Archive for the ‘infertility’ Category

Stress Getting You Down-It May Also Be Affecting A Man’s Fertility

May 19, 2013

Stress just may have an impact on a man’s sperm quality. Men with higher levels of stress and anxiety have lower sperm counts. Also those with the highest anxiety levels were also more like to have sperm that are less motile or have the ability to swim through the cervical canal to find an egg in the tubes connecting the ovary to the uterus. This report appeared in the February 13, 2013 issue of Fertility and Sterility.

Bottom Line: Want to have a baby and your partner is not getting pregnant? Then consider chilling out and find ways to reduce your stress level. It just may help those sperm reach the egg and get your family started. If you have questions regarding male infertility, see your urologist and get a semen analysis. It’s a test that every couple with an infertility problem should do.

Your Chance of Having a Baby Decreases If You Are a Couch Potato

April 23, 2013

A study has lined time watching viewing TV to a decrease in sperm quality in young men. This study from the British Journal of Sports Medicine (February 4, 2013) revealed a positive association between physical activity and sperm quality. Study participants reported their TV viewing habits and the estimated number of hours and physical activity engaged in for the previous three months. The report demonstrated that men who engaged in the most moderate to vigorous physical activity and those who watched the least TV had the highest sperm counts.

Bottom Line: Want to improve your chance of having a baby? Get off of the couch and get moving!

No Sperm, No Baby, No Problem

March 29, 2013

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Women have received a bad rap.  The assumption that most problems associated with the difficulty to conceive and have a baby is the fault of the female partner.  However, let the truth be told, 1\3 are a result of female problems, 1\3 are a male issue, and 1\3 are linked to both male and female problems. 

That’s the bad news.  The good news is that two-thirds of couples treated are ultimately able to conceive.

Part of the issue today is that many women are waiting much later in life to have children.  As women get older they’re going to see more problems trying to conceive. Men are capable of fathering children later in life, certainly into their 40s and 50s. They don’t have the same fertility issues that women have at that age.  That is, the biologic clock of men ticks longer than for women.

Common causes of men’s infertility can be hormonal problems, injuries, illness, medications, or a previous vasectomy. Lifestyle issues like smoking and alcohol use may affect sperm production, but are secondary factors.

A common cause of infertility in men is varicocele, an enlargement of the veins in the scrotum that heats the testicles, affecting the number and shape of sperm.  A varicocle is a common problem and up to 30 percent of all men have a varicocele.

Varicocele can develop in adolescence, and may be discovered by a pediatrician. Because of the long-term effects that can lead to infertility, a pediatric surgeon or urologist may recommend a procedure to correct the problem, depending on the severity. The purpose of the surgery is to seal off the affected vein and route blood flow into normal veins.

Another cause of male infertility is vasectomy.  Men are having a vasectomy, which is a reasonably permanent form of sterilization at an earlier age, and then have a change of heart when they get divorced and then marry a younger partner and want to have children and start a second family.  A vasectomy reversal is now quite successful and can be done as an outpatient in an ambulatory treatment center.

More recently, the public has been bombarded with advertisements for medications aimed at correcting low testosterone or low T. These popular medications for hormone replacement for low testosterone may affect a man’s future fertility.  Men should talk with their doctors about medications if they are trying or may be planning to achieve a pregnancy in the future.

Bottom line: Infertility is just as much a man’s problem as it is for the woman.  Help is available and the place to start is a semen examination to be sure that the man has all the ammunition he needs to father a child. 

Sperm Counts May Decrease With Excessive TV Watching

February 6, 2013
Watching TV may be relaxing but it may affect your sperm count and your fertility

Watching TV may be relaxing but it may affect your sperm count and your fertility

Men, here’s another reason to work up a sweat: It boosts your sperm count.

Couch potatoes who watch lots of TV have fewer sperm than men who exercise moderately or vigorously each week.

Men who reported exercising more than 15 hours a week had 73 percent higher sperm counts than men who exercised fewer than 5 hours a week. And men who watched more than 20 hours of TV had 44 percent lower sperm counts than men who watched little to no TV.

It is possible that exercise produces more antioxidant enzymes that can prevent a natural process called oxidative stress from damaging cell membranes in the body. This damage can disrupt the creation of new sperm cells. Another possibility is that when men watch TV, their scrotums get squished against their bodies, making that region hotter and possibly preventing new sperm from being made.

