I get asked a lot of questions by both males and females about fertility (or, perhaps more accurately, infertility), including how to increase sperm count, how to store and freeze sperm, the best diets and supplements for fertility, and much more.
So I decided it was high time I recorded an episode for you fellas who want your swimmers just a bit more dialed in, and for you couples who may be wanting to conceive. Dr. Amin Herati, MD is an Assistant Professor at the James Buchanan Brady Urological Institute and works at the Johns Hopkins Hospital. where he is the Director of Men’s Health and Director of Male Infertility. Dr. Amin Herati is also an advisor to Dadi, the leading at-home male fertility services company for sperm testing and storage. He is active in basic and clinical research with an interest in the fertility of patients with spinal cord injury, the genetic basis of male infertility, hypogonadism, and pelvic pain syndromes.
According to the Mayo Clinic, problems with male fertility can be caused by a number of health issues and medical treatments including:
- Varicocele. A varicocele is a swelling of the veins that drain the testicle. It’s the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal blood flow. Varicoceles lead to reduced sperm quantity and quality.
- Infection. Some infections can interfere with sperm production or sperm health or can cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections, including gonorrhea or HIV. Although some infections can result in permanent testicular damage, most often sperm can still be retrieved.
- Ejaculation issues. Retrograde ejaculation occurs when semen enters the bladder during orgasm instead of emerging out the tip of the penis. Various health conditions can cause retrograde ejaculation, including diabetes, spinal injuries, medications, and surgery of the bladder, prostate, or urethra.
- Antibodies that attack sperm. Anti-sperm antibodies are immune system cells that mistakenly identify sperm as harmful invaders and attempt to eliminate them.
- Tumors. Cancers and nonmalignant tumors can affect the male reproductive organs directly, through the glands that release hormones related to reproduction, such as the pituitary gland, or through unknown causes. In some cases, surgery, radiation, or chemotherapy to treat tumors can affect male fertility.
- Undescended testicles. In some males, during fetal development one or both testicles fail to descend from the abdomen into the sac that normally contains the testicles (scrotum). Decreased fertility is more likely in men who have had this condition.
- Hormone imbalances. Infertility can result from disorders of the testicles themselves or an abnormality affecting other hormonal systems including the hypothalamus, pituitary, thyroid, and adrenal glands. Low testosterone (male hypogonadism) and other hormonal problems have a number of possible underlying causes.
- Defects of tubules that transport sperm. Many different tubes carry sperm. They can be blocked due to various causes, including inadvertent injury from surgery, prior infections, trauma, or abnormal development, such as with cystic fibrosis or similar inherited conditions. Blockage can occur at any level, including within the testicle, in the tubes that drain the testicle, in the epididymis, in the vas deferens, near the ejaculatory ducts, or in the urethra.
- Chromosome defects. Inherited disorders such as Klinefelter’s syndrome — in which a male is born with two X chromosomes and one Y chromosome (instead of one X and one Y) — cause abnormal development of the male reproductive organs. Other genetic syndromes associated with infertility include cystic fibrosis and Kallmann’s syndrome.
- Problems with sexual intercourse. These can include trouble keeping or maintaining an erection sufficient for sex (erectile dysfunction), premature ejaculation, painful intercourse, anatomical abnormalities such as having a urethral opening beneath the penis (hypospadias), or psychological or relationship problems that interfere with sex.
- Celiac disease. Celiac disease is a digestive disorder caused by sensitivity to a protein found in wheat called gluten. The condition may contribute to male infertility. Fertility may improve after adopting a gluten-free diet.
- Certain medications. Testosterone replacement therapy, long-term anabolic steroid use, cancer medications (chemotherapy), some ulcer drugs, some arthritis drugs, and certain other medications can impair sperm production and decrease male fertility.
- Prior surgeries. Certain surgeries may prevent you from having sperm in your ejaculate, including vasectomy, scrotal or testicular surgeries, prostate surgeries, and large abdominal surgeries performed for testicular and rectal cancers, among others.
Overexposure to certain environmental elements such as heat, toxins, and chemicals can reduce sperm production or sperm function. Specific causes include:
- Industrial chemicals. Extended exposure to certain chemicals, pesticides, herbicides, organic solvents, and painting materials may contribute to low sperm counts.
- Heavy metal exposure. Exposure to lead or other heavy metals also may cause infertility.
- Radiation or X-rays. Exposure to radiation can reduce sperm production, though it will often eventually return to normal. With high doses of radiation, sperm production can be permanently reduced.
