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Men, What You Don’t Know about Your Fertility CAN Hurt You


a blog by Laurence A. Jacobs, M.D., Fertility Centers of Illinois, August 16, 2013

Many men spend their lives unaware that they might be doing things that can harm their fertility. When they end up in my office, they are often surprised to find out that approximately 50 percent of the time, they might be the cause of a couple’s infertility.

Male infertility is typically caused by problems with the sperm, such as sperm count, sperm morphology (size, shape and appearance) and sperm motility (movement). One of the most common causes of problems with the sperm is a varicocele, which is a group of dilated veins in the scrotum that can increase the temperature in the scrotum, resulting in testicular damage and impaired sperm production. Varicoceles are found in 40 percent of infertile men, and it is a condition can often be corrected or overcome.

Chronic conditions, such as diabetes and liver cirrhosis, can affect male fertility, as can obesity and environmental factors. Lifestyle changes such as stopping smoking, losing weight, avoiding exposure to harmful chemicals and keeping temperatures around the scrotum cool by avoiding tight underwear and excessive bike riding, etc., can help improve fertility.

Another cause of male fertility problems that I have seen quite a bit of lately is the use of testosterone (T) and/or anabolic steroid supplements. If you believe the marketing around these products and gels, you would think they are the key to the fountain of youth with promises to boost libido, improve concentration and memory, and increase muscle mass. Many supplements and testosterone products can be obtained on the internet, without prescription or medical supervision. Clinical evidence suggests increasing numbers of men are resorting to these pharmaceutical solutions rather than focusing on lifestyle changes. Many women are also not aware that their partners may be taking these testosterone and steroid products. Amazingly, there are even clinicians (nurses, primary care physicians, and occasionally ObGyns and urologists) who are unaware of the well-established detrimental effects of these products on sperm production.

Taking testosterone or other androgen or steroid supplements suppresses their pituitary’s production of vital hormones (FSH & LH), which then leads to a reduction in testosterone levels in the testicles! The resulting drop in testicular testosterone inhibits sperm production and leads to or worsens infertility, often resulting in azoospermia. The average time for sperm production to recover is more than six months from the time the drugs or supplements are stopped — and occasionally men can suffer from long-term effects on sperm production. Testosterone and/or anabolic steroid supplements should be avoided in men desiring to have children.

The bottom line? Men need to be aware of what they are doing that could decrease their fertility — education and awareness are key.

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