LIFESTYLE FACTORS AND MALE FERTILITY

Lifestyle issues and ingestion of toxins including alcohol and smoking have been shown to have a significant role in male infertility. Some factors which have been shown to affect male fertility are:

FREQUENCY OF EJACULATION
Frequent ejaculation has been shown to reduce DNA fragmentation (damage) in some males and thus can be used to improve sperm quality. Patients are recommended to ejaculate every two days for at least a week prior to attempting conception by natural intercourse or assisted reproduction (ovulation induction and intrauterine insemination or IVF/ICSI).

ALCOHOL
Even moderate alcohol consumption has a major effect on fertility. Its mechanism of action is not fully understood but involves effects on mental function and libido, metabolism of male and female hormones by the liver, and a direct action on the DNA of the sperm.  There is no known safe limit and so ideally alcohol should be avoided.

SMOKING
Toxins in cigarette smoke affect the quality of sperm DNA, sperm’s ability to fertilise eggs and sperm motility. Patients should be aware that although semen analysis usually does not detect the effect of smoking on sperm quality, research has shown that smoking adversely affects male fertility and therefore patients are advised to give up smoking if possible. Alcohol and smoking are both toxic to sperm and together compound the negative effects.

TOXINS
Avoid or minimize exposure to toxins such as heavy metals, pesticides, and pollutants including PCBs, dioxins, DDT and exhaust gases from petrol engines.

HEALTHY BODY WEIGHT
Being overweight can affect male fertility because within fat tissue male hormones are converted to female hormones. An imbalance of hormones may result, affecting sperm production and therefore fertility.

REGULAR EXERCISE
Regular exercise is beneficial for your general health and is also an effective means of dealing with stress. However, excessive exercise should be avoided as it can affect the hormonal control of sperm production.

EXCESSIVE HEAT
Exposure to water temperatures of 40°C (102°F) or higher may lower male sperm counts, and therefore hot baths, spas, saunas and steam rooms should be avoided. A fever may have a temporary effect on sperm quality and decrease fertility. Tight synthetic underwear and cycling shorts may also have an effect on fertility. Cotton loose fitting underwear is recommended so that the testes are not firmly held against the body, thereby avoiding overheating of the testes.

MEDICATIONS WHICH MAY AFFECT FERTILITY
The effects of most drugs on male fertility are not known, however if men are required to take medication for prolonged periods it is advisable to discuss this with their doctors. Some medications which may affect male fertility are:
• Anticancer or chemotherapy medications, and radiation treatment
• Anabolic steroids and corticosteroids
• Antimalarial drugs
• Antihypertensive medications (including beta-blockers, thiazide diuretics)
• Cimetidine, an anti-ulcer drug
• Ketaconazole when taken orally (an anti-fungal agent)
• Hair loss medications
• Spironolactone
• Sulfasalazine
• Tricyclic antidepressant drugs and some sedatives
• Testosterone supplements

RECREATIONAL DRUGS
Opiates and marijuana can effect sperm production and can also decrease sex drive.

NUTRITIONAL SUPPLEMENTS
There is limited evidence of the effects of vitamin and mineral supplements on sperm function and some of the following recommendations still require scientific proof. Any doubt regarding the use of these products should be discussed with the doctor.

ANTIOXIDANTS CAN COMBAT SPERM DAMAGE CAUSED BY FREE RADICALS

• Folic Acid 5mg daily
• The following can be taken individually or together: Folic Acid, Vitamin C and Vitamin E.
• Menovit is a specific formulation to deal with free radicals and male infertility, however studies have not clearly shown that it is effective.

MINERALS/MICRONUTRIENTS
• Zinc
• Selenium – note excess can be toxic – 350micrograms daily is safe according to EPA

HIGH FIBRE DIET
Avoid low fibre diets as they promote the absorption of environmental oestrogens which can affect the male hormonal balance.

STRESS
Stress can lead to lifestyle excesses, poor nutrition and may affect sexual function. Regular exercise, effective time management and if necessary counselling can help to reduce stress.

The Andrology Australia website: www.andrologyaustralia.org has booklets and information sheets and brochures that provide a more comprehensive overview of male infertility.