Whilst some couples will have no problems falling pregnant naturally, according to the latest NHS statistics approximately one third of couples will struggle to conceive due to irregularities with the man’s semen or sperm

For the majority of men, each millilitre of their semen will contain millions of sperm. The purpose of the semen is purely for reproduction, as a vehicle to carry the sperm into the female reproductive tract where it will fertilise with a women’s egg to create a pregnancy.

Most men don’t think to consider the quality of their semen or sperm until they are ready to start a family later in life, when health problems may have escalated. In order to educate more men about the health of their sperm and ensure that they are prepared for starting a family, here Dr Ferran Garcia – Head of Andrology at the internationally-renowned fertility clinic, Institut Marques – offers some advice on how to identify potentially unhealthy semen, and preserve your fertility for the future.

Lead a healthy lifestyle

Dr Ferran Garcia says: “There are several lifestyle factors which can have a negative impact on the quality of your sperm, without you even knowing. For example:

• The effect that alcohol has on the reproductive capacity of men depends entirely on their intake however, research has shown that excessive alcohol consumption can have a detrimental effect on semen volume and sperm morphology. This is because alcohol diminishes the activity of ‘testicular antioxidant enzymes’ which can result in an increase in ‘oxidative stress’. This increase promotes spermatozoa DNA fragmentation and decreases the activity of steroidogenic enzymes – which is essential for healthy, active and fertile sperm.

• Men who are classed as overweight or obese are often associated with a decrease in sperm quality and therefore have a bigger risk of infertility. This is because an increase in the amount of adipose tissue (fat) increases the conversion of testosterone to oestrogen, which can lead to something called ‘secondary hypogonadism’ – a primary testicular failure. This failure causes a reduction in the release of gonadotropins and a decrease in sperm production.

Regular exercise and a healthy diet have been proven to increase testosterone levels and boost sperm quality, so I always encourage my patients to maintain a healthy lifestyle and weight as best they can.”

Stop smoking

• Cigarette smoke has over 7000 substances, many of them carcinogenic, such as nitrosamines and benzopyrene, which can damage the quality of the sperm. Smoking has also been associated with negative effects on the amount of sperm, their motility and their morphology. These effects are caused by the presence of nicotine and other chemicals such as metabolite, cotinine, benzopyrene, as well as cadmium and lead. Furthermore, smoking exposes spermatozoa to high levels of oxidative stress which causes sperm DNA fragmentation. This can lead to fertilization failures or can be the origin of non-evolutive embryos. Both could prevent pregnancy or cause miscarriages.

• Regular consumption of marijuana can reduce a man’s total sperm count and sperm concentration. This effect is increased if associated with other recreational drugs. Long- term cocaine consumers are likely to have a lower concentration of sperm with decreased mobility, as well as a larger fraction of sperm with abnormal morphology.

Assess your surroundings

Dr Ferran Garcia says: “One of the main causes of male infertility is environmental pollution caused by Persistent Organic Pollutants (POPS). These are chemical substances which are generated by humans – usually as a result of industrial processes, and include pesticides, industrial chemicals and by-products of manufacturing and combustion processes. Through industrial processes, these substances are widely dispersed into the environment, and it takes decades for them to degrade – polluting air, water, plants, land and animals in the meantime.

As well as polluting the environment, POPs can also dissolve into human fat, which is known as lipophilicity. When dissolved into fat, some POPs act as oestrogenic endocrine disruptors, which means they behave in the same way as female hormones, even if found in males. This can have an impact on a man’s hormones and cause several problems, including infertility, testicular cancer, prostate cancer and urogenital malformations. The reason this happens is because POPS can alter the endocrine system, the collection of glands that produce hormones, leading to abnormalities.

While POPs are present in many different environments, the most dangerous levels are found in many industrial workplaces, such as building and agricultural sites.

For example;

• Heat exposure – Healthy sperm production is dependent on the temperature of the testicles. In situations of extreme heat, the scrotum’s natural cooling mechanisms are inhibited which causes a reduction in the quality and quantity of the sperm produced. Working in professions which involve long periods of driving has been found to damage sperm quality, as sitting for long periods of time can increase testicular heat.

• Solvents – Regular exposure to solvents and other chemicals has also been found to lower sperm quality. The longer someone is exposed to harsh chemicals in the environment, the greater the chance the individual’s sperm concentration and mobility will be negatively affected.

• Radiation – Men who work in work environments with radiation also have a heightened risk of infertility. This is because the testes are one of the most sensitive areas to radiation exposure. Studies have found that this exposure decreases the rate at which men produce sperm, as well as affecting their testicular function.

Do you have a metabolic syndrome

Dr Ferran Garcia says: ‘Approximately 9% of men who experience infertility will have ‘metabolic syndrome’ – which is when a person has a cluster of conditions and symptoms all at once, including abdominal obesity, high fasting glucose, elevated triglycerides, high HDL cholesterol and high blood pressure.

Growing evidence has linked metabolic syndrome and its individual symptoms to the increasing prevalence of male infertility. For example, previous studies have shown that men with high blood pressure have reduced levels of testosterone compared with normotensive men. A more recent study found out that hypertensive men have less seminal volume, less count of spermatozoa and less sperm mobility, compared to men without a diagnosis of hypertension.

If men think they have metabolic syndrome, they should book an appointment with their local GP or doctor and seek the correct treatment for their symptoms – which will help with their sperm health in turn.”

Look to the future

Dr Ferran Garcia says: ‘Like all other parts of the body, over time a man’s semen will age. As the quality and quantity of the man’s semen gradually diminishes over time, this will make his chances of falling pregnant naturally a lot more challenging. 

If you are concerned that your age or relationship status will have an impact on your ability to have children, there are assisted fertility methods available to help protect your fertility for the future.

Much like ‘egg freezing’ for women, ‘sperm freezing’ is an increasingly popular way for men to preserve their fertility. To freeze your sperm, you would be required to provide a sperm sample – which is then frozen in liquid nitrogen at -196c and stored away for when you are ready to start a family.

To date, sperm-freezing is the most successful method of fertility perseveration in men, with many doctors noting a huge surge in its popularity in recent years.’