Treating The Crisis In Male Fertility (Part 3)

Worldwide sperm counts are in free fall. Male infertility contributes to half of all cases of fertility problems worldwide. In part three of this three-part series, Dr Jaclyn Chasse ND and Dr Jodie Peacock ND focus on how to treat fertility problems in men with a focus on restoring sperm health in three months.

There is a global crisis in male fertility. Evidence comes from declining sperm counts and increasing male reproductive system abnormalities including sperm morphology, sperm motility and low testosterone levels. Indeed, male-factor infertility occurs in more than 40% of couples experiencing difficulty conceiving. 

New data demonstrate a direct association between male health, diet and lifestyle and male fertility. Today we are doing a deep dive into what practitioners can do to support healthy men, healthy sperm and consequently healthy babies. 

We invited two leading experts in naturopathic reproductive health to share their knowledge and insight into male fertility: 

Dr Jodie Peacock, a natural birthing doctor, an author and a public educator. Her book, “Preconceived” has become an important resource for couples seeking healthy babies. 

Dr Jaclyn Chasse is a naturopathic physician dedicated to helping couples conceive naturally. Her practice “Perfect Fertility” focuses on fertility, sexual health and family wellness. 

Today we discuss what factors contribute to male infertility and what treatment solutions exist to effectively address this growing problem.
 

Watch Part 1
Watch Part 1


Key Takeaways


Worldwide sperm counts are in free fall
A Lancet journal article looked at healthy sperm counts in men starting in the 1950s, then watched this indicator through the following decades.  Almost a 70% decline has been observed since then. Also, because cut-off values have changed across decades, men who pass a sperm count test today would probably have been told they were completely infertile in the 1950s.
 

Male mindset
More often than not, males are not expecting to be responsible for the couple's fertility issues. In many cases, the female has had invasive procedures done, endometrial biopsy, ultrasound monitoring and have spent thousands of dollars, and the male has not even been tested for sperm quantity or health.

Half of the cases practitioners will see of couples struggling to conceive are due to male factors. Even if the male has had his sperm checked, and the sperm health report comes back with 5% morphology, the message is "You're good to go". However, that actually means 95 out of every hundred of his sperm don't look like a sperm. That is not good!

While females are typically ready to do whatever is necessary to conceive, males are often not willing to change their lifestyle - even if it means an improvement in their chances of conception. This is an issue of mindset for males and may require couples counseling.


Low male testosterone levels
Compared to previous decades, testosterone levels are dropping for men, which affects their libido significantly. As a result, couples may be having sex less often a further impediment to their ability to conceive.


Factors that impact sperm quality
There are many factors that affect the overall health of sperm. For example, while men have a longer fertility window that women, sperm quality declines with age. 

Sperm health is also dictated by critical functional processes in the body: for example, the balance of antioxidants with free radicals and the health of the mitochondria. 

Many of the environmental exposures that we have or our lifestyle impacts both of those pathways; things like poor diet, lack of exercise, high blood sugar, lack of sleep and stress.

We know that air pollution, water pollution, pesticides in food and even electromagnetic frequencies from things like Wi-Fi and Bluetooth connection, all of those have been studied and shown to have impacts at high doses. 

But when you think about the fact that we are exposed to low levels of hundreds of different things that increase oxidative stress, cause mitochondrial damage, those things add up.
 

Sperm health and the healthiness of the baby
The quality of the sperm can impact the health of the unborn child.For instance, we know that sperm helps to determine how well the placenta forms — a key factor in fetal development. If sperm is not healthy, that can be a serious problem as it constitutes half the DNA of the baby. 

If subpar sperm manages to impregnate the egg, then miscarriage can occur. Or genetic anomalies may occur later on.


Drugs: Alcohol, cannabis and other drugs and sperm health
Studies reveal that marijuana use even once a week can result in a 30% drop in sperm count. Many young men are using cannabis regularly which will impact their fertility. When combined with alcohol and/or cigarettes, there is an increased risk of significant negative effects on sperm health and quantity.

