Archive for the ‘male infertility’ Category

Turing On Your Laptop May Turn Off Your Sperm Count

September 28, 2016

Go onto any college campus or into any Starbucks and you see nearly every person pecking away on their computers.  Some men will balance their laptop computers on their laps.  As a result the heat from the laptop raise a man’s scrotal temperature a very small amount.  This small elevation of temperature, if done often enough, may decrease a man’s sperm count.

Elevated scrotal temperatures have been linked to poor sperm counts according to a study at New York University.  Other situations that can raise scrotal temperatures including hot baths, saunas, and the wearing of tight jockey shorts.

The study which was reported in the Journal of Human Reproduction measured the scrotal temperature every three minutes between men holding computers on their laps which were turned on and men holding computers which were left in the off position. Those men holding a working lap top computer had a 5 degrees Fahrenheit increase in scrotal temperature.  Also noted was that men with their thighs held close together had the greatest increase in scrotal temperature. The researchers concluded that “Working on laptop computers in a laptop position causes significant scrotal temperature elevation as a result of heat exposure and posture-related effects.”

The main question is the increase in temperature enough to impair male fertility? The researchers didn’t conclude the connection between laptop use and sperm counts. However, the authors noted that another study showed that sperm concentration dropped by 40% when median daytime scrotal temperature rose by 1 to 2 degrees Fahrenheit.

Bottom Line:  I know for sure that more heat to the scrotal area is going to be deleterious for sperm production.  Therefore, I suggest that young men or men in the fertility age group may want to limit their use of laptop computers on their laps.

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What Women Need To Know About Their Partner’s Health

September 18, 2015

Women are drives of healthcare. They are responsible for helping to see that their partners take good care of themselves. My wife makes an appointment for my annual physical exam each year and accompanies me to the doctor to be sure that I explain all of my concerns and that she has the instructions for the recommendations and follow up. I don’t think my situation is unique as most women not take care of themselves but also the healthcare of their partner. This article will discuss 5 conditions that can impact a man’s health and should come to the attention of a physician\urologist.

Erectile dysfunction is often a sign of something more serious. About 70% of ED cases are caused by existing medical conditions, such as high blood pressure, diabetes, high cholesterol or heart disease. The more advanced these diseases are, the more at risk a man is for ED. In most cases, ED is treatable. If you loved one has ED, encourage him seek medical care.

Prostate cancer is the second most common cancer in men. About 1 in 7 men will be diagnosed with prostate cancer. The number jumps to 1 in 5 if he’s African-American and 1 in 3 if he has a family history of prostate cancer. Men should know their risk and talk to their doctors about whether prostate cancer screening is right for them.

Male infertility is more common than you think. In about 40% of infertile couples, the male partner is either the sole cause or a contributing cause of infertility.

If he has blood in his urine, pay attention. This can be a sign of a urinary tract infection, kidney stone, enlarged prostate or an early sign of bladder or kidney cancer. All men who have blood in the urine should see their doctor\urologist.

Testicular cancer is the most common cancer in men ages 15-35. Although there is nothing to prevent testicular cancer, if the cancer is caught early, there is a high cure rate. Signs of testicular cancer include persistent pain or a bump in the testicular area.

Finally, if they are going to the bathroom more than three times each night, they should be seen by a doctor. This could be a sign of a prostate or bladder problem, or potentially something more serious.

Bottom Line: Men have unique medical problems and women can be so helpful in directing men to a healthcare provider. I hope this article should be kept in mind regarding your male loved one’s medical health.

Sperm Counts Really Do Count-Improving Sperm Quality

March 24, 2015

Infertility affects 24% of couples wishing to have a baby. Nearly 1\3 are due to female causes, 1\3 to male causes, and 1\3 are due to both the man and the female partner. Therefore, men are involved in 2\3 of the problems that are responsible for failure to achieve a pregnancy. The first test for any man is the semen analysis. This test is obtained after two days of abstinence or no ejaculation and submitted for a sperm count, sperm movement or motility, and the shape of the sperm.

