On this page on male infertility you’ll learn
When a woman doesn’t conceive, gynaecologists usually assume the problem is with her. But it may not be, and indeed 30% of cases may be due to male infertility.
When a couple have been trying to conceive for several years and have even proceeded to IVF (expensive!) sometimes repeatedly (very expensive!!) with all the disappointment and hormone chaos entailed for the woman with hormone/ovulation stimulation, it’s disappointing, not to say disillusioning, when it finally occurs to the consultant that it’s a sperm problem, not an egg problem!
In fact, you both would probably be quite angry. After all, years may have passed.
Why not start the investigation into sperm health at the same time as investigations into the egg-maker?
Just as there are many reasons for infertility due to egg problems, there are many reasons why sperm may not be functional. (By the way, girls, yes I know you’re reading this, for you there’s some useful stuff on our page ‘fertility-center’. See also our page on Male Infertility.)
It pays to know about them, and men, let’s be a little respectful here – you’ll go through the same lessons in humility and indignity as your female companion.
If indeed, the problem is with you, there is lots that can be done. That’s what this page is about.
Important! Gynaecologists are specialists in female reproductive health: NOT in male reproductive health. If the problem is on your side, eventually you’ll need to see an andrologist who does know about male reproductive health.
First, what are the usual tests done on sperm by doctors (and then, often only when pushed!)
Usually there’s only one test, after which your gynaecologist thinks the job is done. What’s that test?
It’s called a semen analysis. This measures:
This is useful but may not uncover a whole range of other factors (most important are in bold ) such as:
Nor does it usually include three other tests:
Often, a good andrologist will realise immediately, from a physical examination, that you have a problem such as a varicocele which consists of enlarged veins in your scrotum, a bit like varicose veins there. They block the flow of blood through your testes and lead to less sperm being produced, and those sperm that are produced are of lower quality.
Varicoceles aren’t unusual. (Why do you get them? Lots of possible reasons, but nobody knows for sure though Chinese medicine has quite a few ideas.)
10% – 15% of the male population have varicocele problems, and it can be asymptomatic (ie without symptoms). It’s more frequent on the left testicle because of the way your body is made and how blood circulates, but of course it can occur on either testicle.
40% of male infertility arises from varicocele problems. So it’s important! But GPs seem reluctant to refer you for this varicocele test (possibly because the NICE guidelines are out-of-date on the matter). However, if you explain that you are getting some pain from the area, GPs are much easier to persuade to refer you for the test. Even so, your GP will probably refer you to a urologist, whereas an andrologist would be more knowledgeable.
If diagnosed, treatment is simple – though not necessarily pleasant, but compare that with the indignities suffered by women during their investigations and count yourself lucky! – surgery.
It usually works and improvement can come quickly.
Find out more about varicocele and its treatment here.
This has the same effect as varicocele, but is caused by an accumulation of fluid in the scrotum round your testicles. It can occur without symptoms. It can be caused by infection, injury or inflammation, or be a developmental issue. Inflammation and infection could come from STD (sexually transmitted disease) or from an undescended testicle in your past.
The problem for men with varicoceles and hydroceles is this. The affected testicle gets too hot. Heat bakes the sperm, rendering them useless or more susceptible to oxidative stress and DNA fragmentation.
So keep your balls cool! (Find out more about HEAT in Chinese medicine.)
Factors to consider:
If you’re typical of us, all this is rather horrifying. There are support groups set up by and for ‘infertile’ men. There’s a list below.
They know how awkward you feel about joining. They also know how much being a member of such a group helped them. Overcome your timidity/hesitancy and get in touch with them. You owe it to your partner to stay sane through all this. Being a member of a support group will help.
Sperm cells are the smallest you have. Tiny. Minute. As they form they travel along (seminiferous) tubules in your testis which are half a mile long. (You read that right!). To mature, they go to your epididymis (about 6 metres long). Then up another tube (vas deferens) to your seminal gland and eventually to your prostate to mix with prostate fluids.
After all this, they can only live a few weeks. In fact they usually die off after month.
Lesson? Ejaculate regularly to ensure you’re supplying fresh bouncy cocksure sperm and not old codgers who’ve been sitting around doing crosswords with alcohol for a bit too long.
How often to ejaculate? The younger you are, usually the more often you can do it with no bad consequences. But as you age, Chinese medicine suggests you may be wise to limit frequency or you’ll start ageing faster. How would you know? From increasing incidence of signs of ‘Kidney’ energy problems such as backache, sore knees, greying hair, poor memory, tinnitus, impaired hearing etc: in fact, signs of ageing.
Yes, men, you have hormones too. You’ve heard of testosterone, of course, but your body also produces female hormones – FSH (follicular stimulating hormone) and LH (luteinising hormone).