Research has shown that sperm production slows if the scrotum temperature rises 1.8 to 3.6ºF (1 to 2ºC) above normal body temperature.

Bottom Line: If you want to improve your sperm count, you should get active and get off of the couch.

Nuts For Your Nuts!-Walnuts and Sperm Quality

November 5, 2012
Walnuts For Your Testicles

Walnutes May Improve Sperm Counts

Eating just 2.5 ounces of walnuts per day can improve your testicles ability to produce quality sperm. Walnuts contain high quantities omega-3 fatty acids which some studies have linked to improved sperm quality.

This study appeared in the journal Biology of Reproduction in August 2012. I might also add that the California Walnut Commission sponsored the study.

Bottom Line: For men with abnormal or low sperm counts and are trying to achieve a pregnancy, consider a handful of walnuts every day. It may not help but it certainly won’t hurt.

The Straight Dope on Dope-Sex and Marijuana

November 19, 2011

The occasional use of marijuana may enhance a man’s sexual performance. However, the long term effects of marijuana and not so pleasurable. The long-term affects include erectile dysfunction and loss of orgasm. Marijuana may also impact a man’s fertility.
Erectile Dysfunction
The Journal of Sexual Medicine published a study suggesting a link between marijuana and erectile dysfunction. The active ingredient in marijuana is tetrahydrocannabinol, or THC. When a person uses marijuana, THC interacts with proteins in the brain called cannabinoid receptors. This interaction impairs the person’s brain function. There are also cannabinoid receptors present in penile tissue. Perhaps the interaction with THC may impair penile function (possibly causing erectile dysfunction)
Problems with Orgasm
In a study from Australia, men who used marijuana every day were four times more likely to have problems reaching orgasm than men who didn’t use weed. In addition, men who used marijuana every day were three times more likely to experience premature ejaculation than men who didn’t.
Other male daily users said they reached orgasm too slowly.
Fertility
Marijuana can also affect a man’s fertility. More specifically, THC hinders sperm cells’ ability to swim to an egg cell. And, if the sperm even reaches the egg, it will have a harder time fertilizing it.
Marijuana can also cause fertility issues for women. If a woman uses marijuana, THC can travel to her uterus, cervix, vagina, and vaginal fluids. Sperm cells that come into contact with THC from the woman behave much like sperm cells from a man who uses marijuana and the “swimmers” may have trouble reaching and then fertilizing the egg .
Therefore, couples who want to conceive are advised to avoid marijuana use.
The Bottom Line
If you’re experiencing erectile dysfunction or problems with orgasm, consider your marijuana intake. And if you planning on starting a family, you should steer clear of the weed.

This blog was modified from Marijuana and Male Sex Health, Published on May 31, 2011 on SexHealthMatters.org

Retrograde Ejaculation or Shooting Blanks

October 26, 2011

Most men experience the joy of ejaculation when the semen, sperm mixed with prostatic fluid, travels outside of the body at the time of orgasm. Retrograde ejaculation occurs when semen goes into the bladder instead of leaving the penis during ejaculation. Retrograde ejaculation isn’t harmful but it can impair fertility since it affects the delivery of sperm to the vagina during intercourse.
During normal ejaculation, internal muscles, called sphincters, close off the opening of the bladder to prevent semen from entering as it passes through the urethra. In retrograde ejaculation, the bladder opening doesn’t close properly and some or all of the semen is allowed to enter the bladder instead of being ejected out the tip of the penis. As a result, semen mixes with urine in the bladder and leaves the body during the next urination.
Retrograde ejaculation does not interfere with a man’s ability to have an erection or an orgasm. Men often first become aware that they have retrograde ejaculation when fertility problems arise. The condition also occurs after prostate surgery where the sphincters can be damaged or injured during the surgery. A common sign indicating retrograde ejaculation is if a man’s urine appears cloudy after sexual climax.
Retrograde ejaculation may occur either partially or completely. Men with incomplete retrograde ejaculation may notice a decrease in semen that comes out during ejaculation. Complete retrograde ejaculation can also be called dry orgasm or dry ejaculation since there is orgasm without the discharge of semen.
Since retrograde ejaculation isn’t harmful, it typically doesn’t require treatment unless it interferes with fertility. In such cases, treatment depends on the underlying cause.
If your doctor discovers that a prescribed medication, such as alpha blockers, is the cause, switching to a comparable medication or discontinuation of the drug often restores normal ejaculation.
Unfortunately, if retrograde ejaculation is caused by surgery or diabetes, it is often not correctable. However, some medications have been shown to improve muscle tone of the bladder neck and therefore reduce the loss of semen into the bladder during ejaculation. These medications include: epinephrine sulfate and epinephrine-like drugs (such as pseudoephedrine, imipramine, midodrin, desipramine and brompheniramine maleate).
Alternatively, men are sometimes encouraged to ejaculate when their bladder is full since having a full bladder can increase bladder neck closure.
If the above measures are not options or are not successful and fertility is still a concern, it is also possible for an urologist to retrieve sperm from a man’s urine following an orgasm and use it for artificial insemination.
It is also possible for men, prior to receiving treatments or surgeries that bring the risk of retrograde ejaculation, to have their semen cryopreserved (frozen) for insemination later.