Many prescription pharmaceuticals can impact sperm quality. Most patients are not warned that their perscription may impact their ability to have children. Long-term use of opiates can disrupt the signals that control testosterone production, which can cause low testosterone and decrease the quantity and quality of the sperm.

Also, antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs), anti-epilepsy drugs and antiretrovirals can affect male fertility.


Pre-puberty lifestyle impacts male sperm health into adulthood
A significant and poorly understood impact on a male’s sperm health is his health and lifestyle between the ages of 10 -12 years old. Impacts such as diet, exercise and stress as well as exposure to toxins in his food and environment in the two years before puberty will impact the male’s sperm health for the rest of his life and as such, his ability to become a father.


Sperm health guidelines
Normal sperm densities range from 15 million to greater than 200 million sperm per milliliter of semen. You are considered to have a low sperm count if you have fewer than 15 million sperm per milliliter or less than 39 million sperm total per ejaculate. The 50th percentile is about 66 million, so you can see where your patient falls on that range.

Sperm motility of more than 40% is considered normal, and the higher the percentage the more sperm there are that can swim to meet the egg. Low sperm motility is when 40% or fewer sperm can swim forward to meet the egg. This does not mean conception is impossible, but it may be harder.


Sperm health as an indicator of general health and longevity
A man's overall health reflects the quality of the semen and the sperm that he produces. And men with low quality semen are more likely to have other health problems.

High levels of oxidative stress and poor mitochondrial function are big parts of almost every chronic disease state from diabetes to cancer, where we know that free radicals cause damage to cells and you don't have enough antioxidants to conduct repairs. If we're seeing functional challenges with sperm, it's likely that other cells are having similar challenges and maybe just not displaying the output of that yet.


Protocols for establishing a male patient's reproductive health
When a patient comes in, start with a semen analysis for a male partner. And if that comes back abnormal, do additional testing to figure out a little bit more about why: could low testosterone be a factor or high oxidative stress or mitochondrial dysfunction.


Treatment  
Men need to be on pre-conception programs just like women do. And that's 3 to 4 months of preparation before having a child.

Always start with lifestyle; focus on the areas where the patient's either most motivated to make change or where that can have the biggest impact.

For example: switch off the router overnight to reduce exposure to EMF. Remove the cell phone from the pocket. Don’t sit with a computer on your lap.

If men are supplementing testosterone, then stop. Testosterone therapy reduces sperm production.

Detox their environment from household chemicals to personal grooming products. Educate patients around the Clean 15 and the Dirty Dozen. Recommend organic vegetables to reduce exposure to pesticide residue.


Supplementation
Make sure that base nutrition is there.  The basics apply as a foundation: a  multivitamin, fish oil and then some specialized nutrients to really boost up the antioxidant content. 

Recommend a good comprehensive multivitamin for men. And fish oil, because fish oil has many good studies for improving cell health, it's anti-inflammatory and it's a nutrient that's truly deficient in most of our diets.

Focus on antioxidants, like vitamin C, vitamin C, zinc and selenium - the usual suspects.

There are some new exciting antioxidants, like Resveratrol and others that can really assist with improving sperm health.

Provide mitochondrial support with acetyl l-carnitine and carnitine. Similarly, CoQ10 is a nutrient that's critical for mitochondria, and Coq10 probably is one of the nutrients with the most published data on fertility, especially male fertility.

With Coq10,  prescribe up to about 600 milligrams per day, which is quite a high dose. 

 

Key Quotes
 

“70% is not a decline in sperm counts. That's actually a collapse” Dr Jaclyn Chasse ND

“When you look at the percentiles, the 50th percentile would be the middle of the bell curve. They set the normal at the bottom fifth percentile. So, what that means is if a man comes back at that limit, then he's better than 5% of healthy men, worse than 95% of healthy men. And that's what we accept. And what men are routinely told, your sperm are awesome [when they are not].” Dr Jaclyn Chasse ND
 

 

Watch Part 1
Watch Part 1


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