Infertility, Subfertility, and Fertility Enhancement

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

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Problems with male infertility should be considered as well as female, and the combination of factors that create the male and female combined infertility syndrome

The possiblities in male infertility or subfertility are also varied and complicated. Male sexual inadequacy is not the clinical reason for problems with fertility, and this notion must be put aside so that the man may feel comfortable discussing potential physiological problems related to the production of healthy sperm. If erectile dysfunction is a problem inhibiting timely fertilization, this is a separate health matter, but one that Complementary Medicine may also address, but when addressing the problems of male infertility and concurrent health problems with both the male and female, these are rarely the issues. Subfertility in various populations now exceeds 10%, and in some studies 40% of the males tested were diagnosed with some form of subfertility problem. Various problems create lowered sperm counts, decreased sperm motility, and problems with the quality of prostatic fluid. A number of common medications and drugs are proven to potentially impact male fertility. These include Tagamet (cimetadine), sulfasalazine (Azulfidine), nitrofurantoin (many brand names), steroid medications (e.g. prednisone or cortisone), and chemotherapy agents, as well as radiation. Tagament treats gastric problems such as acid regurgitation and heartburn, but also is prescribed for herpes zoster, warts, and tendinitis. Azulfidine is a sulfa drug prescribed to treat inflammatory bowel disease, arthritis, and other inflammatory diseases. Nitrofuorantoin is an antibiotic used to treat urinary tract infections. Steroids are common components of many drugs that treat chronic inflammation, pain, asthma, skin problems, and many other diseases and symptoms. Synthetic steroids may also be used as a sports or body building supplement. If a man is taking these drugs, or has taken them recently, this may be a cause of male subfertility or infertility, and discontinuing use may a an easy and inexpensive way to solve infertility problems.

More recent research at the Weill Cornell Medical Center found that antidepressant SSRI medications may affect sperm quality. This 2009 study, headed by Dr. Cigdem Tanrikut, found that SSRI medications appeared to contribute to fragmented DNA in sperm, which is correlated with poorer fertility outcomes, even when in vitro fertilization or other assisted fertility techniques are used. This appeared to occur because the movement of the sperm in the male reproductive tract was slowed, allowing for greater genetic fragmentation over time. The affects of SSRI medications have been well studied due to the high incidence of reports of impaired ability to ejaculate, and electrophysiologic studies have shown that the medications affect the pudendal nerve (Uchio et al; J Urol 1999:1983-86). The sperm volume, concentration, motility and morphology were not significantly changed by the SSRI therapy in this study, and the standard fertility tests would not detect a problem with sperm quality in this case. In another clinical trial, at the Montefiore Institute for Reproductive Medicine and Health in Hartsdale, New York, researchers found that SSRI medication appeared to also significantly effect the sperm motility. The rise in prescription of these medications, and others, may account for the increased incidence of male subfertility and overall fertility problems.

There are a variety of real issues that the man may address to improve chances of natural fertility. Male infertility may be caused by one or a combination of the following problems: deficient androgen production or regulation, alteration of GnRH release from the hypothalamus/hypophysis, problems with FSH receptors, and LH/hCG dysfunction. As we see, men and women may have similar problems hormonally, but the resolution of these problems may be quite different. Also, decreased potassium circulation, acidity of the prostatic fluid, environmental toxin accumulations, imbalances in zinc, which is an important component of prostate fluid, and various lifestyle concerns, such as long soaking in hot tubs, constricting underwear, cigarette smoking, and general issues of health, may also play a part. A thorough testing and analysis of sperm, prostate fluid, hormonal health, and body chemistry should be performed. Both prostate, or seminal fluid, and the sperm itself, may present problems inhibiting male fertility, and clearing of chronic prostate inflammation, neutralizing acidity, and correcting problems with seminal fluid citrates and calcium may be necessary to increase the chances of success. Both prostate, or seminal fluid, and the sperm itself, may present problems inhibiting male fertility, and clearing of chronic prostate inflammation, neutralizing acidity, and correcting problems with seminal fluid citrates and calcium may be necessary to increase the chances of success. In 2014, the bacterial balance, or biome, in the male semen and prostatic fluid was proven to have a strong association with fertility as well. Researchers at National Chiao Tung University and Kaohsiung Medical University, in Taipei, Taiwan, found that healthy sperm samples contained a predominance of lactobacilli and Gardnerella, while Prevotella was significantly higher than normal in low quality semen samples (see research link in Addtional Information). The hope is that probiotic balancing may play a significant role in resolving male subfertility. A comprehensive holistic approach will insure a greater chance of success with male fertility issues. No one wants to hear that the issue is so complex, but this is the reality.

