When talking about fertility, much of the rhetoric focuses
on female fertility. As a result, knowledge about sperm and how to best protect
male fertility is often severely lacking. For couples with infertility
problems, male infertility is a contributing factor in up to 50% of cases, and
actually the sole cause in about 30% of cases. So what do we need to know?
A normal, healthy sperm count is usually considered as about
15 million sperm or more per ml, however it’s not just the number which is
important. You also have to assess quality indicators such as motility (speed
of movement) and morphology (normal shapes), with normal progressive motility
being around 32% or more and normal morphology being around 4% or more. If we
take this last stat you can see men may have up to 96% abnormal shaped sperm,
yet still be considered to have a normal sperm sample as long as other
parameters are within the normal range. As soon as the sperm sample does not
meet the above parameters it does not mean the man is infertile, but rather
that fertility problems are much more likely to occur and the chances of
naturally conceiving are reduced.
So why don’t more men, or women for that matter, usually know
these details? I feel the real issue here is that they simply not realise that
up to half of infertility issues could be due to sperm problems. Through my
experience, when compared to women, men are less likely to talk about fertility
problems with family and friends. Women tend to share and talk with each other
about fertility issues, and getting pregnant seems to be considered a female
issue. In reality, men want to be fathers as much as women want to be mothers,
but it’s just not a topic they want to bring up in pubs or offices. If
awareness of the issues around infertility were better known, I think men would
be more proactive about understanding and improving their fertility. Therefore
raising awareness around male fertility and how to protect this is just as
important as helping women to improve their fertility.
Once we’ve got prospective fathers aware of the importance
of sperm count, what can they do to protect it? When looking at this we must
first be aware that there is a fundamental difference between sperm and egg
production, one well highlighted in the description:
“Men’s testes are like
factories, whereas women’s ovaries are like warehouses”.
Men produce brand new sperm every 2 to 3 months, and so their
lifestyle in the preceding months is incredibly important in determining the
quality of sperm. Lifestyle issues such as high alcohol intake, smoking and
taking recreational drugs, all negatively affect sperm function. Stopping
smoking and recreational drug-use is an obvious first step. As regards to
alcohol intake, there are no quantitative studies, but we advise to reduce alcohol
intake and not drink more than 8 units in 48 hours i.e. no bring drinking! Stress
can also have a negative impact on sperm quality, and it is important men look
to keep this to a minimum. Other factors include anything that contributes to
an intermittent increase in scrotal temperature, such as taking hot baths, sitting
at a desk or on a sofa for long periods of time, and long distance driving
without taking a break.
If men are worried about any of these issues, or would like
to seek help, then the first step should be to seek advice from their GP. If concerned
or worried, sperm tests are available at most fertility clinics, and they can
offer considered medical advice on receipt of results. At my Create Fertility
clinics we run free Open Days for men and women, because in tackling fertility
issues both are just as important.