The ibuprofen noise
A flurry of media coverage following a small study recently suggested ibuprofen might be linked to male infertility — a yet untested hypothesis offered by researchers. The study showed ibuprofen has an effect on the production of luteinizing hormones; these stimulate the production of testosterone, which affects fertility. But “the study did not show any direct link between ibuprofen use and infertility, and I think it’s a big leap to go from one to the other,” says Dr. Kiranpreet Khurana, director of men’s health and fertility at University Hospitals in Cleveland. Rather than succumbing to confusing speculation, experts say guys wanting to have kids should keep an eye on proven causes of male infertility.
Substance use
In terms of lifestyle factors, experts say smoking and alcohol consumption — particularly heavy drinking — are among the most common causes of male infertility, including lowering sperm count and quality. “There’s more and more data now showing that marijuana also causes male infertility,” adds Dr. Edmund Ko, an associate professor of urology and male infertility specialist at Loma Linda University Health in Loma Linda, California. And use of any of these substances can negatively impact sperm production or function — like rendering sperm unable to swim. Illicit drugs from meth to cocaine can also contribute to male infertility.
Supplemental testosterone
Here’s a funny-not-funny thing: Naturally occurring, the hormone testosterone is vital to produce sperm, but when taken as a supplement (as many guys are urged to do to improve their performance) — like injected, or in pill or gel form — testosterone or related anabolic-androgenic steroids can cause sperm counts to plunge. “It’s totally counterintuitive, but giving a guy testosterone is functionally giving him a contraceptive,” says Dr. Craig Niederberger, head of urology at the University of Illinois at Chicago College of Medicine and editor of the journal Fertility and Sterility. Adds Ko: “It can lower the sperm count down to zero, because it will inhibit your normal hormone processes within your body from telling the testicles to make sperm.”
Varicocele
A varicose vein in the scrotum, a varicocele is found in about 20 percent of guys, Ko says. “Varicoceles occur when the valves inside the veins don’t close completely, and so this allows the backward flow of blood down to the scrotum and it causes these veins to stretch out,” he explains. This can raise the temperature in the testicle and be painful. While for many men it doesn’t significantly impact fertility, other guys “may have extremely low sperm counts or a significant portion of their sperm are dead, or they will have sperm with very abnormal morphology or shape,” Ko says. Treatment — like surgically tying off the veins to prevent backflow into the testicle — can improve fertility.
Other medical problems down there
Apart from a varicocele, there are other issues that can affect a man’s ability to deliver sperm. Some guys deal with blockages in the vas deferens, or the tiny tubes that carry sperm from the testicle to the urethra; sometimes these are severed, or they’re born without any vas deferens at all. “You can be born with the functional equivalent of a vasectomy,” Niederberger says. Like with a varicocele, there are procedures which can address or work around these issues as well, from microsurgery to reconnect vas deferens to drawing semen straight from the testes. “Then that can be used in modern forms of in vitro fertilization to make a baby,” he explains.
Diabetes
Uncontrolled diabetes can cause erectile dysfunction, lead to a decline in testosterone — which can reduce sperm production, lower semen quality and cause retrograde ejaculation. That’s “when a man ejaculates but nothing comes out,” explains Khurana, who is also an assistant professor of urology at Case Western Reserve University School of Medicine in Cleveland. “It’s what men will often refer to as dry ejaculate, and that basically means that the ejaculate, instead of going out of the body, is going back inside the body.” Experts say taking steps to properly manage the condition — or prevent it, if you have prediabetes — is key.
Obesity
Extra pounds can put a person at higher risk for conditions like diabetes as well as heart disease — which is less common in guys who are at an age where they’re thinking about kids, but which can also undermine fertility. Obesity can also result in hormonal changes. “It can potentially lower a man’s testosterone level, and having lower testosterone can result in lower sex drive, erection problems,” Ko says. “It can also decrease sperm production.” Just aim for gradual weight loss to shed excess pounds. “If you lose weight too rapidly, then it’s a shock to the system, and that can actually interfere with the making of sperm,” Niederberger says.
Environmental toxins
There’s no shortage of things you could be exposed to that may affect fertility. Heavy metals like lead can definitely kill sperm, Niederberger says. And myriad chemicals from pesticides to BPA, or Bisphenol A, found in everything from canned products to water bottles (though it’s been removed from many products) can kill sperm. “Bisphenol A is one of these endocrine-mimicking agents that very well could be related to problems with male fertility” and other health problems, Niederberger says. Though it’s impossible to keep tabs on all exposures, experts say it’s important to try to pay attention to what you put on and in your body and bring into your home.
Diet and lifestyle
When it comes to improving your odds of being fertile, there’s no shortcut substitute for simply eating well and exercising — not to mention lowering your stress and getting ample sleep. While frequently, frustratingly, the causes for male infertility — which is a factor about half the time when couples struggle to get pregnant — aren’t known, whatever bolsters well-being tends to be good for fertility, experts emphasize. “Anything that’s good for the overall health of the guy is going to be good for the making of sperm,” Niederberger says, “and anything that’s bad for the overall health of the guy is going to be bad for sperm.”
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The Real Sperm Killers originally appeared on usnews.com
