Men, stand up and be counted

Dr T
Dr T Dr T
Image: Fredlin Adriaan

One of the main attractions of visiting Cape Town in the ’90s was the IMAX theatre at the V&A Waterfront.

I remember the excitement and expectation sitting in this futuristic theatre with its massive screen which felt like it was within touching distance for all the cinema-goers.

We watched Serengeti, a film about the magnificent migration of wildebeest across the Masai Mara national park. The story was narrated by the unmistakable James Earl Jones (the voice of Darth Vader).

This seasonal migration takes more than 2-million animals (the majority being wildebeest) across 3,000km of Tanzanian and Kenyan plains in search of food and water.

The most treacherous part of the journey is the crossing of rivers full of hungry, waiting crocodiles.

About 250,000 animals die during the migration. This is from predators like lions but also from exhaustion and thirst.

An even more hazardous and terminal trek is an everyday human occurrence.

This happens just before conception as 100- to 250-million sperm traverse the female genital tract in search of the ultimate goal, the prized ovum or female egg.

This futile journey results in the death of all these humble little swimmers except for the winner that fertilised the egg, but only if sex occurs around ovulation.

Success is the exception to the rule and happens only once or twice a year (as miscarriages are common).

Danger lurks around each corner as the female genital tract is a rather inhospitable environment for the sperm. If the cervical mucus is not too thick at that time of the cycle and they are lucky enough to pick the correct Fallopian tube to swim through, the host’s immune cells may still kill them.

To compensate for this, the human testicle produces tens of millions of sperm per day at an astonishing rate. Unfortunately, the byproduct of this rapid process is that only between 5% and 14% of the sperm will function normally.

The rest will have defects that make them unlikely to reach the ovum, like double tails or misshapen heads.

The process of production is very sensitive to local environmental factors such as temperature, nutrition, toxins and stress.

Infertility is defined as the inability to conceive within a 12-month period of unprotected sexual intercourse.

It is estimated that 15% of couples worldwide suffer from infertility and worldwide fertility rates are on a downward trend.

It is calculated that within the next 50 years fertility rates can drop by up to 50% if European data is extrapolated.

Women are often incorrectly blamed when a couple struggles to conceive and this is revealed by the reluctance of men to accompany their partners for consultation or to go for a semen analysis.

About 40% of all infertility cases involve an abnormality in sperm production or quality.

There is no need to fear accompanying your partner to the gynaecologist. It will show her your support and that you are willing to participate in the process and acknowledge ownership if you are implicated.

You also have the option of going to a urologist, but this referral is mostly done if your semen analysis is abnormal. And there is no need to be embarrassed, as the sample can be brought in by your partner if you prefer.

So why are we producing less or poorer quality and what can be done about this?

  • Stress: acute, chronic and especially performance anxiety about fertility treatment.
  • Age: delays in starting a family.
  • Poor nutrition: lack of antioxidants, a high-fat diet and caffeine ( especially energy drinks).
  • Exercise: strenuous exercise worsens and moderate exercise improves.
  • High temperature: continuous cycling, tight undergarments, prolonged sitting in a car.
  • Smoking and alcohol: the usual suspects.
  • Radiation: the theoretic effect of cellphones not proven yet.

Many vitamins and micronutrient supplements have been assessed as an adjuvant to improve sperm counts. The most successful of these have been antioxidants and especially when used in combination.

They included: vitamin A and C, selenium, zinc, L carnitine, coenzyme Q 10, folic acid and omega 3 fatty acids.

Improving your fertility comes down to some good lifestyle choices. A balanced diet including fresh fruit, vegetables and oily fish (antioxidants and omega 3 fats) and low fat/caffeine/alcohol intake is a must.

Moderate exercise, stress management and avoiding exposure to prolonged heating can all improve the situation. Also, stop smoking.

There are multivitamin supplements on the market specifically made for men with this problem. So please men, volunteer to accompany your partner to this difficult consultation.

She does not only need your support, but you may turn out to be just as involved in the process as she is.

Keep cool, and keep them cool. 

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