Infertility issues, which seemed so rare 20 years ago, are quite common these days. The most significant factor seems to be the desire couples have to start their families when they’re a little older, after they’ve established themselves in their careers. Clearly this affects a woman’s chances of reproducing, since fertility in women declines after age 35. And conception after age 45 is rather rare. Aside from trying to reproduce earlier in her life, there are some surprisingly simple steps a woman can take to increase her likelihood of becoming pregnant. It amazes me (although perhaps it should not) how little emphasis is placed on lifestyle issues and good nutrition by either gynecologists or infertility specialists. In all parts of the world, “wise women” have been using herbs for centuries to help their infertile daughters.
Today, couples who want children spend a lot of time and money at infertility centers. Although the results from these centers can be very gratifying, you might want to start with some simple steps first and see how things go for three or four months. If you’re currently in treatment for infertility, you can safely follow our suggestions at WholeHealth Chicago right along with your specialist’s recommendations.
What is Male Infertility?
Conceiving a child is always far from predictable, but when a couple has not succeeded after a year of having sex without any form of contraception–especially during the woman’s most fertile days of the month–the cause may be infertility. It turns out that 40% of the time, it’s the man who’s infertile, 40% it’s the woman, and 20% of the time it’s both partners. To pinpoint the cause, a couple can ask their doctor–usually an internist for the man, and a gynecologist for the woman–to start a diagnostic workup. Complex cases may then be referred to a urologist or a fertility specialist. In the man’s case, this will involve a semen analysis to determine several key factors: the number of sperm, their movement (motility), their shape (morphology), the volume of semen, and its thickness (viscosity). All of these elements are vital to ensure that one of the man’s sperm can survive to fertilize one of the woman’s eggs. The man will also be examined for physical abnormalities that may be contributing to the problem.
Despite the prolonged frustration that results from infertility, the statistics are encouraging: Up to 60% of couples who haven’t conceived after a year of trying will do so eventually–with or without treatment.
Key Symptoms
The inability to conceive after a year of unprotected sex.
What Causes Male Infertility?
Unlike a woman’s fertility, which declines after age 35, a man’s fertility is not affected by aging. When a man is thought to be infertile, the exact cause often cannot be identified. It can be due to any of a number of factors.
While there’s no minimum number of sperm needed to fertilize an egg–all it takes is one–generally, the higher the sperm count, the greater the chances of conception. A low sperm count can be the result of smoking, alcohol consumption, or certain medications.
The most common physiological reason for a low sperm count is the presence of varicoceles (varicose veins above one or both testes). These increase blood flow–and, in turn, heat–to the area,which can then reduce sperm production. Varicoceles can be corrected by minor surgery. The problem can also be attributed to a deficiency of the sex hormone testosterone, which can be boosted with medication. Another cause (for which there is unfortunately no treatment) is an earlier infection, such as a post-pubescent case of the mumps, that resulted in an inflammation of the testicles.
Sometimes, the seminal fluid is at fault. If its volume is inadequate, the sperm will not be able to survive in the acidic environment of the vagina. Or the fluid may fail to reliquify, as it normally does, a short time after ejaculation. This would prevent the sperm from passing through the cervix. In this scenario, the best option might be artificial insemination.
In some cases, the sperm itself is defective. If a large number of sperm are abnormally shaped, for example, or if they are not active enough, they may not be able to penetrate an egg–a problem for which there is no treatment.
Anatomical defects can also cause infertility. An infection (often from a sexually transmitted disease) or scar tissue (resulting from surgery, an injury, or a long-healed infection) can block the duct system that carries the sperm from the testes. Active infections can be treated with antibiotics, and scar tissue can sometimes be remedied by microsurgery.
Exposure to certain drugs (such as Tagamet and Zantac) and toxins can sufficiently reduce the sperm count to render a man infertile. The doctor should review any prescription drugs for this possible side effect, and a patient should consider any exposure to toxins in his workplace. Various metals, including cadmium, nickel, and manganese, may affect the the sperm’s ablity to find and penetrate the egg. Various research studies also indicate that caffeine (more than four cups of caffeinated coffee a day) and smoking (more than 20 cigarettes a day) also seem to affect fertility by decreasing sperm motility.
