by Dr Agilan Arjunan, Fertility Specialist & Gynaecologist , KL Fertility Centre (Malaysia)

How To Improve My Chances Of Becoming A Father

Treatment options for infertility can not guarantee a 100% success. However, YOU and your partner can help to improve the success rate. Every effort and step to achieving your goal of holding your little sunshine is worth trying. There are some aspects where the male and female partners can play a role.

1. How long should I practice abstinence before sexual intercourse?

Not too long! You should aim to have sex 2-3 times a week during female’s fertile period and sex every 1 or 2 days intervals during fertile window .

2. Can obesity affect my fertility?

Yes it can. Obesity (BMI > 30kg/m2) can reduce sperm production. Aim to have an ideal BMI of 19-24 kg/m2. Antioxidants such as Vitamin C and vitamin E have been found to improve sperm count and sperm motility.

3. Should I stop smoking?

Absolutely. Smoking has been shown to reduce sperm quality. Stopping smoking will help to improve sperm quality and you should stop now! Recreational drugs such as anabolic steroids and marijuana will also impair sperm function.

4. Does type of underwear that I wear matters?

There are some evidence that wearing a brief underwear may raise temperature around the scrotum (skin covering the testicles) and may reduce sperm quality. Wearing boxer underwear may help. Avoiding activities that raise scrotal temperature such as hot tubs and avoid laptops on the lap may also help.

5. Can medication / substances that I take affect my sperm quality?

There are medications taken for other reasons / health benefit may affect sperm quality and lead to male infertility.

 a) Testosterone : Replacement testosterone (male hormone) can reduce your own testosterone level in your body. This will negatively affect sperm production.

b) Anabolic steroids : Mainly used to build muscle and reduce body fat. It is used by many non-competitive athletes . This type of drugs can reduce sperm production.

c) Alcohol: Heavy alcohol intake may decrease own testosterone production, increase rate of clearance of testosterone from body and increase the oestrogen (female hormone) level in male. So men with heavy alcohol intake daily should think of cutting down the amount of alcohol they consume .For couples undergoing IVF treatment, every additional drink that the man drink, risk of conception not leading to a live birth increase by 2 to 8 times!

d) Marijuana: it can reduce sperm production and decrease sex drive.

e) Narcotics (opiates) : This group of medications are commonly used as a pain relief especially after a major surgery. Long term use of opiates may decrease testosterone production and hence may reduce sperm quality. Speak to your doctor if you are on long term opiates and unable to father a child.

f) 5 alpha reductase inhibitor: Examples are finasteride and dutaseride. They are used to treat hair loss and prostate enlargement . This medications can reduce sperm count and volume of semen (fluid that contain sperm). However, the effect is reversible once the medication is stopped.

g) Selective Serotonin Reuptake Inhibitor (SSRI) : They medication are commonly used to treat depression and anxiety. This medication may harm the motility (movement) of sperm.

h) Ketoconazole: This is a anti fungal medication. It may not have any effect on sperm if used as skin cream or ointment. If used as oral pill, it may decrease testosterone level and reduce sperm quality.

Other medications are also known to affect sperm quality such as nifedipine and spironolactone (used as anti-hypertensive medication), cimetidine (for gastric ulcer), sulfasalazine (to treat rheumatoid arthritis)  and colchicine (used for gout ).

i) Soy intake : Reduce soy intake if possible because research has shown that too much soy intake can reduce sperm count. If you think you are safe cause you don’t eat tofu, you’re wrong. Soy is found in many other foods such as fake meat patties, energy bars and health drinks. The effect is stronger if you are obese.

6. What food or supplements can improve my fertility?

Anti-oxidants has been proven to improve sperm count,motility (movement) and morphology (shape of sperm).

Anti-oxidants are substance that prevent cell damage in your body due to free radicals. Free radicals are formed in your body naturally. Sperms are also cells in your body. Anti-oxidants will reduce sperms with DNA damage. Examples of anti-oxidants are zink (oyster,crad,red meat), selenium (brazil nuts, tuna,cod,beef,chicken), Vitamin C (in many fruits and vegetables),Vitamin E (nuts,seeds, leafy greens) , Co-enzyme Q (salmon,tuna,beef).

7. Is my dental health important?

Who knows, dental hygiene is actually associated with sperm quality. A study done among men with reduced sperm quality found that after dental treatment, sperm quality improved compared to those who did not have dental treatment.