Male Infertility – The Rarely Discussed Aftermath

The following is a guest post shared with DCYBs from our friends at Fertility Help Hub.  FHH’s founder, Eloise, talks openly at FHH about her personal journey using donor sperm after her husband’s non-obstructive azoospermia diagnosis and unsuccessful micro-TESE operation. This post is Eloise’s husband’s perspective on their journey, his experiences, diagnoses, and outlook.

Tests

Being told that I had azoospermia (lack of sperm) was the most soul destroying thing I have ever been told. My wife wasn’t with me when I got the news and calling her to tell her, with my hands shaking and heart racing, was near enough impossible because I couldn’t quite comprehend it myself as we’d only been trying to conceive for six months and had just sought fertility specialist help.

The Diagnosis

Having seen more urologists than I’ve had hot dinners (or so it seemed), a blood test confirmed the diagnosis that we had been dreading, that I have Klinefelter Syndrome – a rare genetic condition which affects approximately 1 in 600 men worldwide. That’s not a small number. Klinefelter Syndrome is a genetic condition affecting boys and men that occurs as a result of the presence of an extra X chromosome.

The condition is typically characterised by tall stature, reduced fertility and development of breast tissue, although some patients have no clinical features other than reduced or absent sperm count (azoospermia). Some of these things apply to me, but like me many men don’t find out they have it until they’re trying to conceive and may not be able to.

Where Klinefelter Syndrome is suspected, blood tests will be carried out to assess levels of testosterone and gonadotrophins (luteinising hormone and follicle stimulating hormone). In patients with Klinefelter Syndrome, blood tests characteristically show a low testosterone level, high sex hormone binding globulin (SHBG) and raised gonadotrophins.

The diagnosis of Klinefelter’s syndrome is confirmed by chromosomal analysis (karyotyping), which involves a blood test.

The Operation

Leading up to my Mirco-TESE (sperm extraction) operation in New York, I was advised by my fertility specialist to inject with female hormones, in the attempt to up my natural testosterone levels for when my testicles were dissected. This was a very unsexy daily marital routine, where my wife injected me in the stomach with subcutaneous needles. Despite our best efforts to get my body performing at its optimum, the operation was unsuccessful. Whilst I was recovering in a hotel bed after a 5-hour operation under general anaesthetic, my wife had her eggs retrieved the next day and we weren’t together when the news was confirmed that we’d be using the donor sperm we had on ice.

Whilst microsurgical testicular sperm extraction (Micro-TESE) and intracytoplasmic sperm injection have helped some men with Klinefelter Syndrome to father children, this wasn’t the case for me. Hindsight is a great thing.

Mourning My Genetics

Round 1 with donor sperm failed and to some extent that was a relief – not for my wife, but for me. All the above had happened in the space of 5 months and we were moving at the rate of knots. Did I have time for the news to settle in and for me to mourn my genetics when we got our IVF BFN (big fat negative)…NO. However, a few months later, when we went back to the States and my wife had a frozen embryo transfer with one of our two remaining blastocysts, the future seemed somewhat brighter. I was in less pain, able to enjoy time with my wife on ‘holiday’ in New York and we reconnected as a couple.

This cycle worked but whilst I was overjoyed to have a baby of ours on the way, there were some triggers during the pregnancy which would set me off. For example, scans. My wife didn’t want to find out what we were having, but for me that was imperative for the bonding process, so we did and this helped. I could now imagine our daughter.

How Has This Impacted My Health?

When you’re desperately trying to conceive and all you want is that baby at the end of it, it’s sometimes easy to lose sight of your own health and wellbeing. We were so focussed on the operation that we didn’t really investigate how it would impact my body and testosterone levels long-term. I knew that I would need testosterone replacement therapy long-term but didn’t realise how much lower my testosterone levels would drop as a consequence of the damage to my testicular tissue. Had I known this, would I have had the operation? I just don’t know…

The reality for me now, is that every nine weeks I have to have an intramuscular testosterone injection in the bum, in order to increase my testosterone levels artificially, because they have dropped so low due to my operation and genetic condition. This is uncomfortable and the side effects are increased sex drive, spots, headaches, more hair and a sore arse! Unfortunately this also means that I am at higher risk of blood clots and stroke.

Visit Fertility Help Hub for more information and resources.

Why Supplements Can Boost Men’s Health and Fertility

Can supplements boost male fertility

Proper nutrition is critical to our health in so many ways. Our bodies need the proper amount of certain vitamins and minerals to effectively perform their processes, as well as maintain proper cellular and organ health. This of course includes the organs and processes associated with reproduction, so it is not surprising that the nutrients we consume can impact on fertility, including male fertility.

Even when eating a healthy, balanced diet this is often not enough to get the nutrients we need. A combination of our hectic lifestyles nowadays and modern food production, storage and transportation which saps the nutrients from our food means that the minerals and vitamins we eat are not sufficient. This is where supplements come in.

Of course, male fertility is a complex picture, with many factors influencing fertility, covering genetic, health and lifestyle factors. Although nutrition is just one aspect of this picture, supplements can be useful in improving fertility in men.

The Link Between Nutrition and Fertility

There are several ways in which the vitamins and minerals that men consume impact on reproductive processes and fertility. In some cases, certain nutrients have been shown to increase testosterone levels, which is strongly linked to male fertility, with lower testosterone being one of the possible causes for low sperm count. Other supplements can help to mitigate or counteract health problems which may be contributing to low fertility, such as oxidative stress, or help to increase libido.

