The infertility specialist will take a
detailed medical history and perform a thorough medical examination of both
partners. The man’s tests are easier and less invasive, which is why it makes
sense that you go first before putting her through the ordeal. Dr. Firuza P.,
Director of Assisted Reproduction and Genetics, Jaslok Hospital, outlines the
various tests involved below.
The
man’s tests are easier and less invasive, which is why it makes sense that you go
first before putting her through the ordeal
·
Blood hormone levels, including testosterone.
High FSH and LH affect sperm count
·
Blood sugar levels
·
Semen analysis, after abstinence of three days.
It’s better to have two or three samples, two weeks apart.
·
Sperm count - normal is above 20 million/ml.
Borderline infertility is 15 to 20 million/ml.
·
Sperm motility (movement) 50% should be motile.
This is graded as (1) progressive motility or moving actively, either linear or
circular (2) non-progressive motility or going in small circles, with absence
of progression (3) immobility or no movement.
·
Morphology (shape and structure). You need 14%
with normal shapes, i.e., without abnormally large heads, no caps, tapering
heads, double heads, no heads, short necks, short tail and such.
·
Volume of ejaculate 2 to 5 ml of good color (off
white), liquefaction (40-45 minutes) viscosity, pH (8.0 is ideal).
This is the first sample test. Next up:
·
Sperm apoptosis (dying). You need less than 13%
with apoptosis. More than 40% shows poor fertility potential.
·
Sperm Fish detects chromosomal abnormalities
which should be less than 3%. Further more sophisticated tests may be advised.
Such as Karotyping to check for extra chromosomes which are associated with low
sperm counts; testicular biopsy scrotal ultrasound.
Fertility facts
·
Size has no bearing on fertility. All shapes ‘n’
sizes of penis can produce adequate sperm.
·
Impotency and infertility do not mean the same
thing. An impotent man can harbor fighting fit sperm. A virile man can shoot
blanks.
·
Masturbation doesn’t cause sperm to diminish.
New sperm are constantly being produced in your testicles, in six week cycles.
·
Abstinence for a week or so doesn’t improve the
quality of sperm, but can actually decrease motility.
·
So too daily sex does not increase the chance of
your li’l swimmers reaching the finishing line, but may actually decrease the
semen count on the day of ovulation.
·
Eating spicy food does not lower sperm count.
·
Semen is creamy white and contains sperm in its
infinite variety. It is fluid to facilitate motility and is produced by the
seminal vesicle tubular glands below the bladder. Fluid is also produced by the
prostate to revitalize vaginal acidity and make sperm mobile.
·
A low sperm count can be dramatically improved
if you quit smoking, eat right, exercise, and drink moderately.
·
Your semen analysis can be different on
different days because of variation in temperature, medication, and illnesses.
Getting Sperm Ready
The first steps to creating healthier
sperm, says Dr. Firuza Parikh, is to “eliminate smoke in the lungs, heat in the
testes, free radicals in the blood, stress in the mind and replace with oxygen,
frequent ejaculation, cooling of the testes, antioxidants in your diet and
contentment”. Other strategies:
·
Treat infections and prostatitis and control
diabetes.
·
Supplement containing Coenzyme Q, arginine,
lycopene, zinc, magnesium, essential fatty acids EPA and DHA can help to raise
the sperm count.
·
Clomiphene Citrate in small doses for 25 days,
with a break of 5 days for 3 to 6 cycles, can stimulate testes to produce more
sperm. So does Mesterolone tablets.
·
Microsurgery can unblock the vas deferens,
reverse vasectomy, and ligate varicocele.
·
Assisted Reproductive Techniques (ART). These include:
§
Intra Uterine Insemination (IUI): if your count is mildly decreased and motility is less than 30%.
The first portion of the ejaculated semen, which has the greatest concentration
of sperm and the most active sperm, is inserted into her uterus via the vagina.
§
In Vitro Fertilization (IVF): The best sperm are selected and placed in a culture dish with
mature eggs removed from your partner’s body. 2 or 3 resulting embryos are
transferred from the dish into her uterus.
