In Hong Kong, it is estimated that about one in six couples faces difficulty conceiving. As more couples have children later in life, particularly in their late 30s and 40s, many encounter fertility issues. While people think that most fertility problems are unique to women, around 40% of infertility cases are attributed to men.
We discuss some of the most common fertility myths with Dr. Kwan Lun Ho 何崑崙醫生 a Specialist in Urology based in Hong Kong.
1 – Only women need to take supplements to improve fertility: WE NEED MORE EVIDENCE
There is limited evidence that supports supplements as a treatment for infertility and it is inconclusive that they can improve fertility. Some supplements may correct a deficiency but they do not treat the underlying causes of infertility.
Supplements said to have potential benefits on sperm quality or count include Black seed (Nigella sativa), Coenzyme Q10, Folic acid, Horse chestnut (aescin), L-carnitine, Panax ginseng, Zinc, Saffron, Maca, Eurycoma Longifolia, and Astaxanthin.
2 – Age does not affect male fertility: FALSE
Studies show that age can play a role in male fertility in a variety of ways. Particularly after the age of 50, age may have an effect on sexual function, a decrease in sperm motility and quality, and increasing rates of DNA fragmentation. Other risks associated with age include damage due to longer exposure to environmental toxins and chemicals, increased chance of developing medical conditions, and a decline in testosterone.
Moreover, age can also have an impact on children yet to come. Studies had shown an increase in risks of autism and schizophrenia in children of men after the age of 45.
More research is still required to further provide conclusive evidence with regard to fertility and aging men.
3 – Smoking and drinking do not affect male fertility: FALSE
As with other diseases, health and lifestyle can be a factor in male fertility. Smoking and being exposed to second-hand smoke may lower sperm count and cause a decrease in sperm motility. Excessive alcohol consumption not only damages the liver known to remove toxins from the body, but it can also destroy sperm cells and interfere with testosterone levels.
4 – Bicycles, hot tubs, cell phones and laptops don’t have an effect on semen quality: MAYBE
Activities involving prolonged sitting, such as bike riding, is said to be associated with a risk for sexual function, due to the compression of the penile artery and other vital nerves leading to the penis.
We often hear that heat and heat radiation can have a temporary effect (3 months – the lifespan of sperm¬) on normal sperm production, quality, and quantity. The testicles need to maintain a temperature of about two degrees Celsius cooler than core body temperature. Studies have shown that actions or activities that raise testicular temperature can decrease sperm count, for example: frequent and prolonged hot bath or sauna.
However, effects of radiation from cell phones or laptops on sperm DNA fragmentation were unproven. Research to support these effects on fertility are mixed and inconclusive.
5 – Male infertility is genetic: TRUE
Despite medical advances and according to the National Center for biotechnology Information (NCBI), in about 50% of cases the cause of male infertility remains unknown. This is referred to as idiopathic infertility which is most likely to be of genetic origin.
Those genetic disorders can be Kartagener’s syndrome, Kallmann’s syndrome, cystic fibrosis or Klinefelter’s syndrome. The last syndrome is a chromosomal abnormality in which a male has one Y chromosome and two X chromosomes (XXY), instead of one Y and one X (XY). This disorder causes a defect in the development of the male reproductive organs.
6 – Boxers are better than briefs: WE NEED MORE EVIDENCE
Testicles should not be exposed to high temperatures and should remain a couple degrees cooler than normal body temperature for sperm production and sperm count. Some research shows that briefs cause a slightly higher temperature, however, there is no research indicating it can cause infertility.
7 – Frequent masturbation is bad for sperm health: TRUE AND FALSE
Some data has shown that optimum semen quality occurs after two to three days of no ejaculation. Yet, even if long period of abstinence could result in very high concentration of sperms, they will mostly be lazy or dead ones. However, frequent ejaculation produces lower sperm concentration with better motility.
8 – Lifestyle, diet, weight, depression or stress levels have nothing to do with fertility: FALSE
Health and lifestyle can be factors in male fertility. To improve fertility it is highly recommended to maintain a healthy lifestyle: consuming plenty of fruits and vegetables high in essential vitamins and antioxidants, furthermore, avoiding carcinogenic foods, toxins, and chemicals may improve sperm health as well.
Obesity can cause hormonal changes, lower volume of semen, decrease sperm count and motility, and increase sperm defects.
Stress and depression can interfere with hormones needed to produce sperm and can affect sperm count. Moreover, depression in men causes a decrease in sexual function and libido, or delayed or inhibited ejaculation.
9 – A man with a high sex drive will have a normal sperm count: FALSE
Sex drive and sperm count are not necessarily related. A proper semen analysis is essential to determining fertility and sperm quality.
To resume male infertility can be caused by a number of reasons including low sperm count, abnormal sperm shape (morphology), motility, function, and problems with semen. Medical issues can also contribute, such as hormonal imbalances, testicular diseases and infections, sperm transport disorders, antibodies that attack sperm, Varicocele, genetic defects, medications or surgery for example.
If you have not been able to conceive after a year of unprotected sex, an evaluation for infertility may be considered. A specialist can help identify the cause of the issue and provide treatments to help reach your family planning goals.
Dr. Kwan Lun Ho 何崑崙醫生 is a Specialist in Urology currently working in private practice. His qualifications include MBBS(HK), FRCSEd(Urol), FCSHK, and FHKAM(Surgery). Dr. Ho is fluent in Cantonese, English, and Putonghua.