A Man’s Guide to Fertility

Written by Dr Hossam Elzeiny
11 Jun

It’s a topic that doesn’t get discussed too often at the pub or on the footy field. But the truth is that there are many men trying to become a dad, and it isn’t always as easy as they first thought.

With Men’s Health week upon us, it seems timely to dispel some myths and discuss some tips about men’s fertility.

Myth: Male Infertility isn’t common

With so much discussion around women’s fertility in the media, men seem to rarely get a mention. In Australia, male infertility affects about one in 20 men – and is actually the biggest factor preventing couples from conceiving after a woman’s age.

Last year, a Cambridge University researcher found that as our society is “obsessed with male virility”, but talking about men’s biological clocks appears to be socially taboo. Since male factor contributes to about half of the causes of fertility issues, the first thing we need to do is talk about it.

Myth: Age isn’t a factor

“But Rod Steward fathered a baby at 66!” Yes, but like celebrity mums over 45, this is the exception rather than the rule. After the age of 45, men have higher rates of fertility complications as their sperm volume, motility and morphology (shape) declines. There is also the increased likelihood of damage or breaks to the sperm DNA that may result in a negative effect on fertility. 

Myth: Lifestyle doesn’t matter

The truth is, like women, a man’s lifestyle can directly affect his fertility. The good news is there are some simple changes you can make to positively impact your overall health and that of your sperm.

What can I do to improve my fertility?

Improve Your Diet

Men should eat a healthy diet rich in fresh foods such as fruits and vegetables, and whole grains; olive oil should replace animal fats; nutrients and vitamins, such as vitamin C and vitamin E that are renowned for their antioxidant qualities and believed to increase sperm health.

Maintain a healthy BMI

Having a low or high Body Mass Index (BMI) can affect sperm count. If you’re overweight, try to reduce the weight as obesity may be linked with infertility – one study suggested a gain of 10kg decreases male fertility by approximately 10%.

Reduce Alcohol Intake

That’s not to say that a beer or a glass of wine here and there is a problem, but regular heavy nights out are not going to serve your purposes well. Long-term effects of chronic alcohol use include erectile dysfunction, reduced libido, and subnormal sperm production. Moderation is the key.

Stop Smoking

Scientific evidence suggests that smoking worsens sperm production, motility and morphology (shape.) Nicotine can cause testicular atrophy (a condition where the testes diminish in size and can result in loss of function.) Marijuana can decrease sperm density and motility, and increase the number of abnormal sperm. If you’re a smoker, making every effort to quit is a good idea for your overall health and your fertility!

Some Don’t Like it Hot

Working in hot temperatures, or simply relaxing, such as in a sauna frequently, can increase testicular temperature - resulting in abnormal sperm count and quality. It’s best to avoid taking long hot baths on a regular basis.

Recreational Drugs & Steroids

Cocaine can impair erectile function by suppressing the hormone that produces testosterone. High doses of amphetamines can lead to a diminished libido. Steroids are proven to affect sperm production and function. That’s not even taking into account the other risks associated with these drugs. If you’re a user, you need to stop!

Take the online male fertility check

If you want to know more about your individual circumstance, answer a few simple questions on our Male Fertility Check tool and get some insights into your reproductive health and the things you could do to improve your fertility now.

Male fertility issues can be overcome

If you do get to the point where you need to see a Fertility Specialist, at least for men, fertility tests are pretty straight forward. Secondly, in general, if your specialist then tells you there is a problem with your sperm there are ways to resolve this. This may require lifestyle changes, or surgery. Or you could go through an IVF cycle with ICSI to overcome a problem with sperm count or quality. The point is, once you understand the issue, there are generally ways to address it.

Watch:Hossam discuss Male Infertility

Read more:Male Reproductive System, Abnormal Sperm Production

Find a Specialist in Male infertility:Queensland, New South Wales, Victoria

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We hope this article was informative and useful to you. If you have any questions or feedback, feel free to get in touch at info@blogivf.com.au.



Related Articles

Conceiving in your 40s, what are the chances?

I was recently asked to comment in a Sun Herald article on 26th August (also published online here: Sydney Morning Herald) on Collette Dinnigan, who pregnant at the age of 46, has called on women not to leave it too long to try for a baby.

It is always news when a high profile personality such as Ms Dinnigan, has a child, particularly when the personality in question is a bit older.  The difficulty is that these occasions, while very happy for the people involved, give a misleading picture of the actual likelihood of conception in these circumstances.  Remember that high profile personalities such as Ms Dinnigan, are human beings who quite rightly value their privacy and so very rarely (quite understandably) talk to the press when things aren’t going so well.  It was therefore, a particularly courageous action of Ms Dinnigan, while celebrating her own happiness, to so publicly, point out the difficulties that may face other women, seeking the same fulfilment.

What then, are the issues for women in their forties who are planning to have a child?

The main difficulty is that conceiving is simply harder at that age and, even once a woman does conceive, the risk of miscarriage is higher.  Surprisingly, although we have very good data about the effects of age on IVF conception (more shortly), we don’t have very good statistics about the effects of age on conceiving naturally. The limited available data about natural conception comes from old population studies or studies of unique populations, such as the Hutterites of North America, who do not use contraception.  Interestingly these data, such as they are, seem to be entirely consistent with the more modern and abundant IVF data.  Generally, in one year of trying, 75% of women under 30 years and 66% of 35-year-old women but only 44% of 40-year-old women will achieve a live baby naturally.

