Shooting blanks when you want a baby

Dear Dr. G,

My wife and I, who are both thirty-two-years old, have been trying for a baby since we were married three years ago.

Of course, we are both anxious there has been no positive outcome, despite us being sexually active.

We both understand the miracle of conception and childbirth takes time.

We are glad we avoided all that festive gathering inquisitions during the pandemic, however we are bracing ourselves for all the well-meaning uncles and aunties, when the inevitable questions about parenthood are raised.

We have been dreading Chinese New Year and went to see the Doctor recently.

I was shocked when the tests were completely normal for my wife but sadly my sperm count revealed some “short-comings” on my part.

The doctor said I have oligospermia, which apparently means low sperm count.

Therefore, I am putting Dr. G on the spot for my New Year Resolution on boosting my fertility.

Can you please tell me the causes of low sperm counts?

Am I correct in saying that most times it is due to lifestyle?

I would like to know what food can help increase my sperm production.

I understand this is a numbers game and keen to follow your advice to make the mark.

I know it might be too late for this Chinese New Year, but I am determined for us to have a baby before the next CNY.

On that note, wishing you and your readers Gong Xi Fa Cai.

Regards

Breeding Bret

The World Health Organization (WHO) estimates 1 in 10 couples may suffer from infertility problems. The number has been revised to 1 in 6 in recent years as couples postpone having a baby till later in life. Researchers also revealed around one in every three cases of a couple’s infertility was due to low sperm count. Poor quality of sperm can be caused by oligospermia, which simply means 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)

The “goal posts” for this “numbers game” have shifted in the last few years. For many decades, the low counts were defined as a concentration of less than 20 million sperm /ml of ejaculate. The WHO has recently reassessed the criteria and established a lower reference point of 15 million sperm/ml, consistent with the 5th percentile of ejaculate for normal men, possibly the sign of the time. The severity of oligospermia can also be further classified as mild, moderate and severe, ranging from 10 to 20 million, 5 to 10 million and less than 5 million, respectively. The severity of oligospermia helps clinicians to determine the mode of treatment, which can range from lifestyle changes to test-tube babies.

As such, a man’s sperm count can fluctuate, and oligospermia can be a temporary setback due to a person’s poor state of health.

That said, while infertility is not always treatable, measures can be adopted to boost the chances of conceiving. Fertility can sometimes be improved with a healthy diet, supplements, and other lifestyle strategies.

A person’s nutritional status and dietary habits have been shown to have a significant impact on sperm quality, and as such the choice of food plays a significant part in the ability to conceive. Naturally, a balanced diet that has less meat with plenty of whole grains and lean proteins as well as more fruit and vegetables is encouraged.

Although the scientific evidence regarding vitamins and minerals helping conception is not robust, incorporating some nutrients can have a positive impact on gametes. These include zinc and selenium, which may be deficient in sub-fertile men. Natural sources of such nutrients are lean beef, baked beans, nuts and eggs. However, supplements such as D-aspartic acid (D-AA) has been shown to increase testosterone levels by 30% and sperm quality by 60% over three months.

A possible link between poor sperm motility and Vitamin D deficiency has also been demonstrated. Oily fish, breakfast cereals and plenty of sunlight can enhance the Vitamin D absorption, which may be crucial for the healthier sperm. On the other hand, folate-rich food such as broccoli, spinach and potatoes, can have a positive impact on this numbers game.

Many scientists also believe antioxidants may improve the quality of sperm by decreasing free radicals which destroy cells. Hence Vitamin A, C and E and a wide range of fruits and vegetables, can protect those hardworking cells. One study on infertile men revealed 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%.

In the journey to fertility, the first step is often the acknowledgement that a couples’ fertility issues are not completely of a female origin. When the relatives start asking young childless couples when they are going to take on the responsibility of parenthood, it is hard to avoid that feeling of failure, and start setting targeted timelines.

When Dr. G is put on the spot by desperate men who want a quick fix for their infertility, his advice is to work on gradual improvement. Often, the alteration in lifestyle is the only key to recovery for spermatogenesis.