Some of these health problems in male infertility may manifest as testicular varicoceles, which are accumulations of tissue associated with enlarged veins along the spermatic cord, and are similar to varicose veins. Over time, varicoceles cause increased pressure due to back-flow of draining blood, and result in permanent damage to the testicular tissue. A 2001 study at the Center for Advanced Research in Human Reproduction and Infertility, at the esteemed Cleveland Clinic, found that varicoceles are present in 19-41 percent of infertile men. A simple palpation exam by a urologist, followed by an ultrasound, will reveal this tissue anomaly. Clearing of the varicoceles permanently, and the relationship to infertility as a causative factor is still unclear, but the relationship between varicoceles and underlying health problems, some of which are associated with male infertility, is definitely clear. The Cleveland Clinic center found that varicoceles had a multifactorial etiology, with absence of veinous valves, and compression of the left renal vein against the large arteries seen in most subjects, but with oxidative stress, decreased nutritive circulation, hormonal imbalances, and even chronic inflammatory stress, fatty acid imbalance, and autoimmune reactivity as significant underlying causes or aggravators. Correction of the varicoceles surgically has resulted in improved semen parameters in 50-80 percent of patients, although a number of studies have shown little or no benefit ultimately on pregnancy rates, and the correction has proven controversial, since the general population has a rate of varicoceles of 15 percent, usually with gradual onset beginning at puberty, and most cases not resulting in infertility. The association of varicoceles with men who previously demonstrated fertility but now were having trouble with sperm quality and fertility is much higher, though, suggesting that the aging process, or secondary causes of male infertility were a consideration.

While the clear association between varicoceles and male infertility for all subjects does not exist, the Center for Advance Research in Human Reproduction and Infertility did find that patients with varicoceles had trouble with cooling the scrotum, supplying blood nutrients to the testicles, had increased oxidant stress, and potentially stress upon the adrenal function that could affect the hypothalamic-pituitary-adrenal axis. A reflux of adrenal steroids caused by the varicocele (via the compression of the left renal vein) was associated with decreased serum testosterone and increased prolactin levels. A World Health Organization (WHO) study of the influence of varicoceles on fertility found that the mean testosterone concentration of men aged over 30 with varicoceles was significantly lower than those of younger men with varicoceles (WHO, 1992). Lower concentrations of free testosterone, higher estrogens, and higher levels of steroid binding globulin were observed in patients with varicoceles (Hudson, 1996). The Cleveland Clinic study found that the question of whether varicoceles were a cause of infertility, or a result of the hormonal imbalances associated with infertility, was not answered by scientific studies at that time (2001). The recommendation, though, was to remove the varicocele if male infertility was suspect. A broader conclusion, though, would be to address the underlying health factors associated with the varicoceles, such as the circulation, oxidant stress and inflammation, and potentially the hormonal balance. A significantly higher incidence of anti-sperm antibodies was also found in infertile male subjects with varicoceles compared to infertile men without varicoceles (91 percent compared to 41 percent). While this finding also was unclear as to the actual effect on fertility, it does indicate that the autoimmune response, or immune dysfunction, perhaps caused by chronic inflammatory and oxidant stress, is also a factor to be considered. Oxidative stress was a key consideration in this study of varicoceles and infertility. The researchers at the Cleveland Clinic found that: "In normal healthy men, the seminal plasma contains natural scavengers or antioxidants to neutralize the effects fo excessive ROS (reactive oxygen species) generation. Under pathological conditions, however, ROS production overwhelms the antioxidant capacity and causes increased oxidative stress. ROS may cause the defective sperm function as a result of lipid peroxidation of the polyunsaturated fatty acids in the sperm head and mid-piece, alter sperm morphology and lead to decreased motility and ineffective spermatozoon-oocyte (egg) fusion reaction. ROS may also cause a high rate of double- and single-stranded DNA damage." These researchers concluded that: "The associations made with increased temperature, increased testicular blood flow, increased venous tension, and increased oxidative stress in men with varicoceles, provide the scaffold upon which future investigations should be built, to delineate better the pathophysiology of varicoceles." (Human Reproduction Update, Vol.7 (5);473-481, 2001; Cathy K. Naughton, Ajay K Nangia and Ashok Argarwal)