The main explanation for this, is that women are born with a finite number of eggs, and from that moment onwards, the number of eggs is declining all the time, until women go through their menopause at around 50-51.  Nonetheless, women in their 40s do still ovulate each month.  What is it about their eggs that cause all these problems?

A common misunderstanding with some women is that the fact she looks and feels young, and leads a healthy lifestyle, means that her eggs will be healthier. I regularly see women who have taken enormous care with their fitness and their health.  The rest of their body is in great shape, completely fit and ready to carry that longed-for pregnancy.  Sadly, despite this, the eggs still can’t do it.  The effects of time are remorseless and, sadly, there is no wonder drug to fix it.

Scientists have shown that eggs from older women are more likely to have an abnormal makeup making pregnancy less likely, miscarriage more common and increasing the risk of Down Syndrome, a condition where a child is born with an extra chromosome number 21.

Nor is IVF a cure for this problem. For women, in their early 40s, IVF is still a good thing to try and gives significantly higher success rates than trying naturally.    However, IVF success rates fall sharply after the age of 40 and by the time a woman is 45 are close to zero.

So, what’s the good news?  Well despite all of the above, many women do conceive in their forties, either by IVF, or naturally, and have very happy healthy families.  It is obviously better to have your family earlier, if you can, but all hope is not lost, just because you’re past 40.  Conception and early miscarriage are the big problems but, if you do conceive and get past the first few weeks, by far the most likely outcome will be a healthy child.  While the risk of Down Syndrome is increased, most of the other problems that affect young children are not increased by being conceived a later maternal age.

Finally, many women worry that by having their children later, their long term health and emotional development may be affected.  On the contrary, we now know that the children of older mums grow up to be as healthy and bright as any other child.

Snapshot of Fertility in Australia

There have been a number of happy and high profile stories in the press recently about older celebrities giving birth to healthy children. Stories like this used to be extraordinary, but they certainly seem to be on the increase. While this trend is supported by data that shows the fertility rate and numbers of births are increasing for women over 30 and especially for women in their early 40s, women and couples should understand the risks associated with having children later in life.  IVF Australia, Melbourne IVF and Queensland Fertility Group, have teamed up to create their latest infographic - “Fertility and Age in Australia” which explores some of these issues.
 Fertility in Australia infographic

Paternity, Maternity, Equality

Conceiving a baby in a same sex relationship

IVFAustralia, and its partner clinics Melbourne IVF, Queensland Fertility Group and TasIVF, are proud supporters of ‘rainbow families’. IVFAustralia were an Official Supporter of Sydney’s Gay and Lesbian Mardi Gras this year, and we’ve seen the number of same sex couples accessing our donor program double in the last year.
 
In 2011, a survey of 3,835 LGBT people found 33% of women and 11% of men had children1 - but close to 40% reported wanting to have children or have more children. This so-called ‘gayby’ boom is thanks to changes in community attitudes and laws, including better access to Assisted Reproductive Treatments for lesbian and single women.
 
So, if you’re hoping to experience the joy of starting a family within a gay or lesbian relationship, what do you need to consider?

How long will it take to conceive?

Generally speaking, we’d expect a healthy woman with no fertility issues to fall pregnant through IVF or Artificial Insemination within six months. You can prepare for pregnancy by improving your diet, doing regular exercise and other lifestyle factors.
 
When you access the donor program there are a few extra decisions you need to make.
 
Do you choose a known donor, or an anonymous donor? In a lesbian relationship, do you want to implant an embryo with eggs from one mother into the other? Should you store some sperm from the same donor for later, in case you’d like a related sibling? For two dads, the process of finding a surrogate can also be complex.

How do we choose a donor?

Our fertility clinics offer access to both Australian and US* donor sperm. The access fee for US donor sperm is higher, but the waiting list is also shorter as there is a shortage of local donors (gay men, we’d love to hear from you!)
 
When you’re using donor sperm or eggs, there are a few legal, emotional and ethical factors to consider and a counsellor will help you work through these concerns so you can make the best decisions for your family’s future.

Are there any legal issues?

Each state has different laws about parental recognition and access, so it’s worth seeking specialist advice before you start.
 
For example, in Victoria, the Victorian Assisted Reproductive Treatment Act (2008) removed discrimination against lesbian and single women with regard to fertility treatment, recognised parenting status for non-birth mothers and also effectively legalised ‘altruistic’ surrogacy. It also recognises lesbian couples as equal parents of their child or children as long as they were in a de facto relationship.

What else should we be prepared for?

30 years of research2 has shown that the children of same-sex parented families do just as well as the children of heterosexual parents socially, educationally, physically and emotionally.

The issues your children will face as they get older are just the same as the issues facing any children conceived using donor sperm or eggs: Where did I come from? Should I contact my donor? You need to be prepared for these questions at some point.
 
In the meantime, we hope we can help you fulfil your dream of having a baby, and that you will experience the joys of pregnancy, birth and parenthood.

What should be my next steps?

If you would like to learn more about the fertility treatments available for same-sex couples in your regions, visit one of our websites. 


 * IVFAustralia and Queensland Fertility Group patients only.

1 Leonard et al. (2012) Private Lives 2: The Second National Survey of the Health and Wellbeing of GLBT Australians, The Australian Research Centre in Sex, Health and Society, Melbourne
2Rainbow Families Council of Victoria (2010) Rainbow Families and the Law, RFC, Melbourne, http://www.rainbowfamilies.org 

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