Bottom Line: Retrograde ejaculation or sperm going backward into the bladder is not a very common problem but can be a problem if a man wishes to achieve a pregnancy with his partner. The condition does not need treatment unless a man wishes to achieve a pregnancy.

Men, Want To Become A Father? Try Taking Antioxidants!

January 19, 2011

ABC World News (1/18, story 7, 0:25, Sawyer) reported, “A new report has found that men who take antioxidants while trying to get their partner pregnant are four times more likely to succeed than men who do not. And, the type doesn’t matter — vitamin E, zinc, magnesium all work. Scientists just don’t understand why.”

 

MedPage Today (1/18, Phend) reported that “antioxidant supplements may boost fertility for men,” according to a study published in the Cochrane Database of Systematic Reviews. After pooling “the results from 34 randomized controlled trials that included a total of 2,876 couples with male factor subfertility or unexplained subfertility who were undergoing assisted reproductive technology using their own sperm and eggs,” researchers found that “men taking antioxidants were over fourfold more likely than controls to get their partner pregnant and see a successful live birth.”

Low Sperm Count? The Culprit Might Be Your Laptop Computer

December 24, 2010

Whoever invented the ‘laptop’ probably didn’t worry too much about male reproductive health.  Turns out, unsurprisingly, that sitting with a computer on your lap will crank up the temperature of your genitals, which could affect sperm quality.

It is well known that the scrotum and its contents are about one degree cooler than the core body temperature of 98.0F.  If the testicles are exposed to increased heat such as frequent hot tubs and certain occupations such as bakers and welders, it may decrease the sperm count and result in infertility. Under normal circumstances, the testicles’ position outside of the body makes sure they stay a few degrees cooler than the inside of the body, which is necessary for sperm production.

The researchers at State University of New York at Stony Brook hooked thermometers to the scrotums of 29 young men who were balancing a laptop on their knees. They found that even with a lap pad under the computer, the men’s scrotums overheated quickly. To hold a laptop on your knees, however, you need to sit still with your legs closed. After one hour in this position, the researchers found that men’s testicle temperature had risen by up to 2.50.

Nearly one in six couples in the US have trouble conceiving a baby, and about half the time the man is at the root of the problem.  This number may be much higher for men using laptop computers for long periods of time.

Bottom Line: Your laptop may be hazardous to your sperm production.  The extra heat generated to the testicles is enough to impact sperm counts. The solution may be as simple as putting your laptop on a desk or spreading your legs to allow the added heat to escape.

 

Male Infertility-It’s Not Always the Woman’s Fault

May 9, 2010

Nothing is more devastating to a couple than the inability to conceive and have a child.  Infertility is currently a problem for one out of five couples presently trying to have children.  In one-third of the couples the problem is due to a problem in the man; one-third is due to a female cause; and one third is due to both the man and the woman.  Therefore in nearly 2\3 of the couples, there is a male factor associated with the failure to conceive or for the woman to become pregnant.

Any couple embarking on an infertility work-up does so with some fear and reluctance.  It often helps to know what is ahead, to be informed and aware of how it will feel and what the doctor is hoping to find.

