LIfestyle and Dietary Effects on Male Fertility

There is a large amount of information on the internet regarding things that you can do to improve semen analysis parameters and improve the chances of conception. In reality, the strength of the medical evidence to support their use is not particularly strong. Fortunately, most of these interventions are harmless.

 

General recommendations

 

  1. Avoidance of excessive heat. We know that excessive heat impairs sperm production. Avoid using hot tubs, saunas and jacuzzi tubs as even short term use may impair sperm production and have a negative effect on the mature sperm which have already been produced. Hot showers are perfectly fine.
  2. Avoid toxins such as cigarette smoke and marijuana. These can impair sperm production and motility.
  3. Moderate alcohol intake is fine.
  4. Under no circumstances should testosterone (including anabolic steroids) or supplements for bodybuilding be taken. Ingestion of the substances can impair production of sperm, sometimes irreversibly
  5. A healthy balanced diet with a mix of fruits, vegetables, protein and starches. It is unlikely that moderate intake of any one particular food impair his sperm production. However, soy products (e.g. tofu) contain substances which can have effects similar to estrogen and excessive consumption should be avoided.

 

Supplements, Natriceuticals, Vitamins and Other Treatments

 

Patients frequently ask about the use of supplements specifically designed to maximize fertility. At present, we lack good scientific evidence on whether most of these products have any effect on fertility. In general, you should be able to obtain everything that you need to make healthy sperm from a balanced diet. Having said that, supplemental folate and an antioxidant such as Vitamin C 500 mg per day may help. Your partner should be taking folate as you attempt to conceive since folate significantly reduces the chances of congenital spinal cord defects.

 

Supplements that may help

  1. Folate
  2. Vitamin C
  3. Zinc
  4. L-carnitine
  5. Co-enzyme Q10

 

Whether non-medical interventions such as accupuncture or naturopathy have beneficial effects on fertility is up for debate. One issue is that naturopathy and homeopathy are not based on the scientific method - they have chosen to forego scientific scrutiny of their treatments. If you have questions about the effectiveness of an intervention, you should ask your health care provider to back up their claims with scientific evidence - ideally a double-blinded randomized controlled study which was published in a respectable peer-reviewed journal. Not everything in traditional medicine meets this standard, but it is important to at least acknowledge where there is a lack of evidence. Caveat emptor ('buyer beware') applies if you cannot get a credible answer to your questions on effectiveness. The supplement and natriceutical industry is identical to the pharmaceutical industry in all respects - with two very important exceptions.

 

  1. At present, the supplement industry is not required to demonstrate efficacy (effectiveness) of a treatment. Therefore the possibility of both benefit and harm exists. The current govermental regulations on supplements are a compromise which were designed to limit an excessive burden of regulation on substances which are mainly harmless or associated with minimal harm. The current absence of any regulatory requirement to prove the efficacy and safety of supplements imposes a specific legal requirement that supplement manufacturers are not permitted to make any claims regarding the efficacy of these substances on any specific medical condition. Even though doing so is a violation of US law, it is rarely enforced which often results in misleading and false claims in advertising. The FDA has a limited ability to enforce the the supplement industry, in large part because of underfunding.
  2. There is no requirement to confirm the purity or content of any substance that is sold as a supplement. Some manufacturers are better than others. In 2010, the FDA began imposing Good Manufacturing Practice (GMP)  regulations on the supplement industry to ensure that consumers were at least getting the substance that they were paying for, if not the desired effect. Compliance with GMP means that you are getting the substance you paid for, not a guarantee of effectiveness or absence of harm.

 

Frequently Asked Questions

 

Question: Will accupuncture improve my semen analysis or the chances of a pregnancy?

Answer: Probably not. To date, there have not been any good large scale trials. Studies, all with some serious methological flaws, have shown both benefit and harm with accupuncture. My take is that any fluctuations noted in the semen analysis profiles, for better or worse, are due to normal biological variation rather than any treatment effect. There had been evidence from methodologically flawed studies suggesting that accupuncture might increase the succes of embryo transfer in women. A recent well designed randomized controlled trial published in 2010 (Andersen in Reprod Biomed Online) has demonstrated no benefit. Accupuncture is unlikely to help or harm your chances of pregnancy. As always, do what your wife tells you.

 

Question: Are boxer shorts better than briefs?

Answer: There appears to be no difference in either semen analysis parameters nor the chances of conception depending on your underwear. This has been studied a fair amount. There does NOT seem to be any significant effect on the chances of pregnancy.