Semen Problems and Sperm Issues
Approximately 25% of all infertility is caused by a sperm defect. About 40-50% of infertility cases have a sperm defect as the main cause, or a contributing cause. This is the legacy of male factor infertility. However, in cases of male factor infertility, defects are caused by poor sperm quality or other sperm disorders more than 90% of the time. It can be difficult to know whether sperm is the sole problem, or just a contributing cause of infertility. Partly this is because 'numbers are just numbers'.
For example, we know that men with very low sperm counts can sometimes have children - and some men with normal sperm counts can be infertile. What matters most is not how many sperm there are or how fast they swim - but whether they can fertilize the female partner's eggs. Sperm disorders and defects are a biochemical issue at the molecular level. A sperm defect is present when sperm are irregularly shaped, have poor motility or low sperm count. It takes more than looking at sperm under the microscope to assess the ability of the sperm to fertilize the female's eggs.
The semen analysis is the central testing component used to determine if a sperm disorder is the cause for male infertility. The values of these guidelines only increase the probability that there is a case of male factor infertility, but it does not provide any guarantees. Guidelines for normal semen levels have been defined as follows:
- Volume: 1ml to 5ml or more
- Concentration: 20 million/ml or more
- Motility: 50% or more
- Morphology: 30% or more normal shapes (WHO criteria) or 14% or more (by Kruger strict criteria)
- Clumping: minimal
- Presence of white or red blood cells: minimal
- No hyperviscosity (Thickening of seminal fluid)
Sometimes male infertility from sperm disorders can be overcome with a few healthy lifestyle changes. Making healthy choices can increase the fertility of sperm and help to increase low sperm counts. Read the list below to gain a better understanding of how your choices can affect sperm production:
- Age: Sperm production drops after age 40.
- Alcohol: Too much alcohol lowers the production of the male hormone testosterone. Drink less alcohol to prevent infertility.
- Caffeine: Drink less coffee to prevent or cure infertility. Coffee and medications with caffeine appear to make sperm sluggish.
- Cimetidine: If you are taking this drug and you are trying to conceive at the same time, try to reduce the dosage or take it at another time. This drug is used to treat ulcers but decreases testosterone levels and may affect sperm production.
- Clothing: Wearing tight trousers or underwear has not been proven to overheat sperm-producing cells in testicles, and lower sperm count. But it doesn't hurt to wear loose underwear and clothing just in case.
- Hot tubs: Only use the hot tubs once in a blue moon. Frequent use can lower sperm count by overheating sperm-production cells, especially at high temperatures for over 15 minutes.
- Infection: All sexually transmitted diseases can have an adverse effect on fertility. Get tested for STD's and HIV to prevent this problem.
- Recreational Drugs: Marijuana and other drugs may decrease testosterone levels. Stay away from drugs.
- Smoking: Lowers sperm count and slows sperm mobility. Do not smoke to prevent infertility.
- Steroids: Do not use anabolic steroids or other “miracle drugs”. These may have fertility side effects.
- Stress: Try to decrease the stress in your life. Try alternative therapies to increase your well-being such as acupuncture, chiropractic care, yoga or massage therapy.
- Weight: Maintain a healthy weight for optimal fertility.
Sometimes lifestyle changes are not enough to overcome infertility caused by sperm disorders and semen problems. If you are having trouble getting pregnant, make an appointment at our San Diego, California practice, with Dr. Martin Bastuba, M.D., F.A.C.S. and Male Fertility & Sexual Medicine Specialists.