With so many potential causes of male infertility or subfertility, it is difficult to assess and treat. Most likely, a combination of underlying causes acts in concert to promote subfertility in the male. While standard medicine still look for a single and clinical cause, this may not be effective in a majority of cases of male subfertility. A thorough holistic approach is necessary, and sometimes patience, sorely lacking in couples today that decide to have children. Immediate gratification and entitlement is the hallmark of our modern society, especially if the couple has money. Unfortunately, this may not be Nature's way. To assess male subfertility we need to start with the subjects that scientific research has found to be most prevalent. A program of avoidance of environmental chemicals that could contribute to subfertility, changes in diet when necessary, changes in lifestyle and habits, and also improvements in health and use of Complementary and Integrative Medicine to guide the use of herbs and nutrient medicines, perhaps enhanced with acupuncture, may all be combined in a very workable protocol. A knowledgeable Licensed Acupuncturist and herbalist can best individualize and guide this protocol. For the patient with suspected male infertility, a simple scrotal exam and ultrasound may reveal the presence of varicoceles, increasing the chance, especially with aging, that male subfertility may be a problem. In this case, use of antioxidant therapy, clearing of oxidant and inflammatory stress with herbs, improving veinous health with herbs and nutrient medicines, preventing scrotal overheating, balancing omega 3 and omega 6 fatty acids, and utilizing acupuncture and even physiotherapies to increase circulation and benefit the endocrine health, are all potentially important treatment considerations. The integration of Complementary Medicine into the fertility protocol has many advantages, not the least of which is improving the overall health and correcting underlying health problems.

Some health issues that affect male fertility are very prevalent in modern industrialized society. Subclinical hormone dysfunction is clearly linked, and many of the pertinent hormone dysfunctions mentioned above are linked to pituitary and hypothalamic disorders, as well as subclinical adrenal syndromes. In 2001, researchers (Arafah and Nasrallah) at Case Western University and Univerity Hospitals of Cleveland, Ohio, released a study of pituitary tumors that showed an incidence in the population of the United States estimated at 10% of the population (some studies showed up to 20% incidence). This was based on autopsy series, but a more recent review of MRI studies in otherwise healthy individuals confirmed this rate of incidence. The researchers found no clear record of the frequency of clinically diagnosed pituitary tumors, but found that the estimations of this diagnosis is much lower than the incidence in autopsy and MRI studies. Most of these tumors were found undiagnosed in otherwise healthy individuals, and a variety of 6 tumor types was found, each secreting different pituitary hormones, except for the Null-cell adenoma, which secreted no hormones, but accounted for only 5-10% of the tumors. Most of the tumors were either small or very small (microadenomas) and difficult to detect and diagnose. Pituitary tumors can mildly increase the amount of various hormones in the body that could adversely affect male fertility, as well as female. Signs of these hormonal excesses may be subtle. As stated, research acknowledges the role of Gonadatropin-releasing hormone (GnRH), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) in the male as directly associated or causative of male subfertility or infertility, and many researchers also point to excesses of prolactin and thyroid stimulating hormone (TSH) as potentially involved. Small pituitary tumors may also affect the hypothalamus, which sits directly atop the pituitary, and is closely linked in tissue and function, in male subfertility, as well as adrenal function. The pituitary gland secretes the main hormones that stimulate hormonal release from the adrenals.

