Guide to male fertility

Fertility is primarily discussed or thought of as a woman's issue. But we're forgetting a vital part of the fertility equation — sperm.

Studies have shown that around 40% of cases where couples have struggled to conceive have been due solely to male factor infertility, 40% of cases are due to female factors, and the remaining 20% are a combination of both, or unexplained [1].

The crux of male fertility comes down to whether a man's sperm can penetrate a woman's egg to fertilise it. Read as unpack a sperm's journey to the egg and all it entails.

Sperm and semen are not the same

Before we dive into what may cause male infertility, it's important to understand that a happy ending doesn't mean sperm is involved.

Sperm is the name given to the reproductive cells that look like a tadpole (which is where they get the 'swimmer' term from). Seminal fluid is the stuff that the sperm swims in. Together, they form semen. The seminal fluid helps sperm take on their biological mission by helping sperm swim into the female body.

The sperm's journey to the egg

There are a few things to consider when we talk about male fertility and sperm health:

Sperm delivery

This refers to the moment a guy ejaculates and there's actually a lot that goes on down there to lead up to this moment. When stimulated, the muscles in the walls of the penis contract in a coordinated wave.

This movement pushes concentrated masses of sperm from where it's stored in the epididymis (a convoluted duct behind the testes) and places them at the base of the penis. Along the way, they pass a series of glands. Each of them squeezes out seminal fluids which mix with the sperm to become semen.

Semen accumulates at the base of the penis, putting pressure on the nerves. When enough pressure is built, neurons are triggered. Their signals take control of the muscles at the base of the penis and send off a series of strong involuntary contractions.

That muscular pump squirts semen out of the body with a surprising amount of force.

Some things can delay or prevent sperm delivery, including blockages in the ejaculatory duct or sexual dysfunction — and this is when fertility can be impacted.

Semen volume

Seminal fluid helps the sperm swim strongly into the woman. So the more of it, the better.

Sperm count

The number of individual sperm helps with fertility. It's a pretty long and tiring journey to the egg and not every sperm is trained for long distances.

So, the more sperm you have competing against each other in this fertility race, the better the chances of having a winner who takes all.

Sperm motility

Once the sperm reaches the cervix, they are on their own. They've got to swim efficiently through the woman's reproductive tract and reach the egg to fertilise it.

The woman's body doesn't make this an easy feat, so you've got to have some strong swimmers making the long journey.

Sperm morphology

Have you ever wondered what sperm looks like? The truth is that the 'cream of the crop' does have an ideal shape and size: 3 micrometres wide, an oval head, and an uncoiled tail.

This matters because sperm needs to be a certain shape to have the best chance of penetrating an egg. This doesn’t mean abnormally shaped sperm can’t fertilise the egg, it just makes it harder.

How does age affect male fertility?

While women have a finite number of eggs that can't regenerate and their age heavily impacts the quality and quantity of their eggs; men's fertility is different.

Men's bodies are conditioned to keep the sperm sources strong and they continually make new sperm every day (though it can take around 3 months for new sperm to fully develop).

So, technically speaking, men can conceive at any age but, that doesn’t mean they’ve escaped the biological clock.

While the change in fertility is more drastic in women, fertility declines as men age too. The older the man, the less sperm he is able to ejaculate. Plus, the quality of his sperm declines, which impacts their swimming fitness, and their shape becomes more abnormal.

All of this makes it more difficult to conceive.

In fact, studies have found that conception is 30% less likely for men over the age of 40 years as compared with men younger than age 30 years [2].

What’s more; the older the man, the greater the chance that the DNA in the sperm is damaged.

These genetic sperm defects may cause an increased chance of miscarriage and stillbirth [3][4].

What causes male infertility?

Besides age, a few potential causes of male infertility include:

• Certain health conditions, like pituitary gland problems, immunity issues, sexually transmitted infections and genetic disorders, can all affect sperm quality and health.
• Sexual dysfunction problems, like erectile dysfunction or premature ejaculation. Both these conditions affect the male reproductive system and although they don't directly impact sperm health, they can make conception harder to accomplish.
• Lifestyle factors, like smoking, drinking excessively, being over or underweight, and not exercising enough.

How to test male fertility

To test male fertility, it’s a good idea to see a doctor or a urologist (a male reproductive specialist).

To check up on his swimmers, he needs to get a semen analysis done. This means no sex for 2-5 days to allow the semen to 'build up' and make sure there is enough to analyse.

During check-ups, he'll be asked to go into a room and ejaculate into a sterile container. Yeah, sounds awkward and not quite the type of environment you want to be in when you want to get aroused.  So, another option to make this happen would be to ask if you can take a semen sample at home, or use a special condom they provide to get the sample, you know, the fun way.

Most semen tests will test for semen volume, concentration, motility and morphology.

The doctor may order some blood tests to check whether imbalanced hormones might be getting in the way. And, they might suggest a scrotal or transrectal ultrasound to rule out any abnormalities in the testes or blockages in the ejaculatory duct that would prevent healthy sperm production and swimming.

What are the signs of unhealthy sperm?

Now, you both may be wondering what exactly the doctor or urologist may find that indicates his sperm isn't healthy.

There are a few answers to this question:

• Low sperm count. The more sperm, the better your chances of conceiving. A normal sperm count is at least 15 million sperm cells per millilitre and anything under that is considered low [5].
• Less than 40% of sperm is motile. Although pregnancy is still possible with a lower percentage, 40% is typically the threshold [6].
• Abnormal morphology. Abnormally shaped sperm can make it more difficult (but as we mentioned before, not impossible) to get pregnant.
• High DNA fragmentation. DNA fragmentation measures the percentage of sperm that has damaged DNA and you typically want it to be under 30% [7].

Ways to support male fertility

His daily habits can play a big role in the quantity and quality of his sperm, which means that he may need to get his lifestyle in check.

A few things he can do to improve sperm health include:

• Exercise. When he gets into shape, his sperm benefits too. However, it's important he doesn't go too hard, as doing so can cause too much heat down there and negatively impact sperm movement, count and quality.
• Eat a healthy diet. Research has shown that a diet full of fruits, vegetables, fish and low-fat dairy products can lead to better semen quality [8]. He should also look for foods that are high in selenium, folate, zinc, CoQ10 and vitamin C.
• Take a male prenatal. Though it can't replace a balanced and varied diet, taking a prenatal vitamin can be incredibly helpful for improving sperm health. Kin's Male Prenatal is packed with 10 premium ingredients, including the 5 we mentioned above, all in bioavailable forms his body can actually use.

• Stop smoking. Smoking has been linked to low sperm counts, as well as low motility and increased DNA fragmentation, so if you're actively trying for a baby, it's time to ditch the habit [9].
• Minimise alcohol and caffeine consumption. Drinking excessively has been shown to reduce testosterone levels and sperm production and having more than 2 coffees a day decreases male fertility.
• Be mindful of radiation. Radiation waves have been shown to decrease sperm count and cause poor sperm health and movement, so it's best he keeps his phone out of his pocket.

Looking to optimise your lifestyle? Check out our Male Fertility & Lifestyle guide or join Compound and experience comprehensive concierge care offering.

Image credit: Getty Images