A Review on Male Infertility-Part 2

Prevention and Management of Male Infertility

 The first part of this article is dedicated to outlining some of the common factors that can induce male infertility. It was also previously mentioned that the effects of many of these factors are reversible upon discontinuing use and exposure.

There are so many other risk factors that contribute to the development of infertility that has not been mentioned in this article. Examples include alcohol-derived liver damage (cirrhosis), fatty liver disease, psychological stress, and some sexually transmitted infections such as chlamydia In this article, we are going to outline some behavioral and lifestyle modifications that can foster reproductive health benefit.

Scrotal Temperature

Exposure to heat has a deleterious effect and is considered a significant risk factor for male infertility. Increased scrotal temperature can lead to hormonal imbalances that increase sperm cell death. For example, varicocele, a disorder characterized by the loss of the ability to regulate the temperature of the testes, is the most common cause of infertility and affects about 15% of the male population.

Some risk factors for accumulation of heat (hyperthermia) in the scrotum include prolonged sedentary time (lack of air circulation and increased heat transfer from thighs), obesity, occupational heat exposure (in the case of baking or welding), high environmental temperature and seasonality (higher incidence in summer compared to winter), and using a laptop in a lap position close to genitals. Accordingly, scrotal cooling can improve sperm count, motility and function.

Effects of Physical Activity

Light physical activity increases movement of legs that allows for better ventilation and dissipation of heat. Simple but significant measures can be taken to reduce the impact of heat stress. This includes preventing sitting for an extended amount of time, wearing clothing that does not restrict genital airflow, maintaining a healthy weight, and modifying behavior such as avoiding sauna and hot baths.

Exercise is an effective way of enhancing reproductive health. Resistance and moderate-intensity aerobic exercise improve fertility by promoting testosterone production. In contrast, long term exhaustive aerobic exercise can worsen sperm quality and harm the reproductive potential 

Nutrition and Supplementation Therapy  

Research suggest that supplementary intake of certain factors can enhance reproductive health. For example, carnitine provides the body with an energetic substrate that enhances sperm motility and maturation.

Zinc deficiency is associated with decreased testosterone levels and sperm count. Subsequently, an adequate amount of zinc intake ensures proper sperm motility and production. Studies have shown that low levels of vitamin C lead to infertility and increased damage to sperm’s genetic material.

Vitamin E is a well-documented anti-oxidant and has shown to prevent infertility. Oral vitamin E supplementation improves sperm quality, resulting in higher probability of achieving pregnancy. Glutathione and selenium are vital to the sperm antioxidant defense.

Deficiency of these supplements leads to defects in sperm motility. Lastly, coenzyme Q-10 is used for energy production in sperm and it also has an anti-oxidant function The take-home message is that an anti-oxidant rich diet concurrent with a suitable supplementation regimen is an effective way in enhancing reproductive health.

Author: Parsa Nafari, Bachelor of Science, Kinesiology 

Reviewed by: Dr. Pari Saharkhiz, M.D.  

Reference as they appear in the article: 

1. Sinclair, S. (2000). Male infertility: nutritional and environmental considerations. Altern Med Rev, 5(1):28-38.
2. Plessis, S. D. S., Agarwal, A., & Jr., E. S. S. (2016). Testicular heat stress and sperm quality. In Male infertility: a complete guide to lifestyle and environmental factors (Softcover reprint of the original 1st ed. 2014 ed., pp. 105–125. Springer.
3. Plessis, S. D. S., Agarwal, A., & Jr., E. S. S. (2016). The impact of physical exercise on male fertility. In Male infertility: a complete guide to lifestyle and environmental factors (Softcover reprint of the original 1st ed. 2014 ed., pp. 47-60. Springer.
4. Begum, H., Moniruddin, A. B. M., & Nahar, K. (1970). Environmental and Nutritional Aspect in Male Infertility. Journal of Medicine, 10(1), 16–19. https://doi.org/10.3329/jom.v10i1.1997