Dear Dr G,My wife and I have a dilemma in life, and we are hoping for a solution.We have been married for more than ten years and always assumed we could start a family when our careers were stable in our late thirties.Little did we know that when we started planning for a baby in our late thirties, it would not be as straightforward as having sex during the fertile period of ovulation.My parents told me it must be due to some fertility issue related to my wife.However, at the back of my mind, I suspected our fertility issue lies with me.True enough, when we saw the doctors, my sperm counts did not really make the mark, and nothing abnormal was detected in my wife.I was told my sperm quality is simply not good enough to get my wife pregnant.In fact, we were told to get on with IVF as soon as possible.Both of us are not keen on IVF just yet, as we consider this method of pregnancy unnatural, and we also do not have enough savings to embark on the treatment.When we put this forward to the doctors, they were supportive and asked me to buckle up with a healthy diet and lifestyle to improve my poor-quality sperms.I am determined to make this happen and willing to be guided along the way.Therefore, I am putting Dr G on the spot for detailed clarification to reverse my misfortune in infertility.Before we begin, can you tell me how common is male-related infertility?What dietary adjustments should I consider to enhance sperm quality?What lifestyle changes should I observe to ensure spermatogenesis improves?Lastly, when do I call it a day and surrender to IVF?Regards,Infertile Ian THE World Health Organization (WHO) estimates that about 1 in 7 couples globally are affected by infertility, with male factors contributing to roughly half of all cases. Male infertility typically stems from problems with sperm production, function, or delivery. Researchers revealed that poor quality of sperm can be caused by oligospermia, simply referring to semen content with a low concentration of sperm. However, male factor infertility is also associated with poor morphology and motility, a condition known as OAT syndrome (Oligo-Astheno-Teratospermia). As couples are delaying family planning until later stages of their lives, the issue of infertility will continue to rise. Sperm counts are well-recognised to fluctuate due to the frequency of ejaculations, and oligospermia can be a temporary setback due to a poor state of health. However, several lifestyle factors heavily influence the quality of sperm. Smoking, excessive alcohol, obesity, poor diet, illicit drug use, heat exposure, and contact with environmental toxins such as pesticides and heavy metals can all adversely affect spermatogenesis. In addition, male fertility declines gradually with age, with sperm motility and DNA integrity decreasing over time. Certain foods, such as those in the Mediterranean diet, have been shown to have a significant positive impact on sperm quality. Further analysis of such a diet revealed that a diet rich in antioxidants, vitamins, and healthy fats is associated with better sperm parameters. Here are key nutrients and foods that support male fertility: Zinc and Selenium, found in lean beef, baked beans, nuts, and eggs, support testosterone production and sperm formation. In addition, supplements such as D-aspartic acid (D-AA) have been shown to increase testosterone levels by 30% and sperm quality by 60% over three months. The possible link between poor sperm motility and Vitamin D deficiency was also demonstrated. Oily fish, breakfast cereals, and plenty of sunlight exposure can enhance Vitamin D absorption, which may be crucial for healthier sperm. In addition, foods and supplements rich in Omega-3 are well-recognised to enhance sperm quality. On the other hand, folate-rich foods such as broccoli, spinach, and potatoes can also have a positive impact on this numbers game. Many scientists also believe antioxidants may improve the quality of sperm by decreasing the free radicals which destroy cells. Hence, Vitamin A, C, and E, along with a wide range of fruit and vegetables, can certainly protect those hardworking cells in the scrotum. One study revealed that infertile men showed that taking 1,000-mg vitamin C supplements twice a day for up to two months increased sperm motility by 92% and sperm count by more than 100%. It also reduced the proportion of deformed sperm cells by 55%. Beyond diet, several lifestyle adjustments can significantly improve male fertility. Obesity lowers testosterone, increases estrogen, and reduces sperm quality. Therefore, aim for a BMI in the normal range via a balanced diet and exercise. Moderate exercise improves hormone levels and sperm quality. Smoking damages sperm DNA and reduces count and motility, and the benefits of quitting can be seen within a few months. Excessive drinking and illicit drugs are well-known to lower testosterone and sperm quality. In addition, adequate hydration, sleep, and minimal stress are all crucial lifestyle changes to enhance the quality of sperm. Male infertility can be multifactorial, but many causes are modifiable. Improving diet with fertility-supporting nutrients, adopting a healthy lifestyle, and avoiding harmful exposures can significantly enhance sperm quality and fertility potential. In the journey of male ability to fertility, the first step is often acknowledging that couples’ fertility issues are not completely of female origin. Dr G is often put on the spot by subfertile men wanting to reverse the misfortune of infertility. His advice is that alteration in lifestyle is the only key to recovery for spermatogenesis and a healthy path to fatherhood.