§
Intra Cytoplasmic Sperm Injection (ICSI): if your sperm count is less than 5 million/ml has little or no
motility and abnormal shapes. You need just one sperm that is injected in a
single retrieved egg in a culture dish, incubated and then inserted into your
partner’s waiting womb. IMSI is a refinement on this same technique.
§
PESA and TESA:
retrieve sperm from the prostrate or testicles for men who have a blockage that
prevent an ejaculation.
§
On the anvil an injection of PLC zeta can
kickstart an egg to fertilize because your sperm lack this protein. This sets
off the biological processes necessary for development of the embryo.
§
Donor sperm: If
you produce no sperm or have hereditary genetic defects you can use frozen
sperm from a certified sperm bank.
Donors are supposed to be single men
between 20 and 28, with a college education to ensure a descent IQ, free of
substance abuse, with counts of over 50 million/ml and over 50% motility and
predominantly normal morphology. The donor is tested for Hepatitis B & C,
HIV and VDRL. The semen is then quarantined for 6 months to ensure that it is
free of HIV and other sexually transmitted disease. On the day of the procedure
the semen sample is removed from the cryocontainer and processed for donor use.
The identity of the donor is kept secret.
They may be paid or doing it gratis.
Power up your swimmers
Stay cool:
Sperm dwells best in cool surroundings and are healthier in winter. Stay away
from hot tub baths and saunas. A cool shower hikes sperm production. Ditch your
tightie-whities for roomy boxer shorts and go bare at bed time. Never sit with
a computer on your lap. Use a seat mesh while driving. Make frequent stops when
you bicycle.
Start early:
Says Dr. Hrishikesh P., Infertility Specialist, Lilavati Hospital: “Just like
women have a biological clock, in 40-plus men sperm DNA fragmentation occurs
and the chances of causing a pregnancy are reduced. So think before you put
your career over starting a family”.
Stop substance abuse: This means cigarettes, more than a peg of alcohol a day,
recreational drugs.
Chill out:
Stress can slow down sperm production and lower your libido, to boot. Distress
with adequate sleep, yoga, relaxation techniques, recreation, vacations,
sharing feelings with your spouse
Soak up some sunshine: It boosts your sperm count by increasing levels of Vitamin D. Make
it a couple caper – because the sun pushes up her sex hormones of progesterone
and estrogen which makes ovulation more likely.
Turn off the Idiot Box: According to the Harvard School of Public Health, men who watch
over 20 hours of TV a week have almost half the sperm count of men who watch
very little TV.
Rock between the sheets: Chances of conception rise from 15% for couples having sex once a
week to 50% for couples having sex 3 to 4 times a week. Sex keeps sperm healthy
as it allows fresh sperm to emerge. Its quality falls if it’s stuck in the body
for more than 3 days. On the other hand too much sex may cut the numbers, too.
Get moving:
According to the British Journal of Sports Medicine, men who do 15 or more
hours of moderate exercise every week have sperm counts that are 73% higher
than those who exercise little.
Check out your medications: Ensure that they are not sperm suppressants.
Reduce exposure: to X-rays by wearing a lead shield and to industrial chemicals used
in making plastics which can mimic the female hormone Estrogen to counter male
hormones.
Eat right and stay trim:
- Cut out refined carbs like white bread, pasta, biscuits which
can raise blood sugar quickly causing an insulin surge that can impair
fertility.
- Limit full fat dairy – even a tsp. of malaise, a scoop of ice
cream, a glass of full fat milk, 3 slices of cheese – create poor quality
sperm because female hormones occur naturally in milk.
- Get plenty of sesame, oysters, and almonds. The zinc in these
foods aids testosterone synthesis and increases sperm quantity and
quality.
- Carrots, milk, eggs, oranges, broccoli, strawberries, peanuts,
spinach, almonds. They are rich in the antioxidant vitamins A, C, E which
improve sperm health.
- Strawberries, blackberries, cranberries,
garlic, tomatoes, watermelon provide the antioxidants selenium and
lycopene, which prevent oxidative damage to sperm.
Wash down with lots of water.
