Sperm morphology: are your sperm in good shape

Sperm morphology is one of the parameters that are evaluated in a semen analysis. It is a measurement of the percentage of sperm that are normal in shape. A normal sperm has an oval-shaped head, a well-defined cap (acrosome) that covers part of the head, and a single midpiece and tail. During the production of sperm in the testicle (which takes about 90 days!), defects often occur. For example, sperm may have double heads, missing acrosomes, or short tails.


To evaluate a specimen, a microscope slide is prepared with a very thin coating of semen. The slide is stained to make the sperm clearly visible, and then at least 200 hundred sperm are viewed under high magnification and individually scored as either normal or abnormal based on their shape. The percentage of normally shaped sperm is then calculated.

Morphology is assessed using one of two sets of characteristics: Kruger or World Health Organization (WHO). Kruger criteria are stricter and consider small irregularities as abnormal. WHO criteria are more lenient and therefore do not classify as many sperm as abnormal. Most clinics today are moving toward the Kruger strict criterion which is more predictive of egg fertilization success.

More recent research led to a change in 2010 in the interpretation of sperm morphology. Prior to that time, a higher percentage of normal sperm was required for a sample to be considered normal. Specifically, at least 14% of the sperm in the ejaculate had to be normal in order to have a good prognosis for fertilization. Now, the World Health Organization has adopted a new cut-off. Only 4% of the ejaculate needs to be of normal shape for the sample to be considered fertile.

So what impact does abnormal morphology (teratospermia) have on fertility? 

It is possible for an abnormally shaped sperm to fertilize an egg. However, some studies have shown that having higher amounts of abnormally shaped sperm is associated with difficulty in achieving pregnancy. It is unclear if this is due to the shape of the sperm itself, or by another reason that causes the sperm to be shaped differently and also causes infertility problems. In addition, men who have poor morphology often have other irregularities too, including low sperm count and/or motility.

The next question is whether there is anything that can be done to improve morphology?
There are three main causes of this problem:

1. A genetic trait
2. Exposure to toxic chemicals
3. Increased testicular temperature

Nothing can be done if it is a genetic trait; however, the other two causes may be reversible.
Men can be exposed to toxic chemicals either at work or in the home. If your occupation exposes you to toxins (such as automotive paint shops), you need to follow all safety guidelines. Even some household items such as cleaning supplies or pesticides can cause problems with sperm morphology when used without proper ventilation. You should always use protective masks, gloves and clothing when using these chemicals.

Wearing tight-fitting clothing (like jockey shorts) around the clock can increase scrotal temperature to a point where sperm morphology could be affected. Even sitting at a desk for a prolonged period of time can keep the testicles drawn up close to the body which can result in an increased temperature. It is best to get up and walk around periodically to avoid this situation.

Some medications, such as antidepressants, can also have an effect on sperm morphology. You should review any medications you are taking with your fertility specialist. Lastly, improving your lifestyle may also help. When trying to achieve a pregnancy, you should avoid smoking and/or recreational drugs, and limit the use of alcohol. Dietary supplements have not been shown to have a positive effect on sperm morphology, but some fertility specialists do recommend a daily multivitamin to improve your overall well-being including reproductive health.

Poor sperm morphology, however, by no means eliminates your chances for successfully achieving pregnancy. Recent studies, in fact, suggest that below normal sperm morphology has less of an impact on the success of intrauterine insemination (IUI). This is likely due to the number of sperm used in an insemination. It is common to place 10 million or more sperm in the uterus when performing an IUI, so even if a significant percent are abnormal in shape there are still plenty of normally shaped sperm available to get the job done. If inseminations are not successful, then in vitro fertilization (IVF) may be necessary. The good news then is that a technique called ICSI (Intracytoplasmic Sperm Injection) can be used to inject good quality, normal-shaped sperm into the eggs to achieve fertilization.

So, if your sperm morphology results are not what you expected, don’t be discouraged! There are ways to overcome this setback and still achieve your ultimate goal of parenthood.
 