The world’s largest study on the effects of lifestyle on the quality of sperm has been published this week, with some surprising findings.
Researchers at the universities of Manchester and Sheffield found that smoking cannabis can have a severe effect on male fertility, yet other lifestyle choices such as drinking alcohol and wearing tight briefs were not considered to cause problems, despite earlier reports suggesting otherwise.

Sperm quality has been in decline for decades, and scientists seem unable to make up their minds as to the exact causes, citing everything from smoking to an increased exposure to estrogen.
The latest evidence is good news for jockstrap-wearers and bad news for dope smokers, but how else can you improve your sperm count? Here are five recommendations from leading experts:

1. Eat red food
Last month a report published by Ohio’s Cleveland Clinic, following analysis of 12 studies conducted by different groups around the world, found that consumption of lycopene improved the quality, mobility and volume of sperm dramatically, increasing sperm count by up to 70 per cent. Lycopene is an essential nutrient found commonly in red fruit and vegetables such as tomatoes, strawberries, cherries and peppers.

2. Lay off the laptop
A 2011 study published in the journal Fertility and Sterility suggested there could be a link between using a laptop with a Wi-Fi connection and a reduction in sperm quality. Sperm samples from 29 men were stored normally and under a laptop connected to WiFi. The sperm stored under the laptop became more sluggish and showed signs of DNA damage.

3. Get off your bike
Cycling has myriad health benefits, but not when it comes to your sperm. A 2009 Spanish study found that a prolonged spell on your bike can severely affect the shape and quality of your sperm. After monitoring 15 Spanish triathletes with an average age of 33 the study found that those men that cycled 300 kilometers a week (about 160 miles) – had dered a fertility problem.

4. Keep your cool
The optimum temperature for sperm production is 34.5 degrees celsius, which is slightly below body temperature. A three-year University of California study in 2007 found that five out of 11 men who stopped taking hot baths (including saunas) experienced a sperm count rise of almost 500 per cent.

5. Drink coffee – Go For Joe-but not too much
In 2003, researchers from Sao Paolo University in Brazil studied 750 men and concluded that drinking coffee can improve the swimming speed, or motility, of human sperm, although whether this means pregnancy rates are higher among coffee drinkers is unclear.

Bottom Line: Men are part and parcel of the baby making equation. If you have any questions, see your urologist and start with a sperm count.

Low T-Is Clomid a Solution For Men Who Wish To Have Children?

February 19, 2015

I am now seeing many younger men with low testosterone levels who have symptoms of lethargy, decreased libido, and problems with their erections. Upon further testing, many of these men are found to have low testosterone levels or low T. This blog will discuss the use of Clomid for the management of younger men with low T levels.

Whether you are a 30, 50, 80 or even 110 year old man, having low testosterone levels (hypogonadism) is neither fun nor healthy. The symptoms of low testosterone in men range from lack of energy, depressed mood, loss of vitality, muscle loss, muscles aches, low libido, erectile dysfunction, and weight gain.
Low testosterone in men may be caused by problems in the testes (or gonads). This is called primary hypogonadism and can be brought on by the mumps, testicular trauma, or testicular cancer, etc., and is often treated with testosterone replacement therapy.

Traditionally, if low testosterone is diagnosed, testosterone replacement therapy is prescribed, and it most commonly comes in the form of a cream, gel, pellet, patch, and by injection. And although these types of therapy are effective, some methods are better than others, and there are side-effects with all of them. For example, testicular shrinkage, gynecomastia (breast enlargement), low sperm count/sterility, and polycythemia (overproduction of red blood cells) are common side-effects of testosterone replacement therapy.
However, specifically due to the risk of sterility and low sperm count, such testosterone treatments aren’t a good option for men who want to have children. In these young men, clomiphene citrate (or Clomid) and/or human chorionic gonadotropin (HCG) have been used for decades to increase testosterone production, increase sperm production, and increase fertility. Both these therapies effectively help stimulate the testes to produce testosterone and thereby increase testosterone levels.

Clomid works by stimulating the pituitary gland to make more LH and there is an increased production of testosterone by the testes. HCG works by mimicking LH, which also increases the release of LH to produce more testosterone in the testes. I caution you that using testosterone in a young man wishing to have more children does the opposite of what clomiphene and HCG do and can shut off the release of LH and thus affect the testicles production of testosterone and affect sperm production.