If FSH is raised, something’s not working right. Indeed, the interplay of hormones in your system almost matches that of your female companion.
FSH stimulates sperm production and if/when you have too much testosterone it reduces FSH production. So taking extra testosterone or testosterone stimulants may actually be limiting your sperm production!
You read that right. Too much testosterone can limit your fertility.
Although the basic semen test shows the volume of sperm you are producing, the percentage of healthy sperm and their motility (how fast they run, and whether they go in the right direction and not round and round, getting nowhere) it should also check the shape of the sperm.
A further test goes deeper to see if the DNA in your sperm is healthy. After all, it’s your DNA that combines with the female’s egg that decides – among other things – the sex of your child.
Amazingly, sometimes, even if your DNA isn’t 100% fit, the egg – the ovum produced by the mother, can fix it.
But don’t count on it. Just as a good cook can recover the shambolic mess you’ve made of dinner, well, sometimes even the best cook decides to have beans on toast instead. Well, neither of you wants beans on toast, you want a healthy baby.
If you can persuade your doctor or consultant to get the tests done (and yes, they’ll need some semen for that and getting that’s another story) how do you interpret the results which may be on one side of a piece of paper without much explanation?
Here are a few pointers.
SCSA (Sperm Chromatin Structure Assay) is the gold standard test, but other tests come close, for example the Comet ASA
Many factors influence DNA fragmentation, and consultants aren’t keen to retest and then only if, for at least 3 months, you’ve made changes in your lifestyle and diet, and have solved stress and toxicity problems.
This is a simple test and is a key factor for sperm health! When oxidised, sperm become rogues, damaging other cells, including sperm cells.
How much oxidative stress your sperm suffer is hugely affected by your lifestyle and diet. If you lie around much of the time, taking no exercise, eating wrong foods, your sperm will suffer oxidative stress.
The test for oxidative stress is the mycotoxin test. It’s not expensive, assuming the laboratory has the equipment to test it (the machine costs over £3000) but the test itself typically costs £30 – £40. (
A similar test is the ROX (reactive oxidative test)
Guys! You can hugely improve your oxidative test score by taking exercise and eating the right foods. It’s that simple. See below for suggestions.
Azoospermia means you have no sperm in your ejaculated fluid – your semen. As you will realise, this is important! It could mean you are flooding your female companion with semen, making it all a very pleasurable waste of time.
There are two types
Secretory azoospermia: this happens when your testes produce no sperm.
If due to secretory azoospermia a hormone profile analysis would probably show high levels of FSH (see below) as your anterior pituitary gland tries desperately to encourage your testes to ramp up sperm production. You may, in this case, also have low testosterone because having no sperm, you don’t produce much of the hormone.
Obstructive azoospermia: this happens when there’s an obstruction, a roadblock, on the sperms’ voyage (usually in the ejaculatory duct).
How do they solve obstructive azoospermia? MicroTESE Surgery. (What? Don’t ask: better not to know.)
This is also an important test. Often there are no symptoms. It’s often done by an andrologist. Treatment, if necessary, may involve antibiotics for a while.
It’s important both the male and female partners get tested to make sure neither is infecting, or re-infecting, the other.
This is a test, or filter, for sperm motility. It’s easy to do and costs just £20. It’s used in IVF clinics to separate active from inactive sperm. Only some clinics have the facility for this test.
So, the above is information about the kind of tests and the results you get.
What is ABSOLUTELY clear is this. Men, you can do a great deal to improve the quality and energy of your sperm.
But … you need to get investigated, right from the start. Your female companion will feel supported by your decision. Otherwise, you’re putting all the onus on her.
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Whoever you see should do a proper investigation of your health and healthy history.
This would cover, amongst other things:
It isn’t all inclusive, just some ideas – and some factors are included under several headings!
Your testicles are outside your body for good reasons! To keep them cooler, enhancing sperm production. Anything that keeps them too warm is bad news.
There are seven ways men can take charge of male fertility.
Eating foods that enhance fertility is probably the simplest way to help male infertility. But it isn’t necessarily the easiest! Changing what and how we eat is difficult. Old habits and peer pressure stop us. Still it’s good to know the foods that help, and work towards eating more of them.
Food that is naturally red, blue, yellow, orange, green, purple … Think of
The more colourful food you eat, the wider the range of health benefits for male fertility, your heart and your testes!
Also, buy it fresh. Old food may or may not lose its colour, but its nutritional value deteriorates with time.
By the way, I’ve put this first for a good reason. Colourful food contains huge amounts of vital minerals and vitamins that you don’t get from colourless, junk-type food. So please, pay attention!
Your body needs various kinds of oils and fats, including some saturated fats like butter and milk (but too much saturated fat lowers sperm count!).
But the best fats for fertility include those from oily fish with their omega 3 type oils.
