There may be a crisis for male fertility looming. Studies have shown a dramatic decline in sperm count between 1970 and 2010 of 50%, with a downward yearly trend – fast forward to 2022 and the direst predictions suggest that there will be no good sperm by 2045.
What on earth could be causing this?
Well, several hypotheses have been suggested – obesity, an ‘obesogenic’ diet of fast and ultra-processed foods, and the rise in environmental chemicals – plastics, micro-plastics, dioxins, phthalates, parabens, pesticides and fertilisers and with the pandemic, long-term sitting down and just eating more. Add drugs, alcohol, smoking and now vaping, anabolic steroids, hair growth solutions, male grooming and certain medications and there you have it – a cocktail of factors all conspiring together to bring down the fertile male!
Added to this, men have been sadly ignored in the fertility world for far too long. Infertility is always focused on the woman, even if there is a clear male factor issue. And typically, a man asking a fertility clinic what he can do to help is sperm is met with a blank ‘nothing’.
And yet, vets and farmers know the benefits of feeding their animals a diet rich in specific nutrients. In fact, there has probably been more sperm research done on breeding animals like bulls, rams and stallions sperm than human sperm (see bull story below). Good sperm means money. However, new research is highlighting the importance of the male role and I am lucky enough to work with some of the best male fertility specialists in the UK. My experience in that field helps me to recognise the need for referral to a specialist and I studied the relationship between male sub-fertility, obesity and IVF success for my final MSc research project.
You can improve sperm with the right investigations and medical care, and diet and lifestyle.
“You wouldn’t enter the Marathon without training, so why would you do IVF with no preparation?”
- Dr Sheryl Homa, Andrology Solutions.
An Indian bull, whose semen is worth $3,000, has a meticulously planned diet and vitamin plan. If it works for bulls, it works for human men! But I do recognise that the last thing a man wants is to give up time to discuss his sperm and his diet with a complete stranger – hell! So, I really try to make our consultations easy, laid back, factual, evidence-based and interesting. And I do not make you give up everything, sometimes there is a bit of a time limit to IVF for example so the plan is a little more focused, and sometimes you may just be trying naturally. But couples still need to have a life, a coffee, a pint of beer, a glass of good wine, the gym; good endorphins are essential. There are no outright bans. But it’s still a project, and a team effort. After all the DNA of an embryo is 50% from the man and making the sperm as good as possible is the aim; you want to tick all the boxes and give it your best shot, and nutrition can dramatically improve sperm quality.
Testimonials
“I'm writing to thank you for the great success I've had from following the advice you gave me. We had a consultation in April 2021, when my DNA fragmentation level was about 46% and there was serious doubt about my chances of fathering a child. But thanks to the advice you gave - everything from salads and smoothies to supplements - I got the number down to 29%. And I attach a photo of the result - born in January and is happy, healthy and loud. Thank you so much for your help, without which we wouldn't have him”
“As a bloke the very last thing I wanted to do was see a nutritionist, even though it was ‘my’ problem and boy was I bad tempered when we arrived, my poor wife was very embarrassed. I left the appointment wondering why I had taken so long. I had kept some wine (expensive), coffee (a bit), plenty of sex (result), the ‘egg and sperm salad’ (still eating it), ended up with a natural pregnancy and now have a wonderful baby girl.
Go and see her, she really is OK!”
Case Study
Here is a case study showing results of sperm tests before and after a nutritional consultation with me. This was a very interesting case as the person concerned wanted to become a sperm donor, but unfortunately there were several problems with the sperm and he was told he couldn’t. However, he was extremely determined and highly motivated and was willing to completely take on board everything, and so it really was fantastic to see such a dramatic change in the sperm quality. He subsequently was accepted as a donor. And recently he has married and has just had a baby!
Before consultation, March 2010 This sample was viscous, showing a slightly high pH. If semen remains too thick this may affect the ability of the sperm to move. If the semen is too alkali it may indicate a problem with the prostate gland which should produce seminal fluid that is slightly acid, or a lower pH. Motility was poor with not enough sperm swimming in a straight line (progressively). There were also some anti-sperm antibodies present in the sample. These can prevent fertilisation by sticking to the sperm, particularly the head. Sperm then can’t recognise the egg or penetrate it, and they also stick to each other.
The vast majority of the sperm in this sample were abnormally shaped, which again causes problems with adherence to and penetration of the egg. However just how many abnormal sperm you have before fertilisation is severely affected depends on the criteria used – the WHO define >85% (so <15% normal) as causing problems, but using strict Kruger criteria > 95% (< 4% normal) is believed to severely impair fertility. And of course, it depends on the count too. If you have a very high count you can afford to have more abnormal sperm than if you have a lower count. This client had a moderate count of 37 million, above the 15 million defined as being in the ‘fertile’ range.
After consultation, October 2010 2010 Here you can see a massive improvement. Although the semen is still viscous and there is debris, the pH has dropped. The count has almost doubled to a very satisfactory 64 million and the motility is now well within the normal range. There are no longer anti-sperm antibodies and the morphology is within the normal (Kruger) range. The client was absolutely delighted as you can imagine, and went on to donate as many times as he was permitted.
The Mediterranean Diet
This is the diet that is the cornerstone for health for everyone, and research has shown that it is especially relevant for strong, healthy sperm. Full of strongly coloured vegetables, fruit, seeds, wholegrains, pulses, fish, herbs, olive oil and a little red wine. See: Karayiannis D, Kontogianni MD, Mendorou C, Douka L, Mastrominas M, Yiannakouris N. Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility. Human Reproduction. 2016 Dec 16;32(1):215-22. Vujković M, de Vries JH, Lindemans J, Macklon NS. The preconception Mediterranean dietary pattern in couples undergoing IVF/ICSI treatment increases the chance of pregnancy. Dietary Patterns and Human Reproduction. 2010:31.