Another very prevalent problem seen in male subfertility is the viability of the sperm. Standard tests may only look at the sperm count and motility, and sometimes just the sperm count is tested, but the actual functional capacity of the sperm is a more important consideration. Only recently have scientists uncovered the complex way that sperm function in a drastically changed acidic environment. In 2010, researchers at the University of California in San Francisco discovered the perplexing manner in which sperm stay viable in the acidic male reproductive system, and then adapt to a much more alkaline female reproductive tract, and in fact trigger a drastic change in intercellulary acidity to become viable both in motility and the ability to enter and fertilize the egg. In fact, changes of acidity up to a hundred-fold may be necessary for the male sperm to become active and viable. The sperm cell has a proton pump to keep the acidity inside the cell high as sperm remain idle, and a protein triggered ion channel on the sperm cell membrane that rapidly pumps protons out of the sperm to activate and initiated viability in coordination with the female reproductive tract and eggs. It has long been noted that changes in zinc concentration and levels of cannabinoids (marijuana and endogenous) affect male fertility. This research clearly shows how zinc and cannabinoids may either decrease or increase the male fertility viability. To see a review of this research, click here: http://www.ucsf.edu/news/2010/. Testing for zinc deficiency, avoiding sources of inadvertent zinc excess, and changing the habits of marijuana use, as well as correcting problems with mood disorder that could stimulate excess endogenous cannibinoids or create deficiencies, may be simple and important aspects of a comprehensive male subfertility treatment protocol.

The increasing role of environmental and food chemicals in the rising incidence of male subfertility

In 1996, researchers at the University of Edinburgh, Great Britain, Reproductive Medicine Laboratories, and the Medical Research Council, Centre for Reproductive Biology, reported on a long term study of 500 men and changes in semen quality for men born between 1951 and 1973. The conclusion was that evidence clearly finds that male semen quality is deteriorating over time, and that the probable origin of the problem was exposure to xenoestrogens and other hormonally modulating synthetic chemicals in the food and environment in modern industrial society (British Medical Journal 1996 Feb 24: 312-467-71). This study confirmed meta-analysis of studies of about 15,000 men by Carlsen et al, examining research from 1973 to 1991. The response to this fact by the reproductive medical community in the United States was skepticism, and testing that still looks for more extreme problems with sperm viability, and continues to ignore the real problem of deteriorating sperm quality and the impact this may have on couples trying to conceive and having difficulty despite no significant medical conditions that should be interfering with the ability to conceive. There has been no significant call to regulate these xenoestrogens, xenoandrogens, and other hormonally modulating chemicals in food and industrial products, pesticides, insecticides or other pollutants. The individual males trying to have a child, though, may try to improve sperm quality with Complementary Medicine, and also voice an opinion to our government that this problem should be addressed for future generations of men.

Environmental chemicals may play an extensive role in both female and male infertility. Many chemicals have been created by modern industry that have proven hormonal effects, as xenoestrogens, xenoandrogens, estrogen mimics, and androgen mimics. The role of these many chemicals in hormonal health has been downplayed, as most do not exert strong direct estrogen and androgen effects, but research has uncovered many ways that indirect effects of these chemicals may affect fertility, and with the addition of more and more of these chemicals in the environment, the potential for an accumulative effect is now considered a real threat. Xenoestrogens, xenoandrogens and synthetic hormonal mimics may antagonize normal hormonal effects, disrupt synthesis and metabolism of normal hormones, and disrupt synthesis and metabolism of hormone receptors. Estrogen mimics may affect prolactin release (a hypothalamic/pituitary hormone). Hyperprolactinemia causes both female and male infertility, amenorrhea, erectile dysfunction, chronic fatique, and is linked to polycystic ovarian syndrome. Mild prolactin excess may inhibit pulsatile release of luteinizing and follicle stimulating hormones (LH and FSH), which not only control the ovarian cycle, but also the release of testosterone (via GnRH), affecting follicle stimulating hormone in a feedback mechanism, as well as sperm quality and count, viscosity of prostate ejaculate, and seminal vesicle secretion. These xenoestrogens and xenoandrogens may also affect calcium channels and indirectly create excess prolactin secretion this way as well. The increased allowance of environmental xenoestrogens, xenoandrogens, estrogen mimics and androgen mimics into the environment, and into modern industrial products, soaps and cosmetics, has affected the fertility of both men and women. Fertility is a public health issue and requires regulation.

