Men Listen Up…
Fertility is Male Too!
Infertility is a world-wide problem. One that does not discriminate on the basis of gender, race or ethnicity. Infertility affects an estimated 15% of couples globally. Worldwide, there appears to be a lack of accurate statistics on rates of male infertility however from the data available, males are found to be solely responsible for 20-30% of infertility cases and contribute to 50% of cases overall.
So what do you need to know as a man?
Well first of all, regardless of your wish to have offspring it is really important to understand how your reproductive organs work. Male anatomy 101.
Men and women differ in many ways, including their reproductive organs. Women have a vagina, cervix, uterus, fallopian tubes and ovaries. They produce one egg per month and their fertile window is about 6 days. 5 days prior to ovulation and the day of ovulation itself. Sperm can live in the uterus for up to 5 days.
Men are designed differently. The male reproductive system includes the penis, scrotum, testes, epididymis, vas deferens, prostate, and seminal vesicles. The penis and the urethra are part of the urinary and reproductive systems.
The Male Reproductive Organ Functions
To produce, maintain, and transport sperm (the male reproductive cells) and protective fluid (semen)
To discharge sperm within the female reproductive tract during sex
To produce and secrete male sex hormones responsible for maintaining the male reproductive system
Penis
This is the male organ used in sexual intercourse. It has three parts: the root, which attaches to the wall of the abdomen; the body, or shaft; and the glans, which is the cone-shaped part at the end of the penis. The glans, also called the head of the penis, is covered with a loose layer of skin called foreskin. This skin is sometimes removed in a procedure called circumcision. The opening of the urethra, the tube that transports semen and urine, is at the tip of the penis. The glans of the penis also contains a number of sensitive nerve endings.
The body of the penis is cylindrical in shape and consists of three circular shaped chambers. These chambers are made up of special, sponge-like tissue. This tissue contains thousands of large spaces that fill with blood when the man is sexually aroused. As the penis fills with blood, it becomes rigid and erect, which allows for penetration during sexual intercourse. The skin of the penis is loose and elastic to accommodate changes in penis size during an erection.
Semen
Which contains sperm (reproductive cells), is expelled (ejaculated) through the end of the penis when the man reaches sexual climax (orgasm). When the penis is erect, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.
Scrotum
This is the loose pouch-like sac of skin that hangs behind and below the penis. It contains the testicles (also called testes), as well as many nerves and blood vessels. The scrotum acts as a "climate control system" for the testes. For normal sperm development, the testes must be at a temperature slightly cooler than body temperature. Special muscles in the wall of the scrotum allow it to contract and relax, moving the testicles closer to the body for warmth or farther away from the body to cool the temperature.
Testicles (testes):
“Consider the ovary a warehouse for eggs and a testicle a factory for sperm with constant production”
These are oval organs about the size of large olives that lie in the scrotum, secured at either end by a structure called the spermatic cord. Most men have two testes. The testes are responsible for making testosterone, the primary male sex hormone, and for generating sperm. Within the testes are coiled masses of tubes called seminiferous tubules. These tubes are responsible for producing sperm cells. Unlike women, who are born with a set number of eggs, ovulating approximately one per month, men have a constant production of sperm. Your testicles are constantly producing new sperm in a process called spermatogenesis. The full process takes about 64 days. During spermatogenesis, your testicles make several million sperm per day — about 1,500 per second. By the end of a full sperm production cycle, you can regenerate up to 8 billion sperm.
Tip: If you are making any beneficial lifestyle changes such as quitting smoking, reducing caffeine/sugar intake, it can take up to 3 months for the positive results to be seen in the sperm parameters.
Epididymis
The epididymis is a long, coiled tube that rests on the backside of each testicle. It transports and stores sperm cells that are produced in the testes. It also is the job of the epididymis to bring the sperm to maturity, since the sperm that emerge from the testes are immature and incapable of fertilization. During sexual arousal, contractions force the sperm into the vas deferens.
Vas deferens
The vas deferens is a long, muscular tube that travels from the epididymis into the pelvic cavity, to just behind the bladder. The vas deferens transports mature sperm to the urethra, the tube that carries urine or sperm to outside of the body, in preparation for ejaculation.
Ejaculatory ducts
These are formed by the fusion of the vas deferens and the seminal vesicles (see below). The ejaculatory ducts empty into the urethra.
Urethra
The urethra is the tube that carries urine from the bladder to outside of the body. In males, it has the additional function of ejaculating semen when the man reaches orgasm. When the penis is erect during sex, the flow of urine is blocked from the urethra, allowing only semen to be ejaculated at orgasm.
Seminal vesicles
The seminal vesicles are sac-like pouches that attach to the vas deferens near the base of the bladder. The seminal vesicles produce a sugar-rich fluid (fructose) that provides sperm with a source of energy to help them move. The fluid of the seminal vesicles makes up most of the volume of a man's ejaculatory fluid, or ejaculate.
Prostate gland
The prostate gland is a walnut-sized structure that is located below the urinary bladder in front of the rectum. The prostate gland contributes additional fluid to the ejaculate. Prostate fluids also help to nourish the sperm. The urethra, which carries the ejaculate to be expelled during orgasm, runs through the center of the prostate gland.
Bulbourethral glands
Also called Cowper's glands, these are pea-sized structures located on the sides of the urethra just below the prostate gland. These glands produce a clear, slippery fluid that empties directly into the urethra. This fluid serves to lubricate the urethra and to neutralize any acidity that may be present due to residual drops of urine in the urethra.
The Important Hormones
Gonadotropin (GnRH): Gonadotropin, which is released from the hypothalamus, plays a vital role in human sperm production as it coordinates the release of the other hormones that are also involved in the production of sperm, specifically luteinizing hormone (LH) and follicle-stimulating hormone (FSH) that are released from the pituitary gland.
Follicle-stimulating hormone (FSH): Produced in the pituitary gland, this hormone plays a vital role in the production of sperm and stimulates the germ cells in both males and females to mature.
Luteinizing hormone (LH): In men, LH works together with FSH to produce sperm.
Testosterone: As a male makes his way through puberty, testosterone plays a major role and his testicles start producing more and more of this important hormone. Testosterone is another hormone that stimulates the production of sperm. As well, testosterone is very important for the development of the male reproduction tissues like prostate and testes.
Questions Answered
Does infertility only affect older men?
No. Infertility can affect men of any age.
Does a man’s age affect the quantity and quality of sperm?
At puberty, sperm production starts. It’s likely that when men get into their 40’s there is a reduction in sperm quality and quantity but other factors can speed up this process. Men can father children well into their 60’s.
What abnormalities can there be?
There can be several problems when it comes to sperm production and this can be assessed from a basic semen analysis. For more information on what happens during this test, check out Your Swimmers Article.
Azoospermia: No production of sperm or no sperm in the ejaculate.
Oligospermia: Low amount of sperm.
Teratospermia: Sperm are poorly shaped. Morphology issue.
Asthenospermia: Sperm are not moving the way they should. Motility issue.
Oligoteratoasthenospermia: All of the above.
2 main categories of male infertility
Non obstructive - problem with the production. This can be due to health, heat, hormones, heredity, steroids.
Obstructive - factory is there but the high way is closed. This can be caused by infection or due to structural damage.
5 Ways To Improve Your Sperm
‘Heat kills’. When working from home, remove your laptop from your lap as your thighs can actually increase in temperature by about 5 degrees which can affect sperm DNA integrity. Transmission of wifi and radiation can even be more profound and sperm count can be affected. Sperm needs to be 2 degrees less than body temperature.
Avoid hot-tubs, saunas and hot yoga.
Vegetables, vegetables, vegetables. Deep coloured veg like kale, beetroots, blueberries have all been found to improve sperm motility and quality as they are high in antioxidants and phytonutrients. Eating a mix of nuts, including almonds, is beneficial, as almonds are rich in zinc - which contributes to normal fertility and reproduction.
Exercise, exercise, exercise, ‘more hustle-more muscle’, helps to improve sperm quality. Being overweight has been found to increase scrotal temperatures, so again, reducing this is key. Obesity causes problems with hormones and high BMI causes abnormalities in testosterone production.
Testosterone! This one might seem counterintuitive but listen up! Men taking medications for treatment of “low T” (testosterone) in an attempt to address symptoms such as low energy or decreased sex drive may actually contribute to a low sperm count. It’s important to always be under the advisement of a physician if considering medication for treatment of low testosterone.
>6 cups of coffee a day has been found to negatively affect sperm parameters. 2 cups per day (<200 mg) has been found to have no affect and has even been shown to increase sperm parameter.
And remember - once lifestyle change has been made—such as quitting smoking—it takes about 2 ½ to 3 months for those healthier sperm to appear in the ejaculate.
When to seek medical advice.
If you and your wife have been trying to conceive unsuccessfully for some time then it is advised to see your doctor to investigate further. If your wife is <35 years, it is advised to seek help after 1 year of trying. If she is between 35-40 it is advised to seek support sooner after 6 months and if over 40, immediately.
40% of men with fertility issues have a Varicocele. A varicocele is an enlargement of the veins within the loose bag of skin that holds your testicles (scrotum). A varicocele is similar to a varicose vein you might see in your leg. Varicoceles are a common cause of low sperm production and decreased sperm quality, which can cause infertility. If you are experiencing pain make sure to bring this to the attention of your physician. This is something can be addressed very successfully.