With traditional testosterone replacement therapy, the brain (hypothalamus and pituitary) gets the message that there is plenty of testosterone being made in the testes, so much so that it doesn’t need to make anymore. Subsequently, the pituitary stops producing LH, and the natural production of testosterone (and sperm) in the testes ceases, which is why traditional testosterone replacement results in testicular shrinkage and low sperm count. Clomiphene citrate and/or HCG do not turn off the testosterone manufacturing plant but rather turn it back on or reboot it. While some hypogonadal men require continuous use of clomiphene, for others it can be used for a 3-6 month time period and then discontinued. And, the checks and balances system is not interrupted, so there aren’t the testosterone replacement side-effects which may occur with tstosterone injections, gels, or pellets.
The 5 Main Reasons Clomiphene Citrate (Clomid) May be a Good Alternative to Testosterone Replacement Therapy in Men with Low Testosterone Due to Secondary Hypogonadism:
1. Clomiphene citrate stimulates the body’s own production of testosterone
2. Clomiphene citrate doesn’t interfere with the body’s checks and balances of testosterone
3. Clomiphene citrate comes as a pill easily administered by mouth
4. Clomiphene citrate is generic and very cheap
5. Clomiphene citrate has little side-effects and low risk of developing these side-effects

Bottom Line: Clomid is a treatment option in young men with low T who wish to continue to have children.

Low T (Testosterone) May Mean No Baby

February 19, 2015

I am often seeing men with symptoms of low testosterone levels who are still planning to have children. These men need to know that the standard treatment of hormone replacement may not apply to those men who are still interested in having children. This blog will discuss the management of men with low T and who wish to continue to have children.

Testosterone replacement therapy (TRT) can bring your testosterone levels back to normal and restore your sex drive.
But if you want to have children, there’s one downside to TRT you should know about. It gives you back your sex life, but it might also reduce your ability to father children as long as you’re on it.
Testosterone replacement therapy has a profound impact on a man’s reproductive potential.

Approximately 90% of men can drop their sperm counts to zero while on testosterone. By increasing testosterone, you’re not going to increase fertility.

Testosterone, the hormone produced in the testicles, plays an important role in making sperm. Your brain makes special hormones, called gonadotropin-releasing hormones (GnRH). These hormones signal the testes to make more testosterone, vital for a healthy sperm count. When you’re getting testosterone replacement therapy, testosterone is added into the bloodstream by patches, gels, or other treatment methods such as pellets placed under the skin. Your brain interprets this rise in testosterone levels as a sign that you now have enough testosterone. So it stops sending signals to the testes to make more testosterone. But when your testes don’t make more testosterone, your sperm production goes down.
Therefore, a low sperm count makes it harder to conceive a child. My advice is that if you have any kind of reproductive goal, you should not be using TRT.

If you have low testosterone, one way to improve sperm count is with gonadotropin injections. This stimulates the production of sperm. It may be considered as a way to increase a man’s fertility when your partner are having trouble conceiving a child.
It’s standard practice to check a man’s sperm count when a couple has difficulty getting pregnant. If your sperm count is low, the next step is to measure your testosterone. If it’s below normal, we can then inject the signal to produce more testosterone by giving a gonadotropin.

You should also make sure to follow a lifestyle of regular exercise and a healthy diet if you want to father a child. Overweight and obese men tend to have lower testosterone levels because excess belly fat converts testosterone to estrogen, another hormone that can impact sperm production. Shedding those extra pounds will likely have a positive effect on your fertility. Losing weight can definitely increase testosterone.

Bottom Line: If you have symptoms of low testosterone levels or if you have an abnormal sperm count, hormone replacement with testosterone is not the treatment of choice. You should consider gonadotropin injections as a solution.

Common Causes of Infertility in Men

August 28, 2013

Sperm making contact with egg

Sperm making contact with egg


About 10 percent of reproductive-age couples in the United States will have difficulty getting pregnant. About 30 percent of cases are due to fertility problems in the man, 30 percent to fertility problems in the woman, and the rest to unexplained causes or multiple factors involving both partners.

