Healthy Sperm as The Bedrock of Male Fertility

Dr. Abayomi Ajayi

A while ago, I had cause to engage a group of young, well-educated and enlightened men in conversation regarding issues of reproductive health, and I was amazed by the low level of understanding they displayed on the subject. What is most ironic is that most men, who claim to be knowledgeable about the causes and cures of infertility in women, tend to know very little about what contributes to reproductive health or conversely, what undermines it in men. These days, men seldom  think about their own fertility as the health of their sperm… except perhaps, only during sexual activity. Yet, modern reproductive science shows that every man should consider his fertility and be protective of it. Indeed, there are things that as a man, you can do to safe guard your reproductive health… and the well-being.

The first lesson to learn is that infertility is not just the woman’s problem, at least not anymore, although it used to be the assumption that if a couple was unable to conceive, the woman was the “infertile one”. Nothing could be farther from the truth. Now it is generally recognized within medical circles that the problem lies with the man in 35% of cases (some say a couple’s inability to conceive is due to male conditions 40% to 50% of the time). Does this sound incredible? Perhaps it does sound that way if, for instance, you consider that the average healthy male releases somewhere between 120 million and 600 million sperm each time he ejaculates, and manufactures an estimated 400 billion sperms in his lifetime. It would appear that men have it made in the reproductive department, but this is not always the case, as things often have the tendency to go haywire.

One of the most common reasons for infertility in the male is inability to produce adequate numbers of healthy sperm. Other causes include problems with delivering sperm properly into the vagina, as often occurs in the case of impotence or in disorders affecting ejaculation, including inhibited ejaculation and retrograde ejaculation (when ejaculate is forced backward into the bladder). It may also be caused by failure of the testes to descend into the scrotum, as well as diseases or severe physical injuries which damage the sperm-producing structures, or by antibodies to the sperm found in either the male or the female.    

There can be other obstacles to fertility. We know there are a number of problems that can prevent fertilization from taking place, and many of these can indeed originate from the man. By every means, the major cause of male infertility is an inability to produce enough healthy sperm. I know there are people who may not readily agree with this notion.

I was once asked to justify all these unwanted pregnancies occurring each year in the country if indeed men do not produce enough sperms. The straight answer here is that it is not just enough to produce sperms, because for fertilization to occur, all systems have to be perfectly or near perfectly functional.

To begin with, as a man, you need to know that your sperm must be present in sufficient volume, density, it must be active, it must not be clumping together, it must be relatively normal in shape and size, and it must not be adversely affected by sperm antibodies either in you or in your partner. Further, the sperm must be able to penetrate the barrier of the woman’s cervical mucus and overcome staggering odds to ever reach the fallopian tubes and go on to meet the egg. When a couple cannot conceive despite repeated attempts, we often recommend a semen analysis to assess male factors which might be preventing fertilization. The point here is that the man’s sperm will be put under the microscope, literally and figuratively. How is this done? Simple, you’ll first have to provide a semen sample in a clean large-mouth glass jar or plastic specimen cup, or by ejaculating into a special condom without spermicide during intercourse with your partner. The important thing is to keep the sample warm (you may have to carry it under your armpit), and get to the laboratory for analysis quickly. Most fertility experts want the semen within an hour, preferably sooner. If possible, you may have to produce the required specimen in the laboratory.

I believe I have mentioned a couple of times in past write-ups that the average, healthy man normally produces between 120 million and 600 million sperm in a single ejaculation. Beside sperm, semen contains water, simple sugars (to provide fuel for sperm); alkalis (to protect sperm against the acidity of the male urethra and the vagina), prostaglandins (substances that cause contractions of the uterus and fallopian tubes, and are thought to aid in the sperm’s passage into the womb), Vitamin C, zinc, cholesterol and a few other things. I wish to point out here that while semen can transmit a variety of diseases including HIV, healthy sperm doesn’t contain anything that’s harmful or bad for the health.   

Next is the semen analysis. We discussed this a while back, but it is useful to know that a complete semen analysis includes: volume of the semen, sperm count (the amount of sperm in a certain volume of semen, also known as the sperm concentration or sperm density), sperm size and shape (morphology) and sperm motility (percentage of actively moving sperm). New computer-assisted sperm analysis helps to assess sperm motility more accurately. Using a computer in combination with the microscope, a technician can assess how rapidly sperm move and how straight they swim.

Other factors that infertility specialists look at include the quality of the seminal fluid in which sperm swim and the sperm’s ability to survive in and move through cervical mucus, as well as its ability to penetrate and fertilize an egg.  The question of what is the norm in semen is a hugely controversial subject within fertility circles. For practical purposes however, the “norm” in semen can be accepted to mean the following – Volume: 3 milliliters (2 to 6 ml range considered normal); Concentration: 20 million sperm or more per milliliter; Motility: 50% of sperm still active after hours; Normal forms/ appearance: 30% of the sperm; Viscosity: ejaculate normally liquefies within an hour.  