While a single xenoestrogen or xenoandrogen, or other hormonal mimic in the environment may not exert a substantial effect, the accumulation of these chemicals is increasing each year, and cumulative effects are now recognized as a serious threat to fertility. The most well know of these chemicals are Bisphenol A in soft plastics and can linings, Organochlorines as byproducts of plastic and insecticide breakdown, dry cleaning chemicals, bleaching agents, etc., commercial phenolic antioxidants used in the electronics industry, plastic manufacture, petroleum product protectants (on car seats, mattresses etc.), and food preservatives (BHA and BHT), surfactants, insecticides (e.g. kepone), and pesticides (e.g. DDT). Soaps and cosmetics may contain these chemicals as alylphenol polyethoxylates, which may not directly affect you, but when degraded in waste water treatment and sewage may release estrogenic alkylphenols. Some organochlorines used as bleaching agents in feminine hygiene products, and sealants and composites used in dentistry, create more immediate effects. The actual list of these products is now so large that we hardly know where to turn to regulate this health threat. The individual couple may try to avoid these chemicals as much as possible, and also consider help with detoxification, utilizing Complementary Medicine to help stimulate appropriate metabolic channels of detox, and perhaps some soft tissue mobilization. An assessment can help you understand the various ways that Complementary Medicine may assist in rebalancing hormonal health as well. While no one likes to overcomplicate health problems, a serious examination and education of these complex issues allows a couple to take a more natural and holistic approach to fertility and health in general.

Standard medicine still takes a stubborn attitude towards the problems of sperm quality affected by xenoestrogens, xenoandrogens, and other hormonal modulating environmental chemicals, citing the fact that extreme individual variation is seen in sperm counts and ejaculate quality in standard testing, making this issue unclear. Testing for problems that are more nuanced are usually not conducted. The standard fertility experts concentrate on a number of problems that they see from research that are also confirmed variables in sperm count and quality. These include the role of overheating of the testicles with tight clothing and prolonged sitting at work, as well as habitual hot bath soaking, aging and natural deterioration of sperm quality, ejaculatory frequency affecting sperm quality, seasonal effects, a history of reproductive tract disorders, and Sertoli cell numbers. Some simple recommendations are given to try to resolve these factors when trying to have a baby, such as wearing loose cotton underwear and avoiding prolonged sitting, avoiding soaks at spas in hot water, and resolving issues of reproductive tract ill health. There is much more that the man can do to improve semen viability, though, in a healthy manner, utilizing Complementary Medicine. Sertoli cells are testicular cells responsible for maintaining semen health. Research has shown that the widespread problems seen with deficient numbers, and abnormal Sertoli cells, are associated with a number of biological markers, such as aromatase, anti-Mulleian hormone, abnormal genetic expression related to androgen receptors, and various antigens, that affect Sertoli cell maturation at various life stages. Standard medicine hypothesizes that this occurs in fetal development, but many researchers link environmental chemicals that affect hormones and hormone receptors to this problem. The pathophysiology of this is complex, but well documented. While simple recommendations to prospective fathers to avoid scrotal heating are perhaps helpful, one can do much more than this to promote viability of the male role in fertility.

Other potential environmental issues have also been uncovered in recent years. Studies in 2007 found that fluoride levels commonly seen in drinking water were found to be associated with reduction in sperm counts in laboratory animals, as well as sperm capacitation, and correlations have been found between water fluoride levels exceeding 3 parts per million and decreased birth rates in areas of the U.S. A review of this problem by the U.S. National Research Council found that "the relationship between fertility and fluoride requires additional study." Fluoride accumulation has been found to be able to affect tissues in the brain and reduce melatonin production, and other hormonal relationships exist as fluoride, as well as bromides, are halogens that compete with iodine absorption, potentially causing thyroid problems, as well as poor antioxidant potential in various tissues, including the prostate. In January of 2011, the U.S. Department of Health and Human Services finally lowered the recommendations for ideal fluoride levels to 0.7 mg per liter in drinking water supplies, and the EPA is considering drastically reducing the maximum concentration allowed. This is in response to the health issues mentioned here, and are long overdue when looking at the research and concerns in the scientific community for decades. The last time regulated fluoride levels were lowered was in 1962, in response to similar research warnings. Today, most toothpaste is fluoridated, and fluoride is increasingly found in many commercial food products manufactured with heavily fluoridated water. Fluoride acid, or hydrofluorisilic acid, is a hazardous waste of the phosphate fertilizer industry that has been allowed to be barreled and sold for both water fluoridation and commercial manufacture. Fluoride byproducts in various forms are useful in various industries, and this is the reason why water fluoridation has been allowed despite the health hazards for decades. We've been told that people that are afraid of water fluoridation are just 'health nuts', and the public is unaware of the health hazards of fluoride that should have been reduced long ago. The Obama administration may be the first presidential administration that takes these issues seriously, and sides with public health over industrial lobbying. The couple that want to increase chances of fertility may want to avoid these sources of fluorides, and perhaps try to clear fluoride accumulations with detoxification regimens, antioxidants, and chelation.

