Infertility, defined as the inability to conceive after one year of unprotected sex, affects one in six couples of childbearing age in the U.S. In 40% of cases, the problem is with the man; in 40% it's with the woman, and in 20%, something is amiss with both, say Zev Rosenwaks and Marc Goldstein, fertility experts at New York Presbyterian/Weill Cornell Medical College and co-authors of the 2010 book, "A Baby at Last!"
Since men contribute to
infertility at least half the time, says Dr. Goldstein, couples investigating why they can't conceive should start with a simple sperm count.
About 70% of male infertility is treatable, he says, and in about 25% of cases, it could have been avoided with greater awareness of the lifestyle choices that can harm sperm. a number of lifestyle choices, environmental factors and chance events can sabotage the sperm: an adolescent groin injury, cigarette smoking, heavy drinking, intense cycling and even using a laptop directly on the lap.
Testosterone trouble. Smoking cigarettes, heavy alcohol drinking and using marijuana, cocaine and opioid painkillers can all lower the level of testosterone needed to make sperm or otherwise cut their quantity and quality. So can some commonly prescribed medications for high blood pressure, heart disease, stomach acid, gout, inflammatory bowel disease, enlarged prostates and baldness. In many cases, alternative drugs exist that don't hamper
fertility.
Even extra testosterone can lower a man's testosterone. As many body-builders know, taking testosterone and other anabolic steroids can build muscles but shrink testicles and halt sperm production because the brain thinks the body has plenty and stops making enough of its own. In most cases, normal sperm production resumes within a few months once men stop using the substances.
Exposure to large amounts of radiation can also make men permanently sterile. When getting an X-ray of any part of the body, men should always request a lead shield for their testicles, says Dr. Goldstein.
Sexually transmitted diseases. chlamydia,
gonorrhea and other STDs can block those same ducts with inflammation and scar tissue, and they are rampant in the U.S., affecting up to half the population by age 35. Men with symptoms such as burning on urination or discharge from the penis should see a doctor as soon as possible to minimize long-term damage. Those with multiple sex partners should use condoms and be checked yearly for STDs, experts say.
Avoid Trauma. Men of all ages should take care to avoid trauma to the testes, in part to avoid rupturing the delicate ducts that carry sperm and keep them shielded from the body's immune system, which would otherwise attack them as foreign invaders. Once exposed, sperm trigger the formation of antisperm antibodies which hamper their ability to swim and fertilize an egg.
"That's why wearing a cup for playing sports is so important," says John Amory, a specialist in male reproductive medicine at the University of Washington. "It's not just to prevent pain."
Food and exercise. Obesity can thwart a man's fertility in many ways: lowering libido, reducing sperm counts and disrupting hormone balance. This is in part because fat tissue produces estrogen, which lowers testosterone. Maintaining a healthy weight and diet can significantly increase a man's chance of conceiving a healthy baby, studies show.
Strenuous exercise may hurt fertility, though. Men who run more than 100 miles a week have lower sperm counts and testosterone levels.
Dr. Goldstein also advises male cyclists trying to conceive to ride for only 30 miles at a time—mainly to limit their time wearing tight bicycle shorts. And he recommends using a seat with a wide back rather than a hard, narrow one. "You want more of your weight on your sit bones," he says.
Decrease heat. Men trying to conceive should avoid hot baths, hot tubs and tight pants, since heating the testicles by even a few degrees can hamper or stop sperm production. Studies at Stony Brook University in New York have shown that resting a laptop on the lap can raise temperatures in the scrotum as much as 5 degrees Fahrenheit in an hour. Although most heat problems are temporary, researchers still urge men to use desks or tables instead.
Environmental factors. Some pesticides, heavy metals and industrial agents also reduce sperm production. Less is known about the effects of bisphenol A (BPA), an estrogen-like compound found in some water bottles and other plastics, but some fertility experts tell their patients to avoid them.
Similarly, while the effects of electromagnetic waves on human sperm are not well studied, Dr.Goldstein advises men to not to carry their cellphones in their front pockets as a precaution.