If you’ve had regular, unprotected sex for more than a year (or six months if you’re over 35) without conceiving, see your doctor. The National Infertility Association says at least half of those who have an infertility evaluation and treatment will be able to have a successful pregnancy.

A reproductive urologist can identify male fertility issues, recommend treatment options, and help couples decide which options to pursue. You also may want to see a genetic counselor. Sometimes, there’s a genetic reason for male infertility that could be passed down to children. A genetic counselor can help couples understand their options for conceiving.

Read on to learn about the common causes of infertility and available treatments. Keep in mind that success rates may vary because one couple can have multiple fertility problems.

Lifestyle factors. Making healthy choices can improve your fertility. You may be at greater risk of having trouble conceiving if you:

• Smoke;
• Drink alcohol heavily; Use drugs;
• Take anabolic steroids;
• Take certain medications, including testosterone replacement therapy;
• Have been treated for cancer;
• Have poor nutrition;
• Are significantly over- or underweight;
• Are exposed to toxins, such as pesticides or lead.

If you have any of these risk factors, be sure to tell us about it during your consultation.

Blockages. A small percentage of men have a blockage in their ejaculatory duct that prevents sperm from getting into ejaculate fluid. If your vas deferens or epididymis tubes are blocked or damaged, they can prevent your sperm from getting to your partner’s egg. Infection, injury, congenital defects, or a vasectomy could cause this blockage.
• Possible solutions: Surgery to repair an obstruction or reverse the vasectomy, or surgery to remove sperm for in vitro fertilization (IVF).
• Varicocele. Varicoceles (enlarged veins, similar to varicose veins, in the scrotum) raise the temperature in the testes, which may affect sperm production.
Possible symptoms: Some men have scrotal pain, and others have no symptoms. (The problem can be detected through a physical exam or ultrasound.)
Possible solutions: Surgery to repair the varicocele, artificial insemination, or IVF.

Irregular sperm. If you have little to no sperm, poor sperm motility (ability to move), or abnormally shaped sperm, your sperm may not be able to fertilize your partner’s eggs.
Possible solutions: fertility drugs; artificial insemination with donor sperm (or with your own if your count, shape, and motility are not too abnormal), or intracytoplasmic sperm injection (ICSI).

Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man

July 17, 2013

Normal appearing male sperm

Normal appearing male sperm


Where Have All the Young Sperm Gone? Decreasing Fertility of the Millennial Man
A recent article in the Wall Street Journal (Tuesday July 16, 2013) points out that there by a “sperm crisis” because they believe men’s sperm counts have been decreasing for a decade or more.

A 15 year study in France reported that the sperm concentration of men decreased by nearly one-third between 1989 and 2005. In the U.S., some historical data suggest a decrease in sperm count among American men, but no published recent data exist.
Suspected causes include exposure to pesticides, endocrine-disrupting chemicals like Bisphenol A and lifestyle habits like sitting for too long contribute to the proposed sperm crisis. Also, I reported how men who use lap top computers on top of their genitals for long periods of time, increase the heat to the testicles and the cells that are responsible for sperm production.

In general, men produce upward of 60 million sperm per milliliter of semen. As long as the count is roughly greater than 40 million per ml, men are considered fertile and have the same chance of getting their partners pregnant as someone who produces a higher count. But below that threshold and particularly under about 20 million per ml, their ability to conceive decreases.

Accumulating evidence suggests that early life influences make a difference. Some researchers say that there is a vulnerable period, perhaps between eight and 14 weeks of gestation, in which influences are irreversible. One of the most robust links with decreased sperm count is maternal smoking during pregnancy.

The male’s own current marijuana use was also linked to lower sperm count.

In additional to maternal smoking, there are environmental and lifestyle factors that can affect sperm count which include: shampoos containing phthalates found in plastic bottles, sedentary jobs especially for over hours at a time, hot water such as frequent hot baths which increase scrotal temperature, fatty food appear to contribute to a low count but this impact is potentially reversible.

Bottom Line: By adopting a healthy, balanced diet and lifestyle in pregnancy, you can give your developing baby the very best start in life which will minimize the risk of future decreases in sperm counts.

