Male fertility

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Male fertility is strongly influenced by diet – what you put in, you get out!

It is very easy to monitor the effects that can be achieved through diet, herbal medicine and supplements. A semen analysis after 90 days is a quick easy way to confirm improvements.

Semen analysis and advanced testing

Semen analysis using strict Kruger criteria testing – is one of the most comprehensive tests available, covering all major parameters recommended by the World Health Organisation (WHO). Referral can easily be made for a fast, efficient, private service.

Thorough medical history and lifestyle questions are important – alcohol or drug use, medications (including steroids and hGH), any surgery, infection in the testicles (mumps), undescended testicle, significant trauma to the genital area, normal sex drive (decreased sex drive may be a sign of elevated Prolactin or TSH levels).

If semen parameters are significantly low, referral for further hormone testing or more advanced tests may be required – Genetic reproduction profile, DNA fragmentation, Aneuploidy, Oxidative stress test and/or a Recurrent miscarriage profile.

The semen equation

Count, motility and morphology are the 3 main factors. A simple multiplication can be applied to give one figure of the overall picture. As a rough guide there should be >10 million for natural conception (>100 million will give a much better chance!) and >5 million for IUI and >500,000 for IVF, (1 for ICSI).

Your chances will increase as your total number of motile normal sperm increases.

A semen analysis is a snap shot on a given day. For a better diagnosis the WHO manual recommends a minimum of two analysis a few days apart to get an average. Counts can vary based on a number of factors – drug/alcohol/liquid/food intake, amount of exercise, sleep and sexual intercourse, high temperature or sickness etc.

Spermatogenesis – useful knowledge
Testosterone production

Luteinizing hormone (LH) sent from the brain stimulates Leydig cells in the testicle to produce testosterone.

Sperm creation

Follicle stimulating hormone (FSH) from the brain stimulates germ cells in the testicle to replicate. Then, through meiosis the DNA is chopped up and rearranged to make a new and unique genetic code in each baby sperm cell.

Sperm Maturation

Sperm are made in tiny tubes (seminiferous tubules) lined with Sertoli cells that provide testosterone and nutrients to the baby sperm cells to help them mature. As they grow, they are pushed into the epididymis, where they grow tails and learn how to swim.

Environmental Controls

Sperm also require a precise temperature of 4 degrees lower than body temp. Testicles raise and lower in response to external heat to keep sperm safe.

Storage

Sperm can live up to 3 weeks after they are fully mature. They are stored in the epididymis, a 20ft tube coiled up in the testicle until they are transported through the Vas deferens upon ejaculation.

ASAB’s, ROS, DNA fragmentation and Aneuploidy

ASAB’s are large protein molecules that bind onto the sperm and interfere with sperm transit and fertilization.

As motile cells, sperm generate a significant amount of metabolic bi-product known as reactive oxygen species (ROS). ROS is the bi-product from the sperm’s engine burning sugars and nutrients to generate energy. Small amounts of ROS help sperm in the process of fertilization, but large amounts of ROS can injure and even kill sperm cells. The body’s natural defense against reactive oxygen species is the release of antioxidants. Antioxidants such as vitamin C and vitamin E are typically molecules that contain double-bonded carbon that enables them to easily bond to and neutralise reactive oxygen species.

The genetic integrity of the spermatozoon is needed for normal embryo development. A high level of DNA fragmentation may be a cause of male infertility that conventional analysis cannot detect. This analysis of DNA integrity may help to identify men who are at risk of failing to produce a healthy embryo. It can be of prognostic value in assessing outcomes of assisted conception treatment.

Sperm aneuploidy can also impact pregnancy rate and is associated with recurrent miscarriage. Chromosomal abnormalities in the somatic cell can be detected by blood karyotype analysis. But those arising from errors during meiosis can only be detected by looking at the sperm chromatin directly.