Not only fluoride, but the accumulation of industrial chemicals called organofluorines, such as the now infamous PFOA (perfluorooctanoic acid), a now banned surfactant that made 3M and Dupont billions of dollars with such products as teflon. While the Dupont company paid the then largest find ever to the U.S. for concealing health information related to the organofluorine causing cancers, liver damage, and potentially subfertility, the fine was just a small percentage of the profits made from the chemical. A class action lawsuit was tied to chemical blood and health history analysis of victims, which made clear the causal relationship between PFOA and these diseases, yet the payments and individual awards will drag on for decades due to the vast legal abilities and legal system in place. Perfluorinated compounds (PFCs) and other organofluorines are used as surfactants, stain resistant chemicals, and to manufacture nonstick cooking surfaces, and these chemicals do not break down in the environment, with mounting accumulations measured in humans and animals across the globe now. Many human and animal studies now link these organofluorines with reproductive and developmental toxicity, neurotoxicity, cardiovascular toxicity, metabolic dysregulation, development of arthritis, carcinogenesis and immunotoxicity (PMC: 3776372).

Finally, the subject of flame retardant chemicals may also be an important consideration in the assessment of environmental chemicals that affect male fertility and may be avoided. A number of flame retardant chemicals have been proven to be carcinogenic, impairing of fertility in both male and female study subjects, and potentially damaging the functions of the central nervous system, and the only defense against these chemicals by the industry is that low dosage does not appear to present significant risk. This defense holds no weight over time, though, as these chemicals do not break down easily, and accumulation in both the environment and in human tissues has been demonstrated. Since these flame retardant bromines are lipophilic, they accumulate in fatty tissues, the source for many hormones in the body, affect the brain more extensively, and accumulate in breast tissues and affect nursing infants. PBDE flame retardants not only affect individuals exposed and nursing infants, but also the developing fetuses, where recent research has proven that they can diminish the future fertility of males. There is no coincidence between the rising use of these chemicals, their environmental accumulation, the lowering of male fertility in the population, and the large rise in assisted reproductive technology in standard medicine since 1997.

The chemical group PBDE (polybrominated diphenyl ethers), is a class of chemicals called organobromine compounds, consisting of 290 possible substances, that is similar to PCBs (polychlorinated biphenyls). PCBs have long been noted for their toxicity, accumulation in the environment, as well as human tissues, and their ablility to act as xenoestrogens enhancing breast cancer risks, as well as affecting fetal development and the health of the nursing infant. PCBs have been proven to alter fetal sexual development, stimulating hermaphroditism, and impairing future fertility in the male. PCB production was banned by the United States Congress in 1979 and by the Stockholm Convention on Persistent Organic Pollutants in 2001, and the industry that produced these chemicals was proven to be aware of their toxicity even before introducing the widespread industrial applications before 1930. Numerous studies proved toxicity, and a Harvard School of Public Health conference in 1937 outlined these toxicities, yet massive industry lobbying prevented the government from regulating these chemicals. In the same way, PCBEs have been allowed to be used as flame retardants, often for no logical reason, in a wide array of products, most of which do not need the addition of a chemical flame retardant. PBDEs are used in building materials, electronics, household furnishings, motor vehicles, airplanes, plastics, polyurethane foams, and textiles. Studies have proven that PCBEs reduce fertility in humans at levels found in households, and one study in Sweden (Meironyte et al 1999) found a 60-fold increase in PBDE levels in the breast milk of Swedish women from 1972 to 1997. A 2002 study in San Francisco also found alarming accumulation in breast tissue (She et al 2002), and numerous studies across the U.S. have found mounting accumulations in soil sediment, sewage sludge, plants and human tissues. The public can no longer ignore the threat of flame retardant PCBEs as an accumulative threat that exceeds the toxicity levels and impairs male fertility (see the link below to a 2005 study from the Charite University Medical School in Berlin, Germany, outlining the scientific proof of low-dose PCBE effects on male fertility and neurohormonal health).

