Fertility and the likelihood of conception is impacted by many variables, from age and genetics to your partner’s health and the toxins in your environment. The goal is to understand as many of your personal variables as possible so you can reduce any that may have a negative impact on conception.
If you and your partner have been trying to conceive for a few months without luck, checking your partner’s fertility and sperm health is a great place to start. There is no “wait time” to have a semen analysis done — you don’t have to wait a year or six months, and it can be completed at the time of your choosing. Male infertility contributes to nearly 35 percent of infertility cases, and about 10% of infertility cases are solely due to male infertility, meaning sperm is the reason conception has not occurred.
Causes of Male Infertility
Understanding factors that affect male fertility helps you both achieve your pregnancy goals.
Lifestyle Choices
Lifestyle factors such as diet and exercise, vaping or smoking (i.e. nicotine, marijuana), consuming alcohol, not drinking enough water or staying hydrated, and not maintaining a healthy weight can affect male fertility.
Medical Conditions
Your partner’s medical history also impacts their fertility. Chemotherapy, varicocele repair, trauma to the testicles, and abnormalities of the tubules that transport sperm all impact male fertility. Genetic abnormalities and male hormonal imbalances also affect sperm quality.
Recent illness or fever (in the past three months) and medication use, like certain hair growth products and taking testosterone (which kills sperm) are not safe for sperm health.
Similarly, some infections interfere with sperm production, and can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections including gonorrhea or HIV.
Antibodies That Attack Sperm
Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
Hormone Imbalances
Male infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone and other hormonal problems have several possible underlying causes.
Environmental Issues
Overheating the testicles and being exposed to industrial chemicals, heavy metals, or radiation on the job, or in and around the home can reduce sperm production, and in some cases, the effects are permanent.
How a Semen Analysis Can Help
When it comes to sperm health, you could use your ovulation tests perfectly and have a beautiful LH surge and great BBT rise, but if the sperm is impacted, your chance of pregnancy can be drastically reduced. Also, prior pregnancies years ago do not ensure that the sperm is still healthy and able to create a normal embryo.
It is always best to rule out the possibility of sperm being an issue or find a variable that causes conception to take longer than expected — and that’s where a semen analysis helps.
Sperm formation takes about 74 days from start to finish, then approximately 12-21 days for transport. This means that what happened over the past three months affects the current quality and concentration of the sperm.
Signs of Unhealthy Sperm
A semen analysis measures three major factors of sperm health:
- The number of sperm
A healthy sperm count has a volume of 1.5 mL to 6.0 mL and a concentration of about 15 million or more per milliliter (mL) of semen (the discharge in a single ejaculation). You have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate. Too little sperm in an ejaculation might make it more difficult to get a woman pregnant because there are fewer sperm to fertilize the egg.
- The shape of the sperm (morphology)
A normal sperm has a smooth, oval-shaped head (5-6 micrometers long and 2.5-3.5 micrometers wide) with a long tail. The head shape is important because it affects the sperm’s ability to dissolve through the outer surface of an egg and fertilize it. The more normal shaped sperm you have, the more likely you are to be fertile. Also known as a Krueger analysis, this metric is vital to understanding the health and ability of sperm to fertilize an egg and it should be greater than 3%.
- Sperm motility
Motility looks at how the sperm are moving and whether they are swimming fast, slow, straight, or in a circle. Progressive motility refers to sperm that swim in a straight line or in very large circles. Non-progressive motility refers to sperm that move but do not swim in progression or swim in very tight circles. Progressive motility is needed for the sperm to swim their way up the female reproductive tract. You are most likely to be fertile if at least 40% of your sperm are moving progressively.
Semen analysis results that show low numbers can be a sign of unhealthy sperm and possible male infertility. It’s best to see a urologist to learn more and understand why. If something in the results looks unusual, the doctor might order more tests to identify the problem.
If the first semen analysis is normal, the doctor may order a second test to confirm the results. Two normal tests usually mean your partner does not have any significant male infertility problems.
Increase Sperm Health to Increase Chances of Getting Pregnant
Your partner’s primary care provider can order a semen analysis or, in some cases, your OB/GYN may write a referral for your partner. Many fertility clinics also have “community days” where you can get an analysis done without having to be an active patient there.
Not all types of male infertility are preventable, but by making healthy choices in your daily lives, you can avoid common causes of male infertility.
While trying to conceive, your partner should consider:
- Removing behaviors that negatively impact sperm quality such as smoking, vaping, and excessive alcohol or marijuana consumption.
- Drinking enough water and staying hydrated to improve the amount of seminal fluid and overall volume.
- Maintaining a healthy weight and diet. Exercise, sleep, and what you and your partner eat matters. Move daily, eat more antioxidant-rich foods, and introduce healthy omega-3 fats into your diet to help increase sperm count.
- Reducing exposure to toxins. A low morphology number, called teratospermia, is commonly caused by toxins in your partner’s environment. A healthy, non-processed diet can limit exposure to toxins. Additionally, taking a high quality fish oil supplement and consuming a serving of walnuts daily can help combat everyday toxins.
- Taking necessary steps to mind your emotional health and manage or reduce anxiety and stress. High levels of stress can impact both male and female fertility and female.
And no, your partner doesn’t have to change up the type of underwear he wears. Newer fertility studies show that the type of underwear worn by men does not impact overall fertility and is not a limiting factor.
Throughout the process, keep tracking your own fertility symptoms with Premom, the free ovulation tracker app. When you receive your partner’s semen analysis results, add the notes to your app as another useful reference point — this ishelpful when you book a virtual consultation with one of our Premom fertility specialists and/or your OB/GYN.
References
https://www.healthline.com/health/mens-health/normal-sperm-count
https://www.ucsfhealth.org/medical-tests/003627
www.uptodate.com/contents/male-reproductive-physiology
Jung A, Schuppe HC. Influence of genital heat stress on semen quality in humans. Andrologia 2007; 39:203.
Smith LB, Walker WH. The regulation of spermatogenesis by androgens. Semin Cell Dev Biol 2014; 30:2.
Pinilla L, Aguilar E, Dieguez C, et al. Kisspeptins and reproduction: physiological roles and regulatory mechanisms. Physiol Rev 2012; 92:1235.
