress plays a fundamental role in a lot of the causes of male infertility by negatively affecting sperm quality and function.
Six ways to optimise male fertility
The good news is the power of this dual antioxidant protection can be supported with lifestyle, diet and exercise, all of which have been shown to positively impact on TAC, male health and fertility.
Not sure how? Here are six ideas to get you started...
1. Get moving (moderately!)
Forget go-hard or go-home. Taking moderate aerobic exercise for over 30 minutes three times per week shows excellent outcomes for heart, brain and semen health and has also been shown to up-regulate our bodies total antioxidant capacity and reduce oxidative stress.
One study showed the impact of a four-month intervention of moderate aerobic exercise. In the study, inactive and overweight men who used a treadmill for 35-50 minutes three times per week showed improvements in both their semen quality and their reproductive hormone profile.
2. Eat that rainbow
Diets rich in antioxidant foods like the Mediterranean diet have been shown to increase both TAC and semen quality. In addition they are associated with decreasing the risk of death from all-causes, including cancer and cardiovascular disease.
Polyphenols are plant compounds which have been shown to support numerous health benefits. Studies have suggested that TAC concentrations and carotenoids (a type of polyphenol found in broccoli, apricots, cabbage, and carrots) were “positively correlated with sperm motility, morphology, and concentration”, which confirms the positive relationship between blood antioxidants and sperm quality.
To highlight this further, blood samples taken from infertile men showed lower TAC and lower concentrations of plant polyphenols and vitamins such as carotenoids and vitamin E, especially when measured against fertile men.
3. Put fish on the menu
Essential fatty acids are exactly that... essential! But even if you eat fish regularly, you may not be getting enough omega 3 to balance the high amounts of omega 6 in the modern western diet. Omega 6 is found in plentiful amounts in corn, canola and soya bean oil, margarine, peanut butter, chicken fat, fried food and hidden in a lot of healthy-sounding processed foods, such as granola and hummus. As omega 3 is found mainly in small oily fish, ratios inevitably tend to be lower.
The ratio of omega 6 to omega 3 fats we consume does seem to have an impact on general health, oxidative stress and inflammation. But it also has an effect on men’s semen profiles. One study compared omega 3 and 6 ratios between fertile and infertile men and concluded the infertile men had lower concentrations of omega 3 in their moving sperm cells than fertile men.
The results suggest the potential benefits of improving omega 3 ratios through diet or through Omega 3 supplementation as a viable therapeutic approach in infertile men when the cause is unclear.
4. Consider taking an antioxidant supplement
N-acetyl-cysteine or NAC is an antioxidant and although further research is required, early studies using NAC suggest it may boost glutathione levels (part of your total antioxidant status) and reduce oxidative stress.
One study showed that a three-month treatment using 600mg of NAC per day orally, saw sperm counts and motility increase significantly. Interestingly the men’s hormonal profile and TAC levels also improved.
5. Think zinc
Zinc is an essential mineral present in every one of our cells. It’s responsible for numerous functions from metabolism to immunity and is associated with our growth and development. Zinc is found in meat, seafood, legumes and fortified cereals, amongst other foods and multivitamin supplements. We do not create zinc in our bodies and can only get it from our diets.
But does zinc have a role to play in male health and fertility too? Research suggests it may support improving sperm count and quality. One study looked at 108 fertile and 103 infertile men and examined the effects of zinc supplements (and folic acid) on improving their semen variables. After 26 weeks the sub-fertile men demonstrated a 74% increase in total normal sperm count and a slight improvement in motility.
Another study highlighted that poor zinc nutrition may be an important risk factor for low quality of sperm in unknown causes of male infertility.
6. Try a herbal remedy
Ashwagandha may be an ancient herbal remedy, but it has a lot of modern research behind it. It’s regarded as an adaptogenic herb, meaning it may help your body and brain adapt to managing stress more effectively.
Ashwagandha also shows promise as a herbal remedy for infertility by improving both blood circulation throughout the body (something that’s known to be good for maintaining erections) and naturally enhancing sperm quality.
Advances In Nutrition published a large systematic herbal review examining specific herbs and their effects on testosterone concentrations in Men. Ashwagandha was one of only two evidence-based herbs shown to work and the outcomes suggested ashwagandha herb, root and leaf extracts, may have a positive-effects on testosterone concentrations in men and treating male infertility.
Male fertility within our control
Our ability to improve our total antioxidant capacity shows that lifestyle changes can buffer and balance the impact of mental and physical stress on our bodies. Far from being beyond our control, simple lifestyle changes present an opportunity to improve both our fertility outcomes and our overall wellness.
The lifestyle recipe to improve TAC includes some regular moderate exercise, increasing antioxidant rich food and oily fish, in addition to adding a few key nutrients, which all show excellent potential in improving our sperm health, our physical vitality and our mental health.
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