by Dr. Agilan Arjunan, Fertility Specialist & Gynaecologist, evelyn Fertility & Women Specialist Clinic (Malaysia)
Happy Father’s Day to all fathers around the world. This day celebrates the dedication and effort that you have silently put in even before you embraced fatherhood. Couples who endured through the challenges of infertility , especially the male partner, would truly understand the statement above.
Yes, the effort towards parenthood starts even before pregnancy and carries on for eternity.
So, let’s get back to today’s topic. Are you ready to become a father? You hesitated with your answer, but why? Are you struggling?
Let me give you important pointers to help you prepare yourself to become a father and hopefully by next year, you will be celebrating Father’s Day with your own little bundle of joy.
Nearly fifty percent of all fertility treatments, especially in-vitro fertilisation (IVF), are due to male factor infertility. Many male partners, who are seemingly healthy, are confused and wondering what has gone wrong. Let me sum up what are the relevant issues men should watch out for.
Obesity
Obese men are more likely to have lower sperm count and quality. In extreme cases, they can suffer from azoospermia (no sperm cells found in ejaculate). In fact, obese men can lower their chances of conceiving via an IVF as a couple. So, the solution is weight reduction. However, take note that even after significant weight loss, there may still be mixed results when measuring one’s semen quality. Of course, you will see improvement in semen quality, but it is not appreciated in all obese men.
From my clinical experience, I do see improvement in male fertility when the man achieves significant weight loss, especially men with azoospermia.
Diet
Have you heard of this saying, “You are what you eat?” It is quite true when it comes to male fertility. Processed meat, full-fat dairy products, alcohol, coffee and sugar-sweetened beverages are all associated with poor sperm quality. It is recommended to eat more vegetables, fruits, fish, poultry, cereals and low-fat dairy products to improve sperm quality.
Vitamins
I suppose many of you take Vitamin C supplements. Vitamin intake has been promoted so widely that it has become an additional supplementary daily diet consumption. But do vitamins improve male fertility? Vitamins or more precisely, anti-oxidants has been suggested as a method to improve sperm quality because it reduces damage to sperm cells from ‘oxidative stress’. Yes, your sperms are susceptible to stress too. This ‘oxidative stress’ is self-induced in majority of men as a direct consequence of smoking, excessive alcohol intake and exposure to pollution.
There are many anti-oxidants supplements available in the market such as zinc, CoQ10, carnitine, Vitamin E and many more. A 2019 evidence based medical review article suggested that anti-oxidant use in male sub-fertility may improve clinical pregnancy and live birth rate. Overall, the level of evidence is still low to substantially support the usage of anti-oxidant.
Cigarette and Vaping
It has been known for many years that cigarette smoking negatively affects one’s chance to conceive even though the exact mechanism of how this happens is not well understood. Cigarette smoking has been shown to disrupt DNA in the sperm and affects the testosterone level in men.
Available evidence suggests there is a significant benefit in stopping cigarette smoking if you are trying to conceive a child. Every additional year following smoking cessation of the male partner reduces risk of fertility treatment failure by 4%. Well, what about vaping? Generally vaping is viewed as less harmful than cigarette smoking. Studies in animals research shows that vaping has detrimental effect on sperm production and also can lead to ‘oxidative stress’ formation.
Alcohol
Alcohol consumption has been associated with reduced semen volume and its effect on sperm parameters is dose-dependent. Reduction in sperm count, sperm movement and percentage of normally shaped sperms are reduced in men with heavy and chronic alcohol consumption. There is no evidence of negative effects of occasional alcohol intake.
Caffeine
Seriously, you might be wondering why caffein, out of all things, made it into this list. Sperm quality appears to be unaffected in most studies related to caffein intake. Caffein-containing soft drinks have negative effects on semen volume, sperm count and concentration. Caffein intake may be associated with DNA damage in the sperm. Not surprisingly, the male partner coffee consumption is associated with prolonged time to achieve pregnancy as shown in some studies.
Stress
A word linked with most of the couples facing temporary obstacles to conceive. Psychological stress can lower sperm concentration, movement and increase percentage of abnormal sperm.
This is due to suppression of testosterone by a raised level of stress hormone known as corticosteroids. Some rely on medications to control their stress level. However, antidepressant medication has negative effect on sexual function and semen quality. Men could try non-pharmacological methods such as behavioural therapy, psychotherapy and fertility counselling and support.
Sleep
Sleep disturbance is prevalent and it is becoming more common now in the era of social media. Personally, I feel sometimes we ‘live’ more in social media platforms than in reality. Sleep disturbance is closely associated with psychological stress and have profound effect on sperm quality.
Inadequate sleep and irregular sleep patterns throw off a normal testosterone secretion body pattern which directly affects sperm production. An advice to all men, no matter how busy your schedule can be, please do take some time to have a good night’s sleep.
I have listed the above eight factors to consider in your quest to improve your overall fertility health. Changes do not happen in a day, it takes time. Remember, change is hard in the beginning, messy in the middle and gorgeous in the end. I wish you all the best on your magical journey to fatherhood. Happy Father’s Day!