I am beginning with the man’s role in making a baby because, when it comes to all things fertility, conception, and pregnancy, we mostly relate to women. However, the man plays a vital role in the process of having a healthy baby—and not just in a physical sense. Not only does the man contribute half of the genes that will make up the child’s genome but his sperm influence fertilisation of the egg and formation of the placenta. The placenta is the connection between mother and baby, crucial for maintaining the pregnancy, providing nutrients and oxygen to the foetus, and removing waste material. Men also need to consider that their sperm carry a lot of instructional information as well as genetic code. This information is located in the sperm head—kind of like its brain. It is this information that will determine whether the sperm can penetrate the ovum and whether cell division occurs properly, as well as affecting egg implantation and the integrity of the placenta. These are all vital components of conception. However, the sperm head is relatively unprotected and susceptible to oxidative damage.3 When you consider that the instructions for early cell division and implantation rely on healthy sperm, giving them every possible protection becomes a very important consideration, especially when 50 per cent of miscarriages are linked to sperm malfunction. During my time in clinic, it has been predominantly women who come in wanting to prepare for conception and pregnancy. The man rarely comes along to this very important discussion. Comments often given by the men include, “My mate smokes and drinks, and he had a healthy kid,” or, “My swimmers are fine.” Sorry, guys, this is not necessarily the case. Sperm are very delicate and highly susceptible to oxidative damage, which may render them less capable of successful fertilisation. I believe this lack of concern on the part of many men is mainly the result of insufficient awareness resulting from a strong focus on women when it comes to conception and pregnancy.

The four most crucial impacts on sperm quality are smoking, alcohol, radiation, and toxins.4 Ejaculated sperm can vary in age from a few days to up to sixty days—the higher the age of sperm, the greater the exposure to oxidative damage. This type of damage can be caused by lifestyle factors such as smoking, consuming alcohol, sexually transmitted infections (STIs) and viral infections, obesity, pollution, industrial agents such as benzene, medications, toxins, and increasing age (which for men is thirty- five years and over). Viral infections not only impact sperm quality but can also be passed on during conception, infecting the foetus prior to birth. According to the World Health Organisation, common viruses implicated here include EBV, CMV, and all the human herpes group, which can lead to neonatal or childhood cancers.

Sperm are more vulnerable to toxic exposure and nutritional deficiency than are women’s eggs. Sperm are generated consistently and are, therefore, exposed to any physiological or environmental hazards present at the time of generation. Sperm are also much smaller than eggs and are held outside the body, increasing their susceptibility, especially to physical trauma and heat.

Issues with sperm health can vary from poor sperm count to poor motility (movement), poor morphology (shape), and fragmented sperm DNA. When I used to look at sperm under the microscope, they tended to fall into one of three categories—the Olympic swimming champion, the spinner going around in circles, and the duds that just sat still and didn’t move. Then there were the ones that looked healthy but had empty heads (damaged DNA or lacking in essential communication, preventing proper fertilisation and placental formation), which can’t be identified under the microscope and requires special pathology assessment.

If you’d like to have your semen checked, speak to your GP for a referral to an andrology laboratory or fertility clinic—refer to Appendix 3 for laboratory details. To check motility, morphology, and volume, a semen analysis is carried out. However, to assess any DNA fragmentation a sperm chromatin structure assay (SCSA) will be required.

Francesca Naish from Natural Fertility Management,5 writes, “While one in six couples is infertile, in 40 percent of cases the problem rests with the male, in 40 percent with the female, ten percent with both partners, and in a further ten percent of cases, the cause is unknown. Further, one in 25 males has a low sperm count and one in 35 is sterile.”6 These statistics highlight just how important it is that men take a more active role in preparing for a baby. The optimal time frame for preconception preparation is twelve months (I hear you gasp), but six months will also go a long way to increasing your chances of having a healthy baby. Your investment will depend on how committed you are in having a healthy baby.

There are many factors involved in the production of healthy sperm, and by addressing and supporting these, male fertility can be improved. The quality of seminal fluid—the fluid that bathes and protects the sperm on their journey towards the egg—is also important and has its own microbiome and specific pH (alkaline). The composition and pH of the semen interact with the woman’s microbiome, strongly influencing fertility outcomes. Then there are the mitochondria—the energy producers