What are the things that can hurt or impede your chances of fathering a healthy child? Fertility is often a reflection of your general health. If you are healthy and abide by principles of good healthy living, chances are your sperm will also be healthy, provided you haven’t sustained permanent damage to your sperm-making equipment in the past (through infection, for instance), or weren’t born with a disorder or structural problem that could prevent you from producing viable sperm. There is a list of “threats” to male fertility that I want you to take cognizance of so as to avoid injurious substances, situations and behaviours. The first and probably most obvious is the smoking habit.  Smoking significantly decreases both sperm count and the liveliness of sperm cells. The next threat is the prolonged psychotropic and addictive drugs like marijuana. Use of other “recreational” drugs (like cocaine) as well as chronic alcohol abuse is not advised. In same vein, use of anabolic steroids is inhibitory to a man’s fertility because it can cause testicular shrinkage and infertility.

It may sound odd, but do you know engaging in intense exercise I ill advised for a man seeking to impregnate his wife? Excessive exercise is often discouraged because it has been linked to the lowering of sperm count by producing higher levels of adrenal steroid hormones, which lower the amount of testosterone (male sex hormone) in the body. This testosterone deficiency in turn, decreases sperm production.  

Other concerns include inadequate Vitamin C and zinc in the diet, some groups of antibiotics, anti-diarrheal drugs and anti-fungal medications. Variocele (a varicose vein in the in the testicle that produces too much heat, which harms and kills sperm) has been a major concern for decades (we shall discuss this in a subsequent article). There  are other worries in the guise of infections of reproductive system structures, such as prostatitis, epididymitis, and orchitis, infectious diseases that affect the testes, such as mumps in adulthood, trauma or injury to the testes, exposure to harmful chemicals during your mother’s pregnancy, which can cause testicular and epididymal abnormalities and decreased sperm production are also indicated. Believe it or not, even habits like wearing of tight underwear or jogging pants, or dipping in hot tubs or saunas or anything that raises the temperature of the scrotum, including hot work environments, can contribute to reduced fertility in a man.

I will not forget to mention the role of testosterone deficiency, exposure to environmental hazards such as pesticides, lead, paint, radiation, (x-ray), radioactive substances, mercury, benzene, boron and heavy metals and chemotherapeutic (cancer-treating) agents. A blockage or structural abnormality in the vas deferens or damage to the spermatic ducts, usually due to a sexually transmitted diseases such as gonorrhea or Chlamydia should never be overlooked in both male and female infertility. The impact of malnutrition, anaemia, tuberculosis and excessive stress is worthy of consideration.

Now, can damaged sperm cells result in birth defects?  I have lost count how often I have been asked to comment on this poser. To clear the air, once again, it is suspected that reproduction and foetal development may be affected if the biological father has been exposed to lifestyle or occupation hazards, such as smoking cigarettes, drinking alcohol, taking non-prescribed drugs and being exposed to toxic chemicals. Scientists used to believe that if sperm were damaged, they could not fertilize an egg; therefore, only the “fittest” sperm would carry on the species- some call this the “macho sperm” theory.

Research now shows sperm are vulnerable and that even when damaged, they may still fertilize an egg. Some toxins may alter the sperm’s chromosomes, which carry genetic information. If this happens, the results may range from infertility and miscarriage to stillbirth, birth defects, learning disabilities, and even childhood leukemia and kidney cancer.

It is therefore wise for men who want to have children to change unhealthy lifestyle habits and when possible, protect themselves from hazards and toxins in the environment and workplace. Sperms develop over a three-month period; that means your mature sperm today may have been affected by how you lived three months ago. The ultimate message is this: if you plan to have a child, quit smoking, drinking, using recreational drugs, etc. and wait three months before trying to conceive a child with your partner. I will end this write up with what I’ll say is the best advice for any couple trying to conceive:

. Stop smoking. Smoking is linked to low sperm counts and sluggish motility, and recent findings suggest a 64 percent increase in miscarriage when both partners smoke or when just the man smokes.

. Give up drugs of abuse. Long-term use of marijuana in men results in a low sperm count and sperm that exhibit abnormal patterns of development.

. Avoid alcohol. Chronic alcohol abuse damages the intricate plumbing of the male reproductive system, reducing a man’s ability to produce normally formed sperm cells.

. Ease up on intense exercise. Men who exercise excessively may be reducing their sperm count due to the heat that builds up around the testicles during strenuous exercise.

. Increase Vitamin C intake as low levels may cause sperm to clump together.

. Check into your antibiotics. Some groups of antibiotics have been shown to affect sperm quality temporarily by decreasing count and motility. These groups are nitrofurans (nitrofurazone or nitrofurantonin) and macrolides (erythromycin).

. Stay clear of environmental poisons and hazards. These include pesticides/insecticides, organic solvents, lead, ionizing radiation, heavy metals and toxic chemicals.

. Check your nutrition. A malnourished man who does not get enough of the right foods and nutrients could have abnormal sperm.

. Keep your scrotum cool. Watch out for excessive heat in the scrotal area. Wear loose-fitting underwear (not tight jockey shorts), and avoid tight-fitting jogging pants. Avoid hot tubs, hot baths, saunas or hot work environments.

. Abstain, but not too long. Brief periods of sexual restraint (three to five days) seem to increase both the volume and potency of semen. Prolonged abstinence, on the other hand, will result in a higher volume of older sperm, which exhibit decreased motility.

Credit: City People Magazine