Tips to improve sperm count

Male factor is the cause in approximately 40% of infertile couples. In many cases, the cause is unknown and there is no specific treatment to improve sperm count. The good news is that these couples can often conceive with the use of assisted reproductive technologies (e.g. intracytoplasmic sperm injection or ICSI, testicular sperm aspiration or TESA). In a small percentage of patients, there are hormonal imbalances that can be treated.

Here are some tips that may improve your sperm count.

1. See an urologist specializing in male infertility. A physical examination will sometimes pick up a testicular tumor in patients with severe male factor. Infertility is a risk factor for testicular cancer. The risk of testicular cancer is 2.8-3.6 times higher in men who presented with infertility. (The disease is 99% curable with an early diagnosis). Testicular cancer when identified early requires less toxic therapy than other cancers.
2. A varicocele is one of the most treatable and reversible causes of male infertility. The incidence of varicocele is 35%-40% in infertile men. Varicoceles that need to be treated are palpable and men have an abnormal sperm parameter. Research has shown that after treatment of a variococele surgically or by embolizaton, 70% of patients will see improvement in their semen quality and 30-40% can impregnate their partners.
3. Lose weight. Male obesity in reproductive age men has nearly tripled in the past 30 years and coincides with an increase in male infertility worldwide. Obesity has been shown to decrease testosterone levels through increased aromatase activity and elevated estradiol levels.
4. Get checked for diabetes. Chronic diseases such as diabetes can effect fertility related functioning in males and result in erectile or ejaculatory dysfunction due to neurologic and vascular issues. Diabetes associated erectile dysfunction is a reversible and treated problem in 70%-90% of men using oral and injectable medications.
5. Certain medications can effect sperm production. These include calcium channel blockers, spironolactone, hypertension medications along with medications for Crohns disease, methotrexate and chemotherapies all play a role in effecting sperm production.
6. Quit smoking. Heavy tobacco use could lead to hormone imbalances and sperm production issues.
7. Moderate your alcohol consumption. Heavy alcohol use can also affect sperm production.
8. Quit using anabolic steroids and testosterone supplements. Anabolic steroids are often used by body builders to gain muscle mass. The steroids can result in a significant decrease in sperm counts. The use of testosterone supplements (e.g. Androgel, testosterone patches) can suppress sperm production. These are often used as treatment for “low T”. The physiological action of testosterone is to suppress (negative feedback) the pituitary glands ability to release FSH and LH (hormones needed for sperm production).
9. Stop using recreational drugs. Cocaine has been linked to low sperm count, motility and morphology (shape of sperm) defects. Opioid abuse has been associated with decreased gonadotropins and testosterone levels. Heavy marijuana use has been linked to low testosterone levels, pyospermia (pus cells in the semen) and decreased sperm concentration.
10. Avoid hot tubs, saunas, tight clothing and electronic devices resting on their lap. Data from recent studies have shown that increased radio frequency electromagnetic waves from cell phones might lead to stress on human semen and effects on DNA integrity. Increased scrotal temperatures can cause sperm abnormalities.

None of this is rocket science. At the same time these are modifiable lifestyle issues that are known to affect male reproductive health. Improve your lifestyle and this may result in an improved sperm count!

Can excessive masturbation cause infertility?

Family planning and pregnancy can be quite stressful at time. When the female partner is not getting pregnant after a couple of months several men fear that it may be their fault. The guilt conscience begins to take root.

There are many myths associated with masturbation and many men are not sure what the real truth is any longer. To set your fears aside, whether you ejaculate inside a woman’s body or outside does not affect your fertility. The only difference is that if you ejaculate inside a woman’s body the possibility of her getting pregnant is higher. Those men who are trying to get their partners pregnant should keep this in mind.

Regular intercourse with ejaculation at least 3 or 4 times a week can help keep your sperm quality good. Healthy sperm has good motility and morphology. Sperm motility is the swimming capabilities of the sperm and sperm morphology is the shape of the sperm. A normal sperm will have a head that is shaped in a manner that allows it to easily penetrate the egg. An abnormally shaped sperm may not be able to penetrate the egg even if it reaches it, due to the deformed shape of the head. A sperm that is a good swimmer can reach the egg soon and this is essential for conception. All you need is one good swimmer and sometimes it is hard to find even that in the 3 million semen load.

