Dr Surveen Ghumman Sindhu MD (Obst & Gyne), FICOG
MAX IVF & Reproductive Medicine, Department of Gynecology
MAX Superspeciality Hospitals, Panchsheel, Saket, Vaishali & Patparganj.
How common is male infertility?
Male factor may be the primary factor in 40 % of infertile couples and can be a contributing factor in another 20%. Over the last 30 years, average sperm counts have fallen by one third, increasing their risk of infertility. It is not only reduction in sperm counts but, but the proportion of healthy motile sperms has also reduced.
Interpreting Basic Semenanalysis
Recent WHO criterion states normal sperm count to be more 15 million/ml, total motility more than 40% with progressive motility being more than 32%, normal morphology more than 4% and vitality of 58% or more. All the above parameters should be within normal range to ensure fertility
What lifestyle changes can be made to improve sperm count and quality?
- It is important to balance physical and mental health.
- Quit smoking. Smoking not only decreases sperm count and motility, but may also cause DNA damage affecting the genetics of the sperm and its fertilizing capacity
- Reduce alcohol consumption, as it lowers male hormone testosterone and reduces sperm production.
- Avoid processed and unhealthy food choices. Increased levels of estrogen in contaminated food had led to a drop in sperm count
- Weight loss helps, as being overweight tends to cause testosterone/estrogen imbalances.
- Stop use of recreational drugs, antidepressants, steroids or other drugs which may lower sperm counts
- Exercise should be moderate, aerobic and resistance exercise. Excessive exercise can have a negative influence on semen parameters.
- Avoid high temperatures, i.e. saunas, hot tubs, laptops
- Remove stress through relaxation exercises and yoga
- Adequate sleep should be ensured
- Avoid exposure to industrial chemicals like those used in making plastics — they can mimic the female hormone oestrogen countering male hormones.
- Intake of vitamins like Vitamin C, Vitamin A, Vitamin E and Zinc should be regular. They have an antioxidant property which decrease reactive oxygen species, known to damage sperms. Vitamins also help in synthesis and maintenance of the normal sperms. Vitamin B and selenium also help.
- Good sexual health and regular intercourse in a stable relationship reduces the chances of infections and improves the fertility.
The treatment options for low sperm count depend on the underlying cause. If it is due to varicocele (dilatation of veins) or obstruction to outflow duct, it can be treated by surgery. Hormonal imbalances and infections are treated with medication. If above do not work, assisted reproductive technology and invitro fertilization (IVF) is recommended. In case there are no sperms in ejaculate they can be extracted from the testis and then injected into the egg under the microscope a technique known as intracytoplasmic sperm injection (ICSI). If sperm cannot be sourced from the testis, a donor sperm may be used.