Other oils are good too, such as olive oil, sesame oil, sunflower oil, also the fats you get in nuts and seeds, such as walnut, almond and brazil nuts.
However, before taking oily food, use your nose! Does it smell ‘fishy’, or ‘off’? If so, get rid of it, and replace it with fresh.
Many nuts, like walnuts, keep best in the fridge to delay their oxidation. If you can, buy nuts in their original shells and crack them open yourself, but this is not always easy or possible. In their original shells they usually keep for longer.
Cooking usually makes a food easier to eat and digest. It also adds warmth, which benefits absorption.
Microwave cooking
Microwave food as little as possible. If you cannot avoid microwaving food, transfer it first to earthenware dishes, then microwave it.
A quote from the US FDA: “Microwave radiation can heat body tissue the same way it heats food. Exposure to high levels of microwaves can cause a painful burn. Two areas of the body, the eyes and the testes, are particularly vulnerable to RF heating because there is relatively little blood flow in them to carry away excess heat. “ (https://www.fda.gov/radiation-emitting-products/resources-you-radiation-emitting-products/microwave-oven-radiation)
Does microwave cooking adversely affect the food itself? The WHO says not, but there is no doubt that it can remove, or destroy, up to 97% of the flavonoids in food. Flavanoids are plant compounds which are anti-inflammatory. Microwaving them destroys up to a third more than by boiling. However, it depends for how long you microwave the food.
There is another possible danger, which comes from plastic containers and wraps for the food you microwave. Microwaving can release some of oestrogenic compounds into what you eat from the plastics. Scientists haven’t finally decided about this, but when in doubt, if male infertility is your problem, better avoid it.
So, to microwave or heat up a food, it is better to transfer it first into a non-plastic container, such as an earthenware or ceramic bowl.
If you don’t transfer the foods, then over time you will slightly increase the plastic load on your body, even if for any one dish the danger is minimal. The trouble is that you don’t need much plastic in your diet or environment to disrupt your hormones.
Drink more water.
It’s that simple. However, if your urine is already clear, or only a slighty yellow colour, you may be drinking enough already and too much – from the point of view of Chinese medicine – may be disadvantageous.
(Why? Because you need Kidney Yang energy to warm your Stomach and Spleen to digest what you swallow. Water is a yin substance, so too much yin can swamp your Kidney yang. (Read more about yin and yang here.)
Kidney yang energy provides you with warmth and get up and go. Without it, you’ll lack get up and go, you know where!)
Water is the foundation for blood and seminal fluids. We need fluid for sperm to swim through on their way to glory!
Getting your diet right is more important than taking supplements. See above for what not to do.
Wear loose clothing, such as boxer shorts, instead of tight underpants. Let air circulate and keep everything cool down there. Avoid wearing tight clothing (eg Lycra-type) for long periods ie more than an hour or two.
Stress is a cause of tension and over time it upsets your metabolism and cana certainly lead to erectile dysfunction.
It upsets your digestion, which means you don’t make such good Blood, which means you don’t make such good sperm. To make healthy sperm you need a more relaxed style of life.
Address the cause of your stress where you can. If it is unavoidable, take measures to reduce the negative effects of stress from your body, regularly. For example:
Too often, and your energy will deteriorate, says Chinese medicine, but the younger you are, the less of a problem this is.
Regular ejaculation keeps the freshest sperm at the front of the queue, where you want them. These are the sprinters, quicker than the dawdlers in the rear.
There’s only one winner, and that’s the fastest and fittest.
Remember, sperm die after about a month.
How often to ejaculate? Every few days is good, for most young men. Cut sperm loose regularly! (But older men should be more cautious – perhaps once a week.)
During the female’s fertility ‘window’ of time, there’s no need to perform every day because live sperm in her vagina and tubes can survive for 3 – 5 days. That means sex can be less of an onerous duty for you both and more of a pleasure.
If you have had a proper male infertility investigation and received a fertility assessment – not just a semen analysis – then regular check-ups with an expert make sense to assess progress and see if, by following the suggestions above, you are making progress towards more healthy sperm.
These do exist, and even men who normally never ‘join’ anything say they are really helpful.
Men aren’t always convinced that acupuncture and Chinese herbal can help male infertility!
But they can.
These forms of treatment help the male metabolism work better, approaching it from a completely different perspective, using a philosophy of health that is at least 2500 years old, tried and tested.
That way of thinking about health is laid out on other pages on this site. Once you get your head round it you realise how it can both explain and treat many health issues.
And they do it without medication. Usually, you start feeling better within a few hours, if not within a day or two: just more relaxed and healthy.
That healthier state helps promote better sperm production.
For an acupuncturist near you:
Why You get Nervous Stomach Anxiety and How to Handle It. Acupuncture has great ways to help.
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