Infertility Issues? Start With The Guy

I’ve lost track of the number of couples we treat at WholeHealth Chicago who are involved in one of the hormone injection/surgical procedure stops on the conveyor belt of infertility centers. Currently, it’s estimated that 15 to 20 percent of couples are struggling with infertility, half of them due to male factors.

The infertility docs are nice enough and certainly well-meaning, but I note a lack of imagination in the patient work-up and treatment. Men have it easy. Given a plastic cup and a private booth, they submit a semen sample. If the results are satisfactory, the doc sets her sights on the woman’s reproductive status.

I’d personally be happier if the doc began by insisting that each new couple arrive with a diary of their lifestyle choices over the previous months, including eating and exercise habits and being open about transgressions like junk food, alcohol, cannabis, and tobacco.

Then, along with semen analysis and tests of hormone levels, with a simple test the couple could discover their blood levels of all kinds of controllable nutritional factors (vitamins, minerals, omega-3s, and the like). The fertility doc might as a consequence unearth some real problems that could be addressed before the expensive treatment started.

A guy thing?
Some new research is showing that infertility issues might have more to do with the guy and his nutritional status than specialists have recognized. The eating habits of people in the US are generally pretty atrocious. In fact if you extrapolate our crappy diet to its downstream effect a couple of decades later, we’re eating ourselves into early heart disease, premature diabetes, and higher risks of stroke and cancer.

I hate to sound curmudgeonly here, but maybe some of the infertility issues occurring in some lives (not yours, of course) are the body’s way of saying, “We really don’t need you with your inattention and self-neglect to be reproducing. We’ve got enough issues on this overcrowded and polluted planet.”

Measurements of sperm counts and semen quality reveal declines over the past 50 years. Your father’s sperm was fundamentally in better shape than the man whose sperm will help you make a baby. There are many factors involved, including environmental toxins, chemicals in our food that disrupt hormones, physical inactivity, and emotional stress.

However, we know beyond a shadow of a doubt that diets rich in processed meats, soy foods, and potatoes and full of saturated fat, dairy products, cheese, coffee, alcohol, sugar-sweetened beverages, and sugar itself have all been linked to poor semen quality.

You’ll love the word for this: oligoasthenoteratospermia, which means too few sperm that are also too weak and misshapen to manage the journey to an egg, much less penetrate and fertilize it.

Eating to reproduce
According to all the proper authorities (American Heart Association, Mayo Clinic, WholeHealth Chicago), barely 15 percent of people are eating what’s considered a truly healthful diet. Want more and better sperm? Studies have clearly shown that a diet rich in food sources of omega-3 fatty acids and antioxidants (vitamins C and E, beta carotene, selenium, zinc, vitamin D, and folate) make a significant difference.

You don’t need a tray of supplements. If you pay close attention, everything you need will be in what you eat, provided you focus on wild-caught fish and seafood, poultry (organic/hormone free), and organic whole grains, vegetables, fruits, and even a small amount of organic dairy that might include yogurt, cheese and whole milk.

Which brings me to report on a study published just this week in JAMA (Journal of the AMA).

In Denmark, when a young man reaches age 18, he’s required by law to undergo a physical exam to determine if he’s fit for military service. In the five years between 2012 and 2017, researchers recruited 1,679 volunteers who agreed to provide details on their lifestyle choices (alcohol, tobacco, and exercise) and their diets and intake of nutritional supplements during the three months before the exam.

At the time of the exam, each young man was to leave a sperm sample and undergo an ultrasound examination of his testes (testicles). Also measured were blood levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone. The FSH and LH are pituitary hormones involved in testosterone production and sperm development. High levels of each are a sign that the testicles are not functioning properly.

What they discovered
Just about 66% of the young men took no supplements at all. 12% took a daily multivitamin, 5.8% took fish oil, 4% took vitamin D, and 1.5% vitamin C. Obviously, many of the supplement takers took them in different combinations.

Men who reported taking daily fish oil supplements had larger testes as shown on an ultrasound exam, a higher volume of semen with higher sperm counts, and higher levels of testosterone and lower levels of FSH and LH.

The average sperm count was 147 million for men who took no fish oil supplements versus 184 million for men who had been taking fish oil for more than 60 days.

These differences were noted only in the fish oil takers.

Daily use of a multiple vitamin as well as daily taking of vitamins C and D may have had other health benefits, but it was fish oil that emerged the winner.

Our experience at WholeHealth Chicago
We measure omega-3 levels as part of our nutritional evaluations. Because many people mumble something like “I hate fish” or “My husband won’t touch fish,” unsurprisingly we see a lot of people with low levels of omega-3. Maybe these fish avoiders are inadvertently practicing birth control. Maybe all those huge Catholic families I remember growing up with on Chicago’s south side were partially a result of their fish-on-Friday rule.

Even though my own fertility concerns are not an issue these days, I personally take two of these by Integrative Therapeutics every day. The Metagenics brand is equally excellent.

Say no to oligoasthenoteratospermia and…

Be well,
David Edelberg, MD