Good quality sperm

Optimal quality sperm is produced when the male does not ejaculate for 2-3 days. If you are trying for a baby naturally it is advisable to give yourself few days break from masturbation and then have sexual intercourse. This will improve your chances of conception.

If you are undergoing IVF treatment at some point you will be expected to give a semen sample. Doctors usually advise that you should avoid masturbation and ejaculation at least for 3 days prior to giving the sample. This is to ensure optimum quality of sperm.

Sperm depletion

Frequent masturbation (3 or 4 times a day) can deplete your sperm reserve. Each ejaculation releases approximately 300 million sperm and the male body produces 12 billion sperm per month. If you are conscious about sperm depletion, you can do the math as to exactly how many times you can ejaculate each month.

Low sperm count

If you feel that your sperm count may be low you can have it checked by a simple sperm count test. Low levels of sperm count may affect fertility. You can clear your doubts regarding your sperm count easily by getting it checked with giving a sperm sample to a clinic. They will revert within a few days with the test results.If you do test positive with a low sperm count, do not feel remorse over the thought that it is might be due to excessive masturbation, as that does not affect sperm count.

Excessive sexual intercourse or excessive masturbation does not affect your sperm count, though it may temporarily reduce your sperm reserve till your body can produce more. If you have frequent sex you may find that the quantity of semen you ejaculate is reducing. This is temporary and there is no need for concern. Give it a few days of rest and your body will produce more sperm.

If you are going through fertility treatment then it is worth while discussing your sexual habits with the doctor so that it will does hamper the treatment and healthy sperm production. It is also beneficial to enquire regarding the measures you should take to improve your sperm quality for the treatment. The quality of sperm plays a very significant role in the IVF procedure. Healthy sperm can help with fertilization and improve the embryo quality.

Source: https://www.medicoverfertility.com/blog/can-excessive-masturbation-cause-infertility/

What are the signs of infertility in men?

Male infertility is now coming to light as men are discovering that they are not able to make their wives pregnant. Among the many couples that visit infertility clinics, a lot of them find that the fertility issues they are facing is only due to a problem with the male partner.

Male infertility has no obvious outward signs. A man may not know he is infertile till he undergoes a fertility test and has his sperm checked for count, motility and morphology. In most cases the only signs of infertility in men are when they are not able to make their partners pregnant.

Erectile dysfunction

Erectile dysfunction can broadly be described as a situation where a man has problems getting an erection or sustaining one. A man who cannot maintain an erection is considered infertile. He will not be able to impregnate a woman naturally. For conception he will have to undergo an IVF procedure. However erectile dysfunction is not related to sperm count or quality of sperm. Hence a simple procedure like IUI can help the female partner get pregnant.

What are the signs of infertility in men? A man is considered infertile when there is a problem related to the sperm count or the quality of the sperm. The common problems with sperm are:

• Abnormal sperm morphology
• Sperm with poor motility
• Poor sperm quality
• Sperm that cannot attach the head to egg
• Sperm that cannot penetrate the egg due to abnormal head shape

Over the years the general sperm count in men has reduced. Two decades ago a general healthy sperm count was 50 million per millilitre of sperm. Today 20 million is the general count and is considered as healthy. A sperm count of 10 million or lower is considered as a low sperm count.

Low sperm count is a very common problem in men today. Men with low sperm count can sire children but they will require some kind of medical assistance or a medical procedure to help with conception.

Some men suffer from a condition where there is no sperm in their semen. This is known as azoospermia.
There are men who have healthy sperm and a good sperm count but are not able to release the sperm and hence the sperm cannot penetrate the egg.

Retrograde flow of sperm, when the sperm are ejected they travel back into the bladder instead of entering the woman’s body. This is a condition that happens as a side effect of certain medication and can also be caused due to surgery.

