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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

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

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

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.

 

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