Top Causes of Infertility in Men and Women, Lifestyle Changes May Help

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The University of California at Los Angeles Health reported that 15 percent of US couples cannot conceive biological children.

Couples are believed to have an infertility problem when they have had regular and frequent unprotected sex for 12 consecutive months without conception.

“In the United States, about 10 percent of women, 6.1 million, aged 15 to 44 have problems getting pregnant,” a 2019 U.S. Department of Health and Human Services Office on Women’s Health report found.

The Office publishes an ovulation calendar on its website, womenshealth.gov, to help women target their most fertile days of the month, when they would be most likely to conceive.

Infertility, says the American Pregnancy Association (APA), is an equal opportunity health condition experienced by both men and women at nearly the same rate.

“Often, it’s assumed that the fertility difficulties are with the women,” says the APA on its website, “but in 40 to 50 percent of infertility in couples, (it) is due to male factors. Male infertility alone accounts for approximately up to 50 percent of all cases of infertility. It’s important for both partners to be tested.”

Male Fertility, Testing, Sperm Count, and Sperm Health

When a couple has not been able to conceive after consistently making the yearlong effort, both partners need to have a comprehensive physical and medical workup with their healthcare provider.

First, according to the APA, sperm is collected and inspected microscopically to assess their number, their shape, their appearance, and the speed of their movement. The more healthy and strong sperm are, says the APA, the better chance the couple has of conceiving.

“Normal semen contains 40 million to 300 million sperm per milliliter,” they write. “A low sperm count is considered to be anything between 10 and 20 million sperm per milliliter. Twenty million sperm per milliliter may be adequate for pregnancy if the sperm are healthy.”

If the sperm count is found to be low, a urinalysis can be performed to detect any signs of infection or the presence of sperm in the urine, where it should not be found.

If the sperm is adequate and healthy, then a lab will check the male’s testosterone levels and other hormones.

There are also many at-home sperm count tests available in stores and online at a range of price points.

If no abnormality is found, it’s on to testing the female, but not before taking a general health inventory so that the male can bolster his chances of conception with some simple lifestyle adjustments.

Some lifestyle habits that have been shown to lower the sperm count in men include:

• Being overweight
• Not exercising
• Substance abuse including excessive alcohol
• Not taking the vitamins D, C, E, and CoQ10, which are important for sperm health
• Exposure to toxic environmental chemicals
• Cycling more than five hours per week on a bike that is not fitted properly
• Wearing constricting undergarments instead of loose boxers or cotton briefs that permit air flow and moderate temperatures for men. This has been found to be the optimum environment for sperm health.

In an April 2016 study, Comparing the Effectiveness of Dietary Vitamin C and Exercise Interventions on Fertility Parameters in Normal Obese Men – PubMed (nih.gov), two groups of 100 men with similar body mass indexes were compared for fertility outcomes. One group was given 1,000 milligrams of Vitamin C every other day, and the other group underwent six months of intense, coach-led exercise.

Researchers found that, “Weight loss can significantly increase semen volume, its concentration, its mobility and percentage of normal morphology,” they wrote. “Consuming vitamin C significantly improves sperm concentration and mobility, but the semen volume and the percentage of normal morphology will not change significantly.”

In another study published in the journal Human Reproduction in 2014, researchers found engaging in reasonable exercise and having a generally healthy lifestyle can contribute to a higher sperm count. In particular, the researchers found that “weightlifting and outdoor exercise can help sperm health more than other types of exercise. Consider incorporating these kinds of activities into your routine. Exercise can also help you maintain or lose weight, which may have additional benefits for your sperm health.”

A less conclusive study published in Reproductive Biology and Endocrinology in 2015, found somewhat lower rates of pregnancy in couples where the man had low levels of vitamin D, but it was not significant. That said, couples with better vitamin D levels fared better, the researchers found.

“The pregnancy rates per patient and per cycle and delivery rates per patient and per cycle were all significantly higher (p< 0.05) in couples with normal vitamin D levels,” they wrote.

How can women promote their own fertility?

If the name of the game for men is sperm health, for women it is ovulation.

Once again, healthy lifestyle choices can increase your chances of becoming pregnant. The Mayo Clinic offers these suggestions:

The most common causes of female infertility include:

• Problems with ovulation
• Damage to fallopian tubes or uterus
• Problems with the cervix
• Age, as fertility naturally tends to decrease over time
• An unhealthy weight because being overweight or significantly underweight can inhibit normal ovulation
• Sexually transmitted infections such as chlamydia and gonorrhea
• Regularly working a night shift and not sleeping enough can affect hormone production
• Too much stress and a lack of effective coping strategies.
• Smoking tobacco, which ages  ovaries and depletes eggs
• Drinking alcohol, which elevates a woman’s risk of ovulation disorders
• Caffeine consumption of over 200 milligrams per day (three cups or more)
• Heavy and vigorous physical activity over five hours a week may inhibit ovulation and reduce progesterone
• Exposure to environmental pollutants and toxins

Fertility Lubricant

For couples who are trying to get pregnant, every lifestyle choice can impact your success in conceiving, and lubricants used during sexual activity are no exception.

That’s why the Food and Drug Administration has cleared a list of criteria required from lubricant manufacturers that ensures they are tested and confirmed to be safe for sperm, eggs, and embryos.

“Fertility lubricants are specifically tested to ensure that the lubricant has a similar pH and viscosity as semen and fertile quality cervical fluid so that it provides a protective environment for sperm and will allow sperm to swim into and through the lubricant,” according to the APA. “By matching the quality and consistency of cervical fluid, fertility lubricants supplement your body’s own natural lubrication.”

Consumers looking for conception-friendly lubricants should “avoid lubricants with a low pH, and that contain small penetrating chemicals (for example, glycerol) or paraben preservatives,” advises the APA website.

“They should also “avoid using a lubricant labeled as non-spermicidal with an FDA-cleared fertility lubricant.”

Janis Siegel is an award-winning news journalist and columnist that has covered international health research for SELF Magazine, The Times of Israel, the Fred Hutchinson Cancer Research Center, and others. Ms. Siegel launched a health column featuring cutting edge research from world-class academic institutions.

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