Symptoms that should not be ignored

There are certain symptoms or changes in a man’s body that he may notice, but most of the time these are ignored and not given any importance. However, this is an indication that something is wrong and should be looked into by a medical expert. Some of these symptoms could be related to signs of infertility in men.

• A decrease in sex drive is when a man finds that he is not inclined towards sex. He no longer feels the desire to have sex.
• Any kind of pain in the testicle area. If you notice a lump or some swelling
• Gynecomastia: breast growth in males
• Decrease in body and facial hair is due to a hormonal abnormality

Any kind of sexual problems should be given serious attention. Any of these problems could be signs of infertility in men lead to or hamper male fertility.

Men usually ignore their fertility and do not bother to pay heed to symptoms that their bodies undergo, unless it is causing them pain or discomfort. However conscious awareness of bodily changes can help to catch a problem in the initial stages before it becomes a major issue.

Source: https://www.medicoverfertility.com/blog/what-are-the-signs-of-infertility-in-men/

Male Infertility Treatment: Ayurveda treats all

Whenever you hear the concept of infertility, a woman’s problem is what comes to find. However, infertility affects men as well. Unlike earlier days, people have know come to know that infertility isn’t gender-specific and affects both genders. Infertility refers to the inability to bear a child with your better half. The underlying causes of infertility can be a number of factors. These factors are different for different people. The factors are also different, in terms of gender. This article will discuss the factors that affect fertility of males. The discussion will be from the perspective of Ayurveda.

Male Infertility Treatment is necessary because, in the beginning, couples attempting their first pregnancy don’t get results. The couple is said to suffer from infertility if they try to bear a child for a year, without any results. As mentioned earlier, male infertility is one of the factors involved. The major causative factor in these cases is usually, a low sperm count and a poor sperm quality. In some cases, an exact cause cannot be pinpointed. Therefore, just approaching the problem with modern treatments won’t work. A holistic and natural healing treatment would be needed, to weed out and solve the problem.

Following are some specific factors that are involved in male infertility:-

• Azoospermia(classified as an actual medical condition) is when a man has semen that is devoid of sperms. Azoospermia has different types and there are various treatments centered around these types.
• Oligospermia is when there is a deficiency/very low concentration of sperms in the semen.
• Loss of Libido: A common problem that affects men (as well as women) that involves loss of sexual drive/interest in conceiving a child. There are a number of factors that are involved in a loss of libido.

Male Infertility Treatment in today’s times, is still experimental. This is because a lot of research is still yet to be done, to accurately pinpoint the exact cause and subsequent treatments for the same. Today’s treatments involve Intracytoplasmic Sperm Injection (ICSI) and assisted reproduction. Again, these methods are experimental, and can have undesired effects on the body as well. On the other hand, Ayurvedic treatments for infertility are found in specialized Ayurvedic clinics. India, being the birthplace of Ayurveda, has a number of clinics that offer treatments of Infertility. This is the reason why a lot of people residing out of the country, come here to avail treatment for infertility.

Following are some tips to reduce male infertility:

• Avoid alcohol
• Avoid smoking
• Avoid food that is made of poor quality oil and fats
• Get adequate amounts of physical activity in your daily life
• Specific powders that are prescribed by a qualified Ayurvedic practitioner
• Tonics, that help the body to fight and pacify the condition
• Herbs, the powerhouse of Ayurveda, that have excellent healing effects on the body

At the same time, one should ensure that they lead a healthy lifestyle. Physical/emotional stress can also affect a person’s fertility.

Male Infertility Treatment in Ayurveda is entirely different from the usual modern medicine treatments. Looking at the tips above, you can guess that treatments suggested by Ayurveda are basically diet and lifestyle changes. This is followed by a cleansing therapy that involves complete-body massages and consuming powerful herbs that help rid the body of toxins and other substances that make the body unhealthy. These massages, along with purifying your body, are also mentally and physically relaxing to the body. All of these treatments are suggested, based on an individual’s body type or constitution.