A number of flame retardants have been found to be toxic at normal levels, accumulative in the environment, carcinogenic, and destructive of fertility, and have been voluntarily withdrawn from manufacture in the United States, while being banned outright in most other developed countries. An example of this action is found with Penta-BDE, a PBDE. This PBDE was voluntarily phased out of production in the U.S. in 2004, yet a study of infant products containing foam padding in 2010 found that 4 of 14 common products on the store shelves still contained Penta-BDE (see the New York Times article In Nursery, A Chemical Feared Toxic from the May 18, 2011, Busines Times). In one product randomly tested, the flame retardants represented 12 percent of the weight of the foam in an infant changing pad! The persistence of the industry to include these chemicals that potentially damage male fertility, as well as causing adverse health effects in fetuses, infants, nursing mothers, and the general population, is inexplicable, especially considering the lack of need for the flame-retardants in many products, and the ready availability of harmless flame retardant foams and other products. Today, the couple with fertility issues cannot ignore the possibility that these industrial toxins may be heavily contributing to the problems with subfertility and infertility, and that standard tests of fertility in clinics are not looking at this source of the problem.

Protocols to improve male fertility and viability of sperm

Avoiding environmental xenoestrogens, xenoandrogens, and other hormonally altering chemicals as much as possible is helpful, as well as trying to detoxify and clear these chemicals from the body (you may want to read my article on this website on detox). Studies (cited below) also show that utilizing antioxidants has been proven to improve problems with male subfertility. Since it takes about 30 days for your body to generate new sperm, there may be some time between avoiding environmental and food chemicals that impair sperm quality and count, and the time that your body may produce more viable sperm. Utilizing antioxidants, acupuncture, herbal medicine, and detoxifying or chelating therapies may help during this time. Improving the health and circulation of the reproductive tract is also a simple strategy. Changing sexual habits is important. Since it takes some time for sperm to mature and accumulate, avoiding ejaculation in the days before the optimal window of opportunity for conception is important. Working with the spouse to accurately chart this most opportune time is valuable. Since sperm counts are highest in the morning, timing the opportune sex and having sex upon waking, or during a leisurely morning, may help. Avoiding some lifestyle habits that may decrease sperm count may be helpful, such as decreasing cigarette use, alcohol consumption, and drug use, and avoiding processed and fast foods. Eating healthy will certainly help, and a high protein diet rich in fresh vegetables, whole grains, and healthy fats is advisable. Improving health and circulation with a little increase in daily exercise is helpful, although spending a lot of time bicycling, or on an exercise bike, should be avoided.

Other dietary considerations have not been sufficiently studied, but present enough concern to warrant caution. High fructose corn syrup is the sweetener additive of choice in the food industry, and may negatively impact male reproductive health. A key component of seminal fluid is fructose, and altered fructose may have a negative impact, or carry other potentially harmful chemicals to the seminal fluid. Studies have shown that high fructose corn syrup contains traces of mercury used in the processing, and such heavy metals may be found in toxic forms that are known to negatively impact male fertility. Studies have found an association between male obesity and sperm motility, and increased levels of fructose in seminal fluid associated with obesity. Levels of true corrected seminal fructose are highly associated with male infertility and are suggested as a potentially accurate marker for this health problem. The type of fructose in seminal fluid is called D-fructose, and the fructose in high fructose corn syrup is an altered fructose believed by many experts to be difficult for the body to break down and utilize. Essential fatty acid imbalances are thought to be able to negatively impact male fertility also, and if one is a red meat eater and consumes the standard array of simple carbohydrates in a typical diet, supplementation with omega-3 fatty acid supplements may benefit tremendously.

Stress reduction may also be very important, as both physiological and emotional stress may have a negative impact on reproductive health. An array of herbs and nutrient medicines have been found to promote improved sperm quality and count, ejaculate quality, and hormonal health. The Complementary Medicine phsician can guide this care individually, provide professional products, and increase the effects by providing acupuncture stimulation concurrently. Common herbal and nutrient aids include zinc supplement with isoflavones, L-carnitine, selenium, and a variety of antioxidants, as well as Maca, Vitex, and more specific Chinese herbs. Each individual is different in their needs, though, and a professional assessment and prescription is a better ticket for success.