Including Men in the Infertility Journey

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My guess is that if you're reading this, you're a woman.  (if I'm wrong, MORE POWER TO YOU!!) But the reason I think this is a pretty good assumption is that when it comes to care for pregnancy and infertility, statistics show that there is a MAJOR gender bias. A survey of 15,000 men and women in Britain found that women are more likely to have and seek treatment for infertility than men.  There is also far more research on the psychological consequences of infertility in the females than in men.

I would argue that the gender bias goes even deeper. When couples seek treatment for infertility or look to prepare themselves for pregnancy, this process is typically driven by the female partner (in heterosexual couples).  In fact, in my decade plus of clinical experience, I can think of only 1 couple out of hundreds for whom the process was driven by the father-to-be. This bias can lead to a mis-focus on infertility as a women’s issue, and more education targeting a female audience on topics such as preconception, timing of intercourse, and human fertility. (I'm totally guilty of this!)   

We're not teaching men either! One study published earlier this year in the American Journal of Preventive Medicine showed that, in federally funded clinics in the United States that deliver family planning services, 81% provided education around preconception care for women, while only 38% provided the same education for men.  While men and women both play essential roles in contributing gametes to a future child, it seems that far less than half of men receive education to prepare them.

When it comes to research on male fertility, there is a wealth of knowledge available. Semen analysis is easy to do and to track improvements.

WHY YOUR MAN NEEDS PRECONCEPTION EDUCATION

In 1992, a landmark study published in the British Medical Journal revealed that, over a 50-year time frame, the average sperm concentration in healthy men had declined from 113 million sperm per mL of semen to 66 million per mL. (YIKES!)  While some may argue that the lower sperm counts seen in healthy men today do not pose a risk for fertility, the observed decline is nothing short of concerning for me, how about you? 

Labs have shifted their "normal" ranges to echo these changes seen in this study.  With these changing definitions of normal for sperm, your man may have tested "normal", but be waaaaaay below the OPTIMAL range for his health! Just like you, he needs a preconception program consisting of lifestyle strategies as well as targeted nutritional therapeutics.

PREPPING YOUR MAN (OR YOURSELF!) FOR CONCEPTION

DIET

It is essential to ensure that men considering conception are a healthy weight. Higher BMI and especially big bellies have been associated with lower sperm concentrations, count, motility, and morphology, as well as lower testosterone levels, and getting back to a healthy weight can reverse these effects.  Furthermore, a higher rate of miscarriage has been observed in couples in which the male partner is obese!

FISH OIL, OMEGA 3s & ANTIOXIDANTS

A study of 209 healthy Spanish men demonstrated that higher consumption of omega-3 fatty acids was associated with healthier testicles, and intakes of trans-fatty acids and omega-6 polyunsaturated fatty acids were related to less healthy testicles. Trans-fat intake also brought down testosterone levels.  In addition, a low intake of antioxidants has been associated with poor quality semen. A Mediterranean diet, which is plant-based and rich in antioxidants as well as omega-3 fatty acids, may be a good choice for improving fertility.

EXERCISE

While we’ve known for some time that exercise improves fertility (likely due to its impact on overall health and weight management), a recent study in the journal Reproduction compared 3 types of exercise and their impact on sperm health in 280 healthy male volunteers. Each participant was assigned to 1 of 4 groups: moderate-intensity continuous training (MICT) (30-45 minutes of moderate speed running 3-6 days per week), high-intensity continuous training (HICT) (60 minutes of vigorous running 3 days per week), high-intensity interval training (HIIT) (20-30 minutes of alternating sprinting and walking 3 days per week), or no exercise. All types of exercise led to an improvement in semen quality and sperm DNA health. Men in the MICT training group experienced the greatest benefit. (That was 30-45 minutes of moderate speed running 3-6 days per week) . When men stopped exercising, though, they went back to their pre-exercise levels.  So men, get to the gym and STAY THERE!  (Kidding :) . but a long-term exercise program involving moderate intensity activity is pretty helpful, especially if you can stay consistent! 

In addition to lifestyle factors, several key nutrients can be considered as part of a comprehensive preconception program for men. Early research has indicated that infertile men have lower levels of omega-3 fatty acids, zinc, and coenzyme Q10. In 1 of these studies, food intake of coenzyme Q10 reached an average of only 19.2 mg per day, while the supplemental dose demonstrated to positively impact male fertility is 200 mg per day!  So, supplementation might be a helpful BOOST to your partner's fertility.

If you're trying to get pregnant, keeping your man involved is REALLY important- it always takes 2 to tango!  Plus, it's great practice for parenthood! ;)