Why O “Y” Has My Sperm Gone: Male Infertility

January 5, 2012

Did you know that a man’s sperm production is tied to his ability to have male offspring? When sperm counts decrease, so do the Y chromosomes and it is the Y chromosome that is responsible for siring a son.

In the past it was always thought that having an X chromosome on the sperm made girls and Y made boys and it was just a mere 50-50 coin flip. Now a recent study from Stanford University has demonstrated that men having a low sperm count, or less than five million sperm per cubic centimeter, had fewer Y chromosome and thus less likely to have male offspring.

The next study is going to look at whether treatments that are used to increase sperm counts may affect the ratio of X to Y chromosomes.

Will keep you posted on this piece of important information!

Take Two And Call Me In The Morning-Sex Not Aspirin

January 30, 2011

In the past, this blog focuses on wellness, exercise, and mental health.  In this issue I will devote to the benefits of having intimacy with your partner.  Who would ever imagine that an activity that is so much fun could be so beneficial to your health.

Sexual intimacy is a form of exercise.  Each time that you engage in the sex act you burn approximately 100 calories.  Of course, if you have sex like Lady Chatterly’s Lover, then it’s a lot more.  Now 100 calories a pop doesn’t sound like much, but if you engage in sex 2-3 times a week, that’s 5000-7500 calories a year.  That’s equivalent to the energy required to jog from New Orleans to Mobile, Alabama.

In addition to the aerobic work out of huffing and puffing and increasing your heart rate, sexual activity provides resistance training.  This is the contraction of the muscles of the back, pelvis, and extremities against passive resistance.

Another advantage of regular sex is that it can actually lower your total cholesterol level, and increase the high-density lipoproteins (HDL) or the good cholesterol.  So if you indulge yourself in an extra steak with butter, indulge yourself in extra sex and you’ll be calorically even.

Sex also jump-starts your hormones.  Men can have a surge of testosterone during sex.  Testosterone is the hormone produced in the testicles that is responsible for libido or sex drive, muscle mass, and strength of bones.  Regular sex increases the level of estrogen in women which results in increase in the blood supply to the vagina keeping the vaginal tissues young, supple and moist.  There is even evidence that sex prior to or at the time of the menstrual period may relieve the symptoms of premenstrual syndrome (PMS).  There are other studies that suggests that oxytocin, a hormone secreted by the pituitary gland during sexual intimacy, contributes to long-term bonding between partners.

Sexual intimacy also results in the release of endorphins which is the ultimate painkiller or analgesic.  Endorphins are many times more potent that morphine, the most powerful man-made analgesic in use for the relief of pain.  So the next time you have a headache, don’t turn down sex but turn on and your relief is just a few minutes in the sack away.  There’s even a scientific explanation for the relief of headache pain with sex.  During sex there is an increase in the blood supply to the muscles and the genital organs.  As a result there is a decrease in the blood supply to the brain thus taking the pressure off of the tension in the brain.

For men, sexual intimacy is protective for the prostate.  Prostate infections and prostate enlargement, which begins after the age of 50 in most men, result in compression of the urethra, the tube in the penis that allows transmission of urine from the bladder to the outside of the body.  As a result men complain of difficulty with urination.   For dozens of years,  older men have gone to the doctor to have their prostate gland massaged to express the retained secretions that produce many of the symptoms of prostate disease.  For most men this is uncomfortable and expensive if you don’t have Medicare or insurance to pay for the doctor’s visit.  One inexpensive and fun way to relieve these symptoms produced by an enlarged prostate gland is to engage in sexual intimacy either through intercourse or even masturbation.   Both will produce prostate pleasing results.  So if you want to be good to your prostate gland, be good to your significant other….in bed.

Sex is good for stress.  Never let the sun set on an argument.  Having sex is an effective method of reducing the tensions that exist between partners.  You can’t be arguing when you are having good sex.

So for those of you who are not interested in going to the YMCA or a health club, you can have the benefits of a health club not in your own back yard but in your bedroom.   There are naysayers that say this is fooey. Take Two and Call Me In the Morning-Not Aspirin, But Sex. For those of you who need more motivation, give me a call and I’ll write you a prescription!

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.