Infertility affects 1 in 20 men. Twenty percent of men have low sperm count and two to three percent produce no sperm at all. A low sperm count is the cause of infertility in about 20% of couples.
Should you be concerned?
If you have not conceived after one year of unprotected sex then you and your partner should visit your doctor. It is reasonable to go sooner if you have a reason to be concerned about your fertility such as family history of infertility, childhood surgeries, age above 32 years, or history of chemotherapy.
Sperm production happens over 56 days in the testis due to stimulus from the brain, with the help of hormones. The primary cells which produce sperm are Sertoli cell & Leydig cell in the testis. The hormones produced are FSH, LH by the pituitary in the brain and Testosterone in the testis, which in fact is produced due to the effect of FSH and LH.
Dr Vasan S S
Primarily testosterone in the testis is produced by the Leydig cells is responsible for sperm production and maintenance. Testosterone also is important in the development of male characteristics, including muscle mass and strength, fat distribution, bone mass and sex drive.
Sertoli cells produce immature sperms which are matured by the testosterone produced by Leydig cells. The average testis produces approximately 1500 sperm every second, and the least amount of sperm needed to result in pregnancy are 15 million sperm in at least 1. 5 ml of semen.
Two important parameters of sperm are the movement and shape of the sperm, which convey whether or not the sperm is genetically fine.
How to improve sperms naturally:
1. Reduce Caffeine intake: Research has shown that it may not be caffeine directly but the sugar used with caffeine which may be the culprit in reducing sperm quality.
2. Lose weight: Fat cells converts the male hormone to female hormone. Shedding a few extra kilos will improve the quality of sperms. In fact, overweight women also tend to have lesser chances of conception.
Obesity or overweight cannot only affect your sperm quality but also increase the risk of developing blood-flow problems which might affect your erections.
3. Eat healthy: A healthy diet - high in fruit and vegetables and low in fat with adequate fluid intake-- is essential for maintaining sperm quality
4. Don't self-medicate: Some people take zinc or vitamin E supplement without consulting a doctor. My advice would be please consult your doctor before making major changes to your diet or exercise.
5. Be regular in sexual activity: Regular ejaculations help sperm production and help keep DNA healthy which is important for conception.
6. Exercise regularly: Exercise regularly at least thrice a week. Regular exercise may help fertility by controlling body weight and relieving stress. It also helps by naturally raising testosterone, which is important for sperm production
7. Protect your testis from excessive heat: Testicular temperature is about 1 degree less than overall body temperature. The testis is also in scrotum outside the body to protect it from excessive heat. If temperature raises in the testis the production gets affected and will reduce.
8. Limit or eliminate hot tub bath times: Don’t spend more than 10-20 minutes in a hot tub, bath, or sauna at a time, and not more than once per week. You may skip it altogether when trying to conceive.
9. Limit bike time: Spending more than 30 minutes on a bike seat, especially when wearing tight bike shorts, will increase scrotal temperature and possibly harm your sperm.
10. Don’t keep your laptop on your lap: Computers get hot. When they’re on your lap, your man parts will also get heated. Use lap desk.
11. Take a walk more often : If you sit all day for work, it’s likely your groin is getting overheated from being compressed by your legs and abdomen. Get up and walk around, move a little, air out your man bits.
12. Don't keep your phone in your pocket: Consider keeping your phone out of your pocket. Partially due to radiation from electronic and radio waves, and partially due to the heat that phones emits when used for longer duration. Men should keep their mobile devices in shirt pockets or at the desk/table.
13. Avoid lubricants during intercourse: Lubricants and lotions can interfere with sperm motility, making it harder for your sperm to move. Certain chemicals in certain lubricants can also actually kill your sperm. If lubrication is needed, use coconut oil.
14. Know the side-effects of your medicines: Ask your doctor about the medications you’re on. Some medications can have an effect on your sperm production and sperm health. This is especially true for cancer treatments, which may render you permanently infertile. So even if you aren’t trying to conceive, but are dealing with cancer, ask your doctor about saving and freezing your sperm.
15. Take fertility-boosting vitamins/supplements: Deficiency of vitamin C, zinc, and/or folic acid can contribute to not only low sperm counts, but also chromosomal abnormalities in your sperm, which can result in miscarriages. It’s in fact estimated that more than half of first trimester miscarriages are due to these abnormalities (which come from deficits on both the female and male sides of the equation).
Zinc is necessary for sperm health. Boosting your zinc has been proven to boost sperm count, quality, and motility. Zinc-rich foods include oysters, beef, etc.
16. Watch your alcohol consumption: Alcohol has no impact on sperm production if consumed in limited quantities. However, drinking excessively can adversely affect sperm quantity and quality.
17. Don't smoke: Smoking affects sperm counts but it is not known what effect this has on male fertility. However, stopping smoking will improve your general health and your life expectancy, but effects are seen after 3 months.
18. Is it your job: Certain jobs can affect fertility, for example, the pesticides used by agricultural workers or even the vibrations felt by engine drivers. If you are concerned that your job may be affecting your fertility ask your doctor.
19. Destress: Stress, be it physical or emotional has wide ranging effects on the body. It is well known to affect erectile function and may well affect fertility. Over 80% of couples conceive after one year and over 90% of couples conceive after two years of unprotected sex. Set aside time for you and your partner to relax. Enjoy yourselves
(The writer is noted andrologist with Manipal Hospital. He is also president-elect, South Asian Society for Sexual Medicine (SASSM). Views expressed are personal)