In the end, one must remember that a lot of fertility problems are because of a delay or absence of early detection. Delaying a thorough diagnosis of your semen will only lead to infertility in the near future. The earlier an individual tackles the problem, the quicker his problem/condition can be solved with natural treatments. The best thing that a person can do, is stay health with good eating habits and a healthy lifestyle that can keep him fit, active and energized. This why Ayurveda shines in its attemtps to cure infertility. Its method of detoxifying and purifying the various systems in the body eventually leads to a healthy body and personality.

Source: http://www.ayushakti.com/blog/male-infertility-treatment-ayurveda-treats-all/

Another Male Fertility Test is coming to Market: The Episona SEED Test.

Episona, an “epigenetics data” company  is a bringing a new male fertility test to market.  The test is hoped to provide additional useful information in the evaluation of the male fertility patient in addition to and beyond the information a semen analysis provides.  

Epigenetics refers to heritable changes, not in DNA but rather in gene “expression”.  Epigenetics therefore refers to anything other than DNA that can influence an organism’s development.  Known consequences of epigenetic changes include change in cancer risk, mental retardation disorders such as Angelman and Prader-Willi syndromes, autoimmunity disorders such as Lupus, Neuropsychiatric disorder such as Alzheimers as well as risk for autism.

Epigenetic change can be a normal and natural occurrence but can also be influenced by endogenous as well as exogenous factors.  These factors can include, age, environment, lifestyle and disease. Concrete examples include smoking, obesity, malnutrition, extreme stress or sleep deprivation. Several mechanisms have been identified as contributing to epigenetic change including:  DNA methylation, histone modification, chromatin remodeling and non-coding RNA, all of which can play a role in initiating and sustaining epigenetic changes.    Of these mechanism, DNA methylation is the most broadly studied  mechanism.

DNA methylation  refers to the addition of “methyl groups” to specific segments of DNA.  When this happens to a gene “promoter” the typical effect is to turn off transcription of that gene.

Episona is bringing their product to market Seed in collaboration with MDx, a company that uses DNA methylation testing to predict the presence of cancer. Episona’s product examines over 480,000 regions on sperm DNA for abnormal methylation at different gene sites important to fertility.  Seed is the first product on the market to evaluate epigenetic changes in DNA to predict the risk for male factor infertility as defined by the ability of a sperm to fertilize and egg and also as being able to predict poor embryo development.

Some early concerns:

It is not clear whether  SEED results vary result to result over time.  It is also not clear (as of now) if lifestyle or other changes can affect results such as improving diet, stopping smoking, getting sleep, etc.
New tools for the diagnosis of male infertility such as the Androvia Cap Score (discussed in a prior blog) and the Episona Seed test are encouraging developments and I am hopeful they will both serve to benefit my patients.

Source: http://www.malefertilitydoc.com/male-fertility-vasectomy-information-articles.html/2016/12/23/male-fertility-test-episona-seed-test/

Male Fertility Tips

If you want to produce and fertilize an egg with the best quality, super sperm you need to commit to some simple easy lifestyle changes. First very important piece of information is that the sperm regeneration cycle takes about 74 days. It takes 21/2 to 3 months for sperm to fully mature. When sperm are initially formed they lack the ability to swim forward or fertilize an egg. So these lifestyle changes need to be long term not just a few days or weeks. These tips work for couples who are trying to conceive on their own as well as if your are producing a semen sample for fertility treatments, such as IUI or IVF.

THINGS TO DO

• Keep a diet rich in Vitamin E, C, Zinc and Folate (water soluble B vitamin)
• Protect / try to avoid infections
• Keep stress low – manage your stress
• Keep cool- temperature
• Wear loose clothing and underwear such as boxers

THINGS TO AVOID OR NOT DO

• Avoid pollution as much as possible
• Avoid extreme temperatures- no hot tubs, overly hot baths or showers
• No Drugs
• No Smoking

It is also recommended that you abstain for ejaculating for 2  to 3 days as it affects sperm counts. That way you insure the greatest number of sperm available for fertilization.

Source: http://www.repromedfertility.com/blog/male-fertility-tips-4041/