It’s well-known and accepted that a healthy diet and lifestyle are important for fertility and especially to aid egg quality and conception. However, did you know that it’s equally important for men to follow a healthy diet too, with new research suggesting that poor sperm quality may be a major contributor to recurrent miscarriage?
What is meant by ‘poor sperm quality’?
If male factors are suspected to be the cause of infertility, semen is usually tested for three characteristics:- Sperm count (the overall number of sperm per sample)
- Sperm motility (the ability to swim to the egg)
- Sperm morphology (how many sperm have a normal shape and appearance).
All of these parameters have their own significance and may make natural conception difficult, requiring medical intervention. If no sperm is found in the ejaculate, then surgical sperm retrieval may be needed.
However, we also see many couples who have “normal” sperm but are still struggling to conceive or carry to term. This suggests that the problem is something more than just these three factors, and recent research points to this being due to DNA fragmentation in the sperm causing chromosomes to be missing or mutated. Faulty genes in embryos are the biggest cause of miscarriage and those faults can come from the male or female side. Around one-third of miscarriages occur due to male factors, but this can be helped by sperm selection methods used in the IVF lab.
Male age is a factor, but the real issue is oxidative stress.
Much like egg quality, sperm quality also starts to decline after the age of 35 with the sperm from older men having more DNA abnormalities, and sperm motility declining as well.
The cause of this isn’t ’ageing’ per se, but rather oxidative stress which occurs when your body is under attack from damaging free radicals. These can interfere with proteins and lipids in cells, and cause abnormalities in DNA. In healthy individuals, cells produce antioxidants that neutralise these free radicals, so in general, the body is able to maintain a balance between antioxidants and free radicals.
Several factors can contribute to oxidative stress and excess free radical production including:
- diet
- lifestyle (such as taking drugs or smoking)
- certain medical conditions such as diabetes and inflammatory disorders
- environmental factors such as pollution or exposure to chemicals
- some steroids used for muscle building may stop the formation of sperm completely and irreversibly
- the heat from intensive exercise – e.g. cycling
- certain medications may affect sperm motility and capacity to fertilise
Can sperm damage be reversed?
The good news is that a recent research study from the US shows that sperm decline and DNA damage can be arrested and reversed through a healthy diet, vitamins and antioxidants. The study found that men with the highest total intake of Vitamin C, Vitamin E, zinc, and folate had far less sperm DNA damage, and in fact, had sperm like much younger men.
Each sperm takes about two months to develop, so changes will take at least that amount of time to be seen. If you are thinking of conceiving it’s good to start your diet and supplement regimen well in advance.
The optimum diet for sperm health
When we say ‘diet’, we don’t mean counting calories and deprivation but making smart choices about what you consume. The healthiest diet is one that is low in meat and saturated fats, and high in grains, fruit, vegetables, and ‘good’ oils, such as the classic ‘Mediterranean’ diet.
Antioxidants are found naturally in food, with leafy greens and fruit being high in folate, and tomatoes (particularly cooked tomatoes) being a great source of lycopene. There are a group of antioxidants called anthocyanins which are found in purple berries, fruits and vegetables which help fight damaging free radicals. Eating a variety of colours of fruits and vegetables every day is the easiest way to get the most out of your diet. And the good news is that chocolate also has antioxidant properties (although due to its sugar content, we recommend moderation!).
It almost goes without saying that you should avoid fast food (which tends to be high in trans fats and sugar) and sweetened fizzy drinks. Studies have shown that fast food consumption is associated with a delay in pregnancy but interestingly, even two servings of greens per day can counter this effect and significantly reduce the time to pregnancy.
Alcohol and sperm health
Alcohol is known to increase oxidative stress however, one of the most contentious issues is how much alcohol is too much. Many studies show that moderate levels of alcohol make little difference to sperm health, and others indicate the opposite. One study on men in California in an IVF context vs ‘natural’ pregnancy, found that there was an increase in the miscarriage rate for couples where the male drank alcohol in the month before the IVF cycle.
Our view is that the occasional beer isn’t going to make a big difference, but if you have already suffered pregnancy loss, then no alcohol in the lead up to your IVF cycle would be a safer choice.
Supplements to improve sperm quality
The most important change for sperm health is to take an antioxidant supplement daily. One very comprehensive review of 34 prior studies showed that men who took an antioxidant had a four times higher chance of their partner conceiving, and they were five times more likely to have a live birth.The easiest way to do this is a multivitamin, and preferably one with methyl folate rather than synthetic folic acid, especially if there is a history of miscarriage. This is because the very common MTHFR gene affects men as well as women and can contribute to miscarriage risk by impacting DNA quality in sperm, which in turn can affect the growing embryo.
In addition, the following supplements which tend not to be included in multivitamin formulas are also beneficial:
- Coenzyme Q10 (also called Ubiquinol) has been shown to improve sperm count, motility, and morphology. It also enhances cellular energy production and prevents oxidative damage,
- Alpha-Lipoic acid - ALAs are found in dietary oils like soybean, walnut, and canola, however, supplementation is often required to increase sperm count, concentration and motility.
- Omega-3 fatty acids are found in fish oils. Supplements are beneficial to increase sperm count, motility, and can also improve DNA damage.
- L-Carnitine - if there is evidence of oxidative damage to sperm DNA, L-Carnitine supplements have been found to substantially improve (by up to twofold) the number of motile sperm. It is of particular use for men who have infertility as a result of varicocele.
We appreciate that this is a lot of supplements to be taking daily for some months, however, all evidence points to quite dramatic improvements in sperm health so we firmly believe it’s worth it.
Environmental Factors
A healthy diet and some supplementation will give you the best start, but you also should be aware that exposure to chemicals can also negatively impact sperm quality.
Harmful chemicals can be found in everyday products like laundry detergents, colognes, air fresheners, and cleaning materials. Some of these can be absorbed into the body and interfere with hormones which can lead to infertility. The most common ones to avoid are BPA (and its sister BPS) and phthalates. High levels of phthalates have been linked to lower levels of testosterone and higher levels of oxidative stress. A US study of 500 couples found that the men with the highest level of phthalates were 20% less likely to impregnate their partner.
To read more about the dangers of chemical exposure, you can check out our article on How to avoid chemicals that can reduce fertility.
In Summary
It’s a good idea to embark on a healthy diet and supplementation with your partner. There is a three-month window prior to ovulation when changes in diet and lifestyle will make a difference to egg quality, and for men, it takes two months for sperm to develop. If these are quite big changes for you from your normal diet, then supporting each other makes the changes much easier.
It’s always a good idea to speak to your doctor about which diet regimen and vitamin dosage is right for you as these can be targeted to your specific needs.
Want to find out more?
If you have any further questions, you can arrange a chat with one of our patient care team.
For more health and wellness information on how to increase your chances of conception, check out our fertility news page, or download our e-book below.
Sources:
https://www.ivf.com.au/planning-for-pregnancy/complementary-therapies-for-pregnancy
It Starts With The Egg - Rebecca Fett