In the next section we will examine the ways nutritional supplements may assist with male fertility issues. Because these supplements act in specific ways, it is vital to consult with your doctor to determine whether nutritional supplements could be beneficial in your case.

Can Supplements Boost Male Fertility?

There are a number of supplements which can improve or strengthen male fertility:

  • Vitamin C: Vitamin C has been linked to improved semen quality, as well as combatting some of the effects of oxidative stress, a condition which has been shown to lower fertility. One study showed that participants who took 1000-mg vitamin C supplements twice daily for two months had an increased sperm count of more than 100%, reduced proportion of deformed sperm cells by 55%, and increased sperm motility of 92%.
  • Vitamin D: There is some evidence that higher Vitamin D levels are linked to greater sperm motility, while Vitamin D deficiency has been shown to cause low testosterone levels.
  • D-Aspartic Acid: Also known as D-AA, D-Asperatic is form of amino acid, the building blocks of protein. This particular amino acid is found naturally in male reproductive organs and tissues, including the testes, semen and sperm. Studies show that D-AA levels are much lower in infertile men and suggest that taking D-AA supplements will boost testosterone levels in men, aiding with sperm count and motility.
  • Zinc: Zinc is an essential mineral vital to many bodily processes, including reproduction and fertility. Research has linked low zinc levels to lowered testosterone, sperm quality and increased risk of infertility in men.
  • Tribulus terrestris: Tribulus terrestris is a medicinal herb also known as puncture vine, goat’s head or Gokshura. Research suggests that this herb improves erectile function and libido. Some have promoted it as increasing testosterone levels, but there is no evidence for this. It is likely, however that it enhances male libido.
  • Fenugreek: Fenugreek is another medicinal herb, which is also commonly used in cooking. A study showed that taking fenugreek extract contributed to higher testosterone levels, as well as strength and fat loss, in male participants.

The timing of when you take your supplements is important: if you are not sure when to take your supplements, check with your doctor.

Other Health Benefits of Supplements

Taking nutritional supplements have benefits which go well beyond just fertility. Supplements can often by essential to achieving optimum health and fitness by ensuring our bodies have the required levels of the nutrients they need.

For example, Vitamin D is vital for bone health as well as lowering the risk of cardiovascular disease, autoimmune disease and even some forms of cancer, nearly half of adults in the US suffer from Vitamin D deficiency. Other vitamins, particularly Vitamin C and the B group vitamins are hugely important for maintaining a strong immune system, gastrointestinal health, and cellular health in general.

Important supplements are not limited to vitamins. Omega-3 fatty acids are highly beneficial in improving energy levels and reducing inflammation, and iron is critical for healthy levels of oxygen in the blood. For those looking to build more muscle mass, amino acid supplements can be highly effective. Check this muscle supplement guide for more on how to use supplements to build muscle.

Nutritional supplements can have many health benefits, and depending on the nature of your fertility challenges, may just help to boost your fertility!

Are Poor Sleep Habits Lowering Your Sperm Count?

Low sperm count has been an issue for men for years, but it’s becoming a more and more common reality in recent years.

While many different factors contribute to low sperm count, including stress levels and drug use, one of the more unknown influences is sleep. Or, rather, lack thereof.

Sleep and Sperm Count

Studies have found that disrupted circadian rhythms can lower sperm quality and count. A circadian rhythm, or the cycle of biochemical processes within our bodies, is most commonly altered by poor sleeping habits. This connection between interrupted internal clocks and decreased sperm count has been shown in night shift workers who maintain strange sleep schedules. Men in this group have been found to have a lower sperm count than men who work and sleep normal hours.

While there haven’t been many studies on the impact of circadian rhythms on human sperm count, a recent study on animals found that a disruption in these patterns can lower sperm count by 70 percent.

Disturbed circadian rhythms aren’t the only connection between sleep and sperm numbers, however. It is also believed that low-quality sleep lowers testosterone levels, the hormone vital to producing sperm.

Either too much, or too little sleep can impair sperm count. Surprisingly, however, oversleeping has been found to have the most impact on sperm count. In fact, a 2016 study found that sleeping more than nine hours a night can lead to a 39 percent drop in sperm count.

Why should we be concerned?

A low sperm count is one of the largest causes of male infertility. A low sperm number can make it harder to conceive and extend the amount of time it takes to get pregnant.

It isn’t just a fertility concern, however. Low sperm counts can also be an indicator of poor overall health. Studies have found a correlation between lower sperm count and an increased risk of heart and bone density problems, as well as a higher chance of being overweight. Similarly, low sperm count may also be connected with a higher risk of developing testicular cancer.

How to Get Better Sleep

Outfit your bedroom: Cater your bedroom to meet your own sleep needs. If you wake up sweating, try a mattress that stays cool throughout the night. Or, if you snore, invest in firm pillows to keep your head propped up. Listen to your body and adapt your sleeping environment accordingly to improve your sleep.

Stick to your schedule: Keeping a consistent sleep schedule is necessary, as well. You should be maintaining your bedtime, even on the weekends, and sleep between 7-9 hours a night.

Avoid LED light: Be sure to limit your use of electronics close to bedtime. The artificial light can prevent the release of the sleep hormone, melatonin, and make it much harder for you to fall asleep. If you must use electronics, try to wear LED-blocking glasses to protect your sleep cycle.