The nature of the infertility work-up necessitates that it become a priority in your daily life.  Suddenly, there are specific days that you must have intercourse.  In certain tests you even have to report to the doctor’s office a specific number of hours after intercourse.  As a result, spontaneous lovemaking becomes difficult.  Vacations and business trips become low priority.  Schedules have to be made to fit the demands of the testing cycle. Many women find it hard to take time off from work, especially if they don’t want it known that they are undergoing an infertility evaluation.  It is a stressful time.  Both husband and wife are being tested and scored.  There is a feeling of “pass or fail” and a real sense of despair if a test comes back showing questionable or negative results.  Women often feel frightened and violated by the infertility tests.  Men often feel helpless.  For the husband, testing is over if the semen analysis is normal.  In contrast, he may see his wife having to go through various tests which can be painful and frightening.  This understandably can upset both members of the couple.  Added to this worry and uncertainty is the lingering fear of what the doctor will find.  What if they indeed find an answer, but a discouraging one?  Suffice it to say that deciding to start an infertility workup is a big decision. (This paragraph could be deleted if you are pressed for space)

The following is an overview of the tests involved.  You may want to use it to understand what may be required medically or as a tool to double-check that you have had all the tests.

Initial Appointment

Some infertility specialists like to see the couple together for the first appointment.  This provides a opportunity for the couple to establish good communication with the doctor.  It also is an opportunity to evaluate what, if anything, has been done and what will be needed in the future.  The doctor will be able to explain tests to the couple and will give them a time frame in which he or she hopes to complete the evaluation.(Could be deleted)

The doctor will take a very careful medical history from the male. The doctor will want to know about the medical history of the immediate family.  Attention will be paid to details concerning previous surgery, infections, chronic illnesses, and hospitalizations.  Background information on smoking, alcohol intakes and medications and exposure to environmental or occupational toxins will be requested.  Of course, a reproductive history from both partners will be needed.  Details about the types of birth control practiced will be obtained.  In addition, any history of previous pregnancies should be discussed. Information about frequency and nature sexual intercourse and previous venereal disease is crucial in the evaluation.

Physical Examination

A physical examination of the male is usually done on the first visit.  The physical exam will include an examination of the genital organs, with the doctor noting size, position and condition of the penis and testes.  A rectal exam is done to determine the size and consistency of the prostate gland and seminal vesicles.  The doctor will also note the development of secondary sex characteristics such as hair and fat distribution.

The Medical Evaluation of the Male

Semen Analysis – This is the first and most informative test done on the male.  An analysis can be done any time because a man is not cyclic as women are.  Abstinence from intercourse for 48 hours before the analysis is suggested.  Abstinence for a longer period than two days is not necessary.  For the semen analysis, the doctor will ask the man to masturbate a specimen into a sterile container.  This can be done at home and kept at body temperature and delivered to the lab for evaluation.   Then the laboratory will examine the specimen under a  microscope looking for the number of sperm present, how fast the sperm are swimming (motility) and the shape of  the sperm (morphology).

A fertile semen specimen should have at least 20 million sperm, with at least 50% of the sperm motile and 50-60% with good morphology.  Normal volume is 2-5 cc.

Several additional tests may be done on the male if the semen analysis is not normal.

Evaluation for a varicocele is done by palpating the scrotum while the man is bearing down or coughing.  The link between the presence of a varicocele and infertility is not clearly understood.  The most common theory is that the presence of a varicocele causes poor circulation which ultimately inhibits normal sperm production.

In the event of a subfertile semen analysis, a small biopsy of both testicles may be done.  This procedure is done in a hospital under local or general anesthesia.  The testicular tissue is examined in the laboratory.  This test can tell the doctor if there is an absolute infertile state with no sperm-producing tissue present, or blockage in the vas deferens indicated by the presence of normal testicular tissue yet little or no sperm in the ejaculate.

Finally, if a blockage in the vas deferens is suspected during a testicular biopsy, a vasography can be done to pinpoint the area of  the blockage.  This is an x-ray study in which dye is injected into the vas deferens and a series of x-rays are taken.

Once an infertility work-up is underway it is  important that the couple get the results of each test as they are done.  Couples should ask  their doctors for explanations if need be.  It is your body and you have a right to know what is being discovered.  Sometimes it is wise to make a consultation appointment with your doctor if you feel confused or upset about the tests end results.  This is especially important if the work-up has been going on for a long time or if there is a male factor  problem as well as a female one, which is being treated by another doctor.  It is easy to feel helpless and powerless during an infertility work-up.  Good communication with your doctor can help alleviate some of these feelings.

If men have a normal semen analysis, then the focus shifts to the female partner.  For men who have decreased sperm counts or abnormal motility, there are medications that can be given to enhance the number of sperm and methods to put the sperm in contact with the egg.

Bottom Line: Infertility is problem that impacts the lives of many young couples hoping to conceive a child.  The man is cause of the problem in 50% of infertile couples.  Help is available and much can be done to help a couple make their dreams come true.