Treatment and Prevention
If a definite anatomic defect is found, surgery will likely be the only option available. On the other hand, if the sperm count is low, or the sperm appear defective for no apparent reason, a supplement program is a perfectly reasonable option, especially if you hear the words, “We don’t know the cause but there’s nothing that can be done.”
All of the supplements listed below are safe when used together or with any conventional medications. They should be taken for at least several months.
Just a reminder: If you have a serious medical condition, it’s always a good idea to check with your doctor before starting a supplement program.
How Supplements Can Help
Antioxidants–including vitamin C, vitamin E, and mixed carotenoids (a powerful blend of antioxidants)–protect the fragile sperm from naturally occurring molecules called free radicals. Vitamin C is especially important for smokers, whose sperm counts are frequently depressed and who tend to have low vitamin C levels.
Zinc plays a key role in male reproduction, boosting testosterone levels and raising the sperm count. For long-term use, zinc must be taken with copper, because zinc inhibits the body’s absorption of this mineral.
Flaxseed oil is an outstanding source of omega 3 fatty acids, which are essential for healthy sperm and for hormone production.
A three-month regimen of the amino acid arginine will not only increase the sperm count, but enhance its motility.
The herb Panax ginseng is believed to stimulate the production of testosterone and the formation of sperm. Every three weeks, alternate it with a round of Siberian ginseng.
Several studies have shown that the amino acid carnitine has helped normalize sperm counts in men with previously low levels.
Coenzyme Q10 is an enzyme involved in energy reactions throughout the body. Studies have demonstrated that raising blood levels of CoQ10 have increased sperm counts.
Vitamin B12 is necessary for maturation of cells. Several studies have shown that raising levels of B12 have improved sperm counts in infertile men.
Self-Care Remedies
Avoid smoking and drinking.
Wear boxer shorts rather than briefs to keep the testicles away from the warmth of the body, which can reduce sperm count.
Reduce stress through regular exercise, yoga, meditation, and other techniques.
Supplement Recommendations
From David Edelberg, M.D. at WholeHealth Chicago: You really need a whole-person approach when dealing with issues of male infertility. For example, taking all the supplements listed below isn’t going to help all that much if you live on junk food and smoke cigarettes.
As your partner is undergoing her own evaluation for infertility, make sure she’s on a good supplement program as well. The healthy diet you both should be eating will also provide vitamins and minerals.
How to Take the Supplements
Start by taking all the supplements together and give everything at least a six-month trial. They’re all safe for long-term use.
Vitamin C, carotenoids, and vitamin E are all potent antioxidants that mop up rampaging free radicals and protect the sperm. Low levels of each of these vitamins has been correlated with low sperm counts. Coenzyme Q10 also acts as an antioxidant and seems to help increase sperm counts as well. In addition, vitamin C prevents sperm from clumping together and increases its motility.
Zinc is an important mineral for male sexual function, increasing the amount of the male hormone testosterone and raising sperm count. Levels of zinc tend to be abnormally low in infertile men who have low sperm counts. (Zinc needs to be taken with copper, which zinc inhibits the body from absorbing.) However, limit your zinc to the recommended doses. Excessive zinc can actually reduce sperm motility.
Flaxseed oil (which should be taken with food) acts to keep sperm healthy and has shown promise in treating male infertility.
Both vitamin B12 and the amino acid arginine are involved in cell replication, and can increase sperm count and speed up sperm motility if deficiencies exist. B12 is best absorbed through the mucous membranes, either as a tablet you place under your tongue or as a spray you use every morning. A three-month course of the amino acid arginine, a favorite of nutritional physicians specializing in anti-aging medicine, can bring any depleted levels into normal range.
Carnitine, another amino acid, also affects sperm motility (more motile sperm contain a higher carnitine content).
Siberian ginseng, traditionally used as a “male tonic,” may also increase sperm counts and reproductive capacity. Alternate the Siberian ginseng every three weeks with Panax ginseng, which may boost sperm production.
At the end of six months, you can drop the arginine and the carnitine and reduce the B12 to once a week. If these supplements haven’t worked in six months, they probably aren’t going to work, but at least you’ve given them a try.
Continue these supplements at least until conception occurs, then simply stop everything except your basic multi and antioxidant combination. However, any time your partner takes fertility medications, add the carnitine and arginine back into your own regimen to enhance the chances for success.
Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
Be well,
David Edelberg, MD