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Men's Health Month: Taking Charge of Male Fertility

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Many people fail to realize the correlation between overall health and fertility. Infertility is often a symptom of an underlying medical problem, even at a young age. In honor of Men’s Health Month this June, Fertility Authority is raising awareness of men’s health and fertility, including ways to improve sperm quality and quantity and treatment options for addressing male infertility.

Marc Goldstein, M.D., DSc, FACS, a Urologist at the Center for Male Reproductive Medicine at Cornell Medical Center believes many of the misconceptions about male fertility date far back in history when women were blamed for a couples' inability to have children. "Even today, men do not have a urologist that they consult regularly as a woman has an OB-GYN. OB-GYNs work with women and do not focus on the man, so many fail to order a semen analysis. There is also the misconception that the inability to get a woman pregnant calls into question one's masculinity, so many men are in denial about potential problems with their fertility," he states. These misconceptions stand in the way of men seeking a fertility evaluation, diagnosis, and treatment. They often assume that male factor infertility does not affect young men.

Moshe Wald, M.D., a Urologist at the University of Iowa Hospitals and Clinics says the greatest obstacle to getting the message out about health conditions and male fertility is the lack of understanding that complications may arise at any age and should be taken seriously. Many men put off seeing a urologist or fertility doctor with the belief that erectile dysfunction or low testosterone only affect older men. Embarrassment about reproductive impairments as a symptom of health complications further impedes proper diagnosis and care. “Something I see in practice is that occasionally men are surprised that there can be issues with their fertility even at a younger age,” he says.

Men should address fertility concerns before age further confounds their reproductive health. With age comes an increased risk of DNA fragmentation in sperm, increased risk of Autism or Down Syndrome in offspring, and two to three times the risk of Schizophrenia in offspring, Dr. Goldstein explains.

How Health and Environmental Factors Impact Male Fertility

Issues like low testosterone, erectile dysfunction, or ejaculatory complications most often occur in later years but can also impact men earlier in life. They are often the side effect of health conditions like diabetes, weight-induced hormone imbalance, cancers (even those that do not directly impact the reproductive organs), high blood pressure, and heart disease. “Interestingly, the same underlying process that causes heart disease can affect erectile mechanisms. When a patient presents with erectile problems, we not only treat the problem, but also refer him to his primary care physician to rule out problems with the heart and other health conditions,” Wald advises. Varicocele, Crohn's Disease, and Inflammatory Bowel Disease can also pose risks to male fertility. For this reason, it is important for men to speak up about their health and reproductive concerns to receive the appropriate treatment.

Aside from disease, occupational hazards or lifestyle factors like smoking, recreational drug use, and alcohol consumption can pose health risks which compromise male fertility. Exposure to extreme heat can prevent healthy sperm production and exposure to certain dyes or chemicals can alter the body's natural hormone levels. Chronic smoking restricts blood vessels leading to erectile dysfunction and a decline in testicular health while excessive alcohol consumption impairs liver function, increases the amount of estrogen in the blood, and decreases healthy sperm production. In addition, certain prescription drugs can decrease male fertility.

Treatments for Male Factor Infertility

The good news is that there are many treatment options available for restoring hormone balance with prescription drugs, or even addressing male infertility via assisted fertilization as is the case with intracytoplasmic sperm injection (ICSI). Vitamins like folic acid and CoQ10 may also be recommended though there are varying opinions on the benefits of taking vitamin supplements to significantly improve male fertility. “Men with low blood testosterone levels and symptoms of low testosterone levels may potentially benefit from prescription testosterone replacement. Men who are seeking fertility treatment might be candidates for using Clomid to improve fertility during fertility treatment, but only for the short term duration. Once a man has stopped fertility treatment, and has an established indication of low testosterone and low testosterone symptoms including low energy, low libido, erectile dysfunction, memory issues, and low blood testosterone, he should then be treated accordingly,” states Wald.

Of course there are small steps men can take to boost their fertility as well. Maintaining a balanced diet and exercising in moderation can improve blood circulation, and weight loss can improve the male hormone profile and erectile function. In general, activities and habits that are good for heart health also benefit reproductive function and healthy sperm production.

Most importantly, both doctors encourage men to be aware of the ways in which health conditions impact fertility at any age and to be proactive about achieving overall health. "Male fertility is so easy to evaulate both by providing a semen sample and performing a physical exam. It just makes sense for men to get checked out by a reproductive urologist since about half of all infertility is attributable to men," Goldstein recommends.

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