Difficulty conceiving is a growing concern among couples and individuals these days. Just last week the bill to protect IVF was blocked in the Senate, even though many families are built using IVF. Ease in conception is becoming a privilege and infertility is affecting many of us, myself included. In my practice, many of my female patients inquire about their hormones in order to optimize fertility. This is such an important step before trying to conceive, but often the forgotten step is looking into male fertility even though we know that the sperm is 50% of the equation! Studies show that sperm quality and quantity are plummeting at a staggering rate, which is why we should be testing sperm early in the preconception process.

The Rise of Infertility

Infertility is most often defined as the inability to conceive despite carefully timed and unprotected intercourse for 12 months, though the timing may be less for certain ages or conditions. As of 2023, 1 in 6 people are affected by infertility. Let that sink in. This is affecting a lot of people, and this experience of infertility is not talked about nearly as much as it should be. Instead, people are experiencing and processing these feelings alone.

When we look further at the infertility statistics, we see an even breakdown among couples. We see about 30% female factor infertility, 30% male factor infertility, and 30% a mix of both. This is why a proper work up of both partners in the preconception phase is so important.

Male Factor Infertility

Male Factor Infertility is associated with low sperm parameters, both quality and quantity. Sperm count and concentration refer to the quantity of sperm in a sample. Motility refers to ability to swim normally and morphology refers to the percentage of normal looking sperm. We recognize that both low quantity of sperm impacts the ability to conceive. Low quality sperm has also been associated with delayed conception and less favorable pregnancy outcomes.

It is not uncommon for male partners to have their first semen analysis after 12 months of trying to conceive, which can be a very painful 12 months. Additionally, there are many times where sperm parameters fall into the “subfertile” range and patients are told it is normal. From a functional medicine point of view, these subfertile sperm parameters can give us a lot of information, so that we can properly support the body and improve overall lab results. There are many ways we can optimize sperm in preparation for natural and assisted conception.

Understanding Sperm Guidelines

As I mentioned earlier, semen analysis is incredibly important because it gives us insight into the sperm health. A number of studies have shown a steady decline in both quality and quantity over the last 70+ years. To put this in perspective, an average man in the 1940s likely had a sperm concentration of 113 million sperm per milliliter. Today, the average man has over 50% less sperm, at around 47 million sperm per milliliter. As we’ve seen this decline, we have also seen a change in our reference ranges. The World Health Organization publishes reference ranges every decade or so, and what is considered “normal range” for sperm count, motility, and morphology have all decreased over the years.

Below are the three levels of fertility sperm parameters put forth by a study published in the New England Journal of Medicine.

Steps to Improving Sperm

The first step to improving sperm is to get a baseline of current sperm health. A semen analysis is easily ordered through a healthcare provider. There are also at-home semen analysis companies like Fellow and Legacy, where the sample is gathered at home and mailed overnight for analysis. Both provide us with useful information. With the information gathered from the results, then a treatment plan can be put in place to improve and optimize sperm quality and quantity.

The process of building sperm is called spermatogenesis, and it takes roughly 75 days from start to finish. This means that in order to improve sperm quality and quantity, lifestyle changes and supplemental support must be in use for almost 3 months before we see the positive impact of those changes. Unfortunately, often times the male partner is not tested until 12 months into trying to conceive, and the thought of waiting another 3 months to improve sperm can feel like a lifetime. For this reason, I recommend testing the male partner early in the preconception period to fully assess male fertility.

About the Author

Dr. Hannah is a naturopathic doctor providing whole body adjunctive healthcare to families in Southern Maine. She believes every patient has their own unique health journey, which influences her personalized treatment approach. She has a passion for helping women, mothers and families heal and thrive, all while uncovering the root cause of whatever ails them. Her goal is to empower and guide her patients on the path towards healing the mind, body and soul through natural methods of healing. Dr. Hannah sees patients locally in Portland, Maine. Through telehealth, she is happy to serve the people of Lewiston, Ellsworth, Bangor, and all the towns in between!

Disclaimer

The information provided on or through this website is for educational and informational purposes only. This information is not a substitution for proper and personalized medical diagnosis or treatment. Always seek the advice of your physician or trusted healthcare provider before making an adjustments or changes to your healthcare regimen. Natural medicine is not inherently harmless, and therefore it is important to speak with your healthcare providers for personalized medical advice.