Infertility Struggles? It’s Not Always a Woman’s Issue

At the Shady Grove Fertility Centers throughout the mid-Atlantic region, there are rooms that in any other context might be considered lascivious. Replete with lustful images on the wall and stacks of porn magazines, the rooms are designed for men to masturbate – but not for pure pleasure.

The men are collecting their own sperm samples, as a first step in analyzing the potency of their sperm cells for making offspring.

Stories about couples struggling with infertility often feature the woman as the protagonist. But men also face fertility problems. At the Shady Grove facilities, men are part of the infertility problem in 40 to 50 percent of couples who come in, says Gilbert Mottla, a reproductive endocrinologist with Shady Grove in the District of Columbia. “It’s fairly common for us to find both [partners] are contributing to [infertility],” Mottla says. Less common, however, is to find that a man is the sole cause of infertility.

Specialized clinics like Shady Grove have been testing and treating men alongside women for years. “We look at couples as one. We test in parallel,” Mottla says.

“It’s emotional for both partners to find out that there’s a problem,” adds Karen Boyle, director of male fertility, microsurgery and sexual health at Chesapeake Urology Associates, and regional director of male fertility at Shady Grove. “I think women are brought up talking about reproduction. Men don’t really get that exposure to reproductive health. For men, it’s very, very emotional. It really wraps up into their sense of masculinity, their feelings of virility and being able to be a complete partner.”

Good Treatment Options for Men

The upshot is that men naturally focus on solving problems. “All in all, guys are resilient. If we have a plan in place and are moving forward, I think they cope with things very well,” Boyle says. And fortunately, she adds, men have many treatment options. The first step to gauging a man’s fertility is taking a detailed reproductive and health history, as well as conducting a semen analysis. In addition to looking at the thickness of semen, technicians assess the number of sperm, their shape and whether they are moving in a straight line, as healthy sperm do, Mottla explains.​

If the problem is just thick semen, which can prevent the sperm from reaching the egg, ​that’s a relatively easy issue to solve with a sperm wash and/or intrauterine insemination, which essentially moves the sperm closer to the egg, Motta says. If the problem is not in the semen, experts evaluate a man’s testicles, prostate and hormone levels. “We want to find any reversible complications; anything that can help improve sperm production,” Boyle says. Sometimes sperm production problems can also be a symptom of other conditions such as diabetes, or cancer of the testicles or prostate.

Various procedures can also be used to retrieve sperm or improve sperm production. But sometimes, at a very basic level, men can make simple lifestyle changes such as eating a better diet and quitting smoking to boost their sperm supply and quantity, says Suzanne Munson,​ a staff nutritionist at Fairhaven Health, a company based in Bellingham, Washington, which makes fertility products.

“If you’re not going to do anything else, make sure you are getting a good antioxidant supplement and a good multivitamin,” Munson says, noting that “colorful foods” such as berries, veggies, carrots and tomatoes are especially rich sources of antioxidants, which neutralize “free radicals,” damaged, disease-causing cells​ that are known to degrade sperm.

Munson says that men’s products sell almost as well as women’s (although it’s usually women who will inquire about products for men), and that men’s products are also arguably an easier sell. “We seem more mainstream acceptance of supplements for men,” she says, speculating that this is because treating men is usually inherently less complicated than women. For example, if a woman is taking the fertility drug Clomid and wants to also try herbal supplements, the potential drug interactions could pose too much risk, Munson says; the benefits of supplements for men are more straightforward, she adds.

The most important nutrients for men to consider if struggling with fertility, Munson says, are carnitine, zinc, vitamin B-12, selenium and coenzyme Q10, commercially known as CoQ10. Men, especially those with pre-existing conditions, should consult their physician before taking such supplements, Munson says.

Causes of Male Infertility

Addressing diet when evaluating men’s fertility problems makes sense, since infertility woes can be caused by lifestyle factors. Smoking, for example, is terrible for sperm, as is excessive alcohol use, obesity and over-exercising, Munson says. Competitive biking can be especially bad for testicles because the activity generates heat, which can cause testicular damage. For that same reason, men with fertility issues should avoid saunas and hot tubs, Munson says.

Another factor in male fertility is age. While men don’t experience the equivalent of menopause in women, their sperm quality does start to decline as the years tick by. Although men can still father children well into their 60s and even 70s, their sperm quality might be more questionable starting at around age 50. Some studies have linked a higher incidence of conditions such as autism andschizophrenia in offspring to older dads​, but that data is not nearly as strong as, say, the data linking conditions like Down syndrome to advanced maternal age, Mottla says.

Because of concerns over the effects of aging – and other situations, like if a man wanted to preserve his sperm before going to war – some men have decided to freeze ​their sperm. This is not as common as freezing eggs, and it’s best to use fresh sperm to fertilize an egg, but the process can work, Boyle says.

In her clinic, Boyle says she hasn’t seen aging or concerns over its effects deter men from fathering children. “I see many, many men well into their late 50s and 60s. It isn’t until the 70s, and even the 80s, that you start to see decreases in [sperm] production,” Boyle says. “Age is a great unequalizer [between men and women].”

 

 

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