When I first met Gabi* and Tom* they had been trying to get pregnant for five years.
They’d tried to conceive naturally for a year and then suffered twofailed rounds of IVF.
So, before they went into a third attempt, they wanted to see if there was anything else they could do to support their journey and improve their chances.
It only took me one glance of Tom’s semen analysis (as well as their full health questionnaire and test results) to understand why they hadn’t gotpregnant naturally.
Tom’s volume, sperm concentration, motility (the sperm’s ability to swim forward), and morphology (the shape of the sperm) were all low.
Luckily, his initial reaction to this news was not one of heartbreak or disappointment. Rather, he was relieved. Their infertility was no longer unexplained.
‘What can I do about it?’ Tom asked. ‘How do I fix this?’
However, some anger soon followed.
‘Why do clinics concentrate far more on the women than the men even though we are 50% of the picture?’ He queried, frustrated.
I wish I had a definitive answer, but the sad reality is,male infertility isa subject that is seldom talked about and that needs to change.
As a holistic fertility specialist, I see all manner of singles and couples. Yet, it might surprise you to know that, in my practice, 90% of the issues I deal with are due to male infertility.
To be clear, infertility in men is most often due to too few sperm, poor sperm quality or sperm that do not move properly. And over the past 10 to 15 years there has been a general rapid decline in sperm quality and quantity.
Broadly speaking, poorer diets, exposure to hormone disrupting chemicals including plastics, increased stress levels and reduced exercise levels all have a potential impact on sperm production and quality.
Let’s also not forget that more people are having children later in life – the over 35’s being one of thefastest growing age groupsto become parents – and contrary to popular belief, sperm also goes through an age decline.
We have all been told that female fertility starts to drop around the age of 35 and that by 40 our eggs are past it! (Not always the case by the way).
That, as a woman gets older, her egg quality decreases and there is an increased risk of complications during pregnancy including everything from miscarriage, to gestational diabetes and pre-eclampsia.
And don’t even get me started on the heinous double standard that, in the past, if you were over 35 and pregnant, you weredeemed a ‘geriatric mum’. Granted this term has now been replaced with ‘advanced maternal age’, not great but a little better.
My point is, why aren’t we also talking about men in the same way?
Men, your sperm are also at risk of reducing their ability to fertilise an egg and grow a healthy baby after the age of 35 to 45.
For a start, sperm production slows down and genetic issues increase with age, as the DNA in the sperm head fragments more. This then increases the risk of miscarriage, pre-eclampsia or a preterm birth, yet often the reason for a loss is put down to the women.
Men, your sperm are also at risk of reducing their ability to fertilise an egg and grow a healthy baby after the age of 35 to 45
Did you also know that it’s the sperm’s genes that build the placenta to provide the baby with oxygen and nutrients throughout the pregnancy until birth?
If the genes aren’t great then how will that placenta form and support the growth of the baby?
Thebiological clock ticksfor both parties, not just a woman.
Another couple I worked with – she had low AMH (a hormone made by the ovaries) for her age and his sperm were on the lower side of ‘normal’ – were just a few days off starting IVF when they got a naturally conceived positive pregnancy test. It was a hugely happy result.
This is even more incredible when you remember just how much that one sperm has to go through to fertilise an egg.
It’s a real David and Goliath event. The sperm is the smallest cell in the body and has to swim the equivalent of 3.5 miles to reach the egg (the largest cell).
And even then, that may not be enough because, in reality, it isthe egg that chooses the sperm.
See, mother nature only wants the strongest swimmers with the best DNA. You might have sent millions of sperm to go find the egg, but they don’t read maps.
Some will go the wrong way and die, while others often can’t swim well – especially if they have 2 heads, half a head, no tail or are swimming round in circles.
Usually only about 100 sperm reach the Boss level and even after all that, it’s a game of chance.
I know, that all sounds intimidating. All too often I hear complaints that there is little that can be done to improve sperm health but that’s not true.
I advise them to cut out heated seats, hot saunas, and sitting at a desk all day, as well as to avoid phones in pockets, laptops on the lap and remind them that cycling is a huge no no
My clients all receive the same basic advice, starting with eating better.
I ask them to cut out processed foodsand drinks, increase their water intake while reducing alcohol intake and consume lots of fruit and vegetables – 8 to 10 portions a day is ideal.
All this provides the full spectrum of nutrients that the body requires to make the basic building blocks of hormones and each cell (remember the egg and sperm are cells too).
Of course, you will still make sperm if you don’t eat well, but a nutritious diet helps.
Next, I ask them to move more. Exercising is also important so long as they don’t overdo it – we want the testosterone to go to the sperm, not the muscles.
Stress – high levels and continuous – is also bad for both general and sperm health, so I advise my clients to reduce it where they can, maybe even to take up activities such as yoga, mindfulness, Tai Chi, massage or reflexology which can help.
Lastly, I advise them to cut out heated seats, hot saunas, and sitting at a desk all day, as well as to avoid phones in pockets,laptops on the lap and remind them that cycling is a huge no no (all these heat up the testes and damage the sperm).
Generally speaking, the combination of eating well and looking after yourself can bring good outcomes.
It certainly has helped Tom and Gabi who have now had their first positive pregnancy test ever. It’s still early days but it’s the furthest they have got!
This is not to say that men are always the problem – generally, 30% of fertility problems are due to the man, 30% due to the woman and 30-40% are due to both or unknown reasons – but it does happen.
In fact, according to one study, 7% of all men are affected by infertility and it affects around 1 in 7 heterosexual couples in the UK. So it’s definitely something we should be talking about more.
Despite perceptions that it’s not ‘manly’ to talk or to have an issue, male infertility is not a taboo topic. And, no, being infertile does not make you any less of a man.
If anything, discovering an issue and confronting it head on is about the strongest thing you can ever do.
Should you be concerned though, my advice is this.
Have further tests to see where the issue is and how it can be improved – a semen analysis will show the basics but it doesn’t show the DNA in the head of the sperm or if there is an infection present.
Speak to an andrologist – the male equivalent to a gynaecologist – as they can check for structural issues including varicoceles that cause pain and heat in the testes which can damage the sperm.
And lastly, talk to others. While they are few and far between, thereare male only support groupslike TestHim – the men that run it all have had fertility issues.
But you should also speak to your mates at football, at work, on nights out – you may be surprised at how many of your friends and colleagues have been through something similar or are worrying about it happening in the future.
The only way we can remove the stigma is by getting it out in the open and talking about it more.
Because sadly, infertility is not going away anytime soon. In fact, if we carry on living the way we are then the issue will only continue to grow. And it’s important we recognise that this is not a ‘women only’ problem.
More from Metro
Infertility needs to be addressed by everyone, and men need to be listened to and heard.
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