- Overheating the testicles. Elevated temperatures may impair sperm production and function. Although studies are limited and are inconclusive, frequent use of saunas or hot tubs may temporarily impair your sperm count. Sitting for long periods, wearing tight clothing, or working on a laptop computer for long stretches of time also may increase the temperature in your scrotum and may slightly reduce sperm production. But, the research isn’t conclusive.
Some other causes of male infertility include:
- Drug use. Anabolic steroids taken to stimulate muscle strength and growth can cause the testicles to shrink and sperm production to decrease. The use of cocaine or marijuana may temporarily reduce the number and quality of your sperm as well.
- Alcohol use. Drinking alcohol can lower testosterone levels, cause erectile dysfunction and decrease sperm production. Liver disease caused by excessive drinking also may lead to fertility problems.
- Tobacco smoking. Men who smoke may have a lower sperm count than do those who don’t smoke. Secondhand smoke also may affect male fertility.
- Weight. Obesity can impair fertility in several ways, including directly impacting sperm themselves as well as by causing hormone changes that reduce male fertility.
Dr. Herati is on the cutting-edge of male infertility research and treatment. He believes in an individualized approach to care that addresses the whole patient, and, as such, invests significant time into building a rapport with his patients so that they feel comfortable opening up about these issues, allowing him to accurately identify and manage each patient’s needs.
During this discussion, you’ll discover:
-Is infertility a genetic issue to any degree?…07:27
- Gene and epigenetic mutations passed on through generations
- Lifestyle factors that affect fertility are marked on DNA and passed on to future generations
- Our health is a factor of our ancestors’ health
- A simple 23andMe test wouldn’t ID such mutations; there are 3,000-4,000 genes involved in sperm production
- The surface of identifying gene mutations that affect fertility has barely been scratched
-Why infertility is more an issue among men in recent history than generations prior…11:03
- Men are more prone to hesitate to seek help when there are fertility issues
- Fertility is a barometer of a man’s health
- Study: New Insights Into The Genetic Basis Of Infertility
- Nature doesn’t want sick people to make babies
- Low testosterone is related to a higher risk of prostate and reproductive health issues later in life
- If under 35 and no success after 12 months (6 months if over 35), test both partners, not one or the other
- Environmental endocrine disruptors – cleaners, chemicals, etc.
- Genetic info is transmitted up to 3 generations
-Environmental causes of infertility…21:30
- Chemicals, cleaners
- Herbicides, pesticides
- Cleansing agents and wipes containing benzalkonium chloride
- The End Of Alzheimer’s by Dr. Dale Bredesen
- Podcast with Adam Wenguer where we discuss infertility:
- Radiation and x-ray exposure
- Varicose veins may be a sign of infertility
- Non-ionizing radiation such as computers and cell phones can flip the polarity of cells
-Testosterone replacement therapy and its effects on fertility…31:15
- Exogenous testosterone injected into the body can negatively affect the hypothalamus and pituitary gland
- Drops LH and FSH (luteinizing hormone and follicle-stimulating hormone)
- HCG is analogous to luteinizing hormone
- Nasal testosterone is not as disruptive as HCG
- Jatenzo oral testosterone
-Injectable peptides to regulate male fertility hormones…39:45
-Does a cool crotch affects one’s fertility levels?…44:50
-The effects of alcohol, tobacco, and drugs on fertility…48:50
- The impact of drugs on male fertility: a review
- Marijuana affects testosterone levels and fertility
- 50-60% reduction in testes size for users of THC marijuana
- 2/3rds of sperm produced never make their way out; poor quality sperm gets out if using weed
-Monitoring diet and food allergies in relation to fertility…53:10
-Why plenteous semen doesn’t always equate to abundant sperm…56:05
-Strategies for enhancing fertility…59:40
-Why the experts are recommending you cum more frequently…1:06:37
- Constant cell death and turnover
- The more rapid the ejaculation, the better the DNA health
-Diets or foods recommended for fertility…1:09:15
-How to proactively take care of business, even if you’re not ready to have children…1:18:25
- Advanced paternal aging, the effects on sperm
- Avoid secondarily infertility by banking sperm early-late teens early 20s
- Store sperm with Dadi
-And much more!…
Resources from this episode:
- Dadi (use code BEN20 to save $20)
– Podcasts And Articles:
– Other Resources:
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Do you have questions, thoughts, or feedback for Dr. Amin Herati or me? Leave your comments below and one of us will reply!