When a couple is having trouble getting pregnant, the focus often turns to a woman’s health. But just as men are equal partners in conception, they can be contributors to fertility problems, too.
“It’s important to appreciate that when you have a couple challenged with infertility, in about 40% to 50% of the time, we are able to attribute the male as the primary or contributory cause,” said Dr. Natan Bar-Chama, director of the Center of Male Reproductive Health at RMA of New York and a board-certiﬁed urologist and male infertility specialist.
“People assume if a couple is having a hard time getting pregnant, it’s the woman’s responsibility to make the changes and it’s her body that’s not working right, but we’re learning more and more that that’s not the case,” added Lauren Manaker, a registered dietitian and author of “Fueling Male Fertility,” a guide that provides men with simple ways they can support a couple’s goal of becoming pregnant, whether they are trying naturally or undergoing assisted reproduction.
Problems that can affect male fertility include low sperm count, sperm abnormalities and low testosterone levels. Additionally, evidence suggests that recurrent miscarriage may not be related only to female factors, yet the focus continues to be on the female partner when couples experience pregnancy loss, Manaker explained.
The promising news is, various lifestyle factors have been shown to support male fertility and improve chances of conception. But this requires men to be proactive about their role in conceiving a baby.
“Men don’t access health care with the same seriousness as women do,” Bar-Chama said, from his experience. “Women regularly visit their ob/gyn from early on in their reproductive life cycle … but men are often neither proactive or preventative in their approach to medical care.”
What’s more, Manaker added, “men don’t want to talk about apples and their sperm.”
According to Bar-Chama, an initial fertility evaluation, which encompasses assessing lifestyle risk factors, along with an initial semen analysis is a simple first step to determine whether a problem exists.
Lifestyle and male fertility
Lifestyle factors affecting male fertility include diet, body weight, levels of exercise, stress and use of tobacco and drugs.
“There is a growing body of solid scientific data that correlates obesity, poor nutritional status, lack of exercise, smoking and marijuana usage … with decreased semen parameters such as sperm concentration, motility and morphology,” Bar-Chama said.
Lifestyle factors may affect sperm parameters, pregnancy and miscarriage rates, but Bar-Chama says that one of the most concerning issues is alterations in sperm that can be transferred to offspring and affect their development and long-term health.
“Sperm DNA from obese or marijuana-exposed animal models and men demonstrate alterations that are transferred to the progeny and can result in increased risk for cancer, effects on behavior, birth defects and overall long-term health repercussions,” he said.
“Men need to appreciate that their lifestyle behaviors may not only affect their ability to initiate a healthy pregnancy but, just as importantly, affect the future well-being of their child – something that has clear lifelong repercussions and that should be seriously considered prior to initialing fatherhood,” he added.
Getting started with lifestyle changes: Tackling obesity
Obese men are more likely to experience infertility. Their obesity also appears to put them at increased risk of a nonviable pregnancy.
Male obesity hurts fertility in a variety of ways. Increased fat in the scrotum can raise testicular temperature, which negatively affects sperm parameters and fertility, explained Paula C. Brady, assistant professor of obstetrics and gynecology at the Columbia University Irving Medical Center and reproductive endocrinologist at the Columbia University Fertility Center. Obesity can also cause several changes to sex hormones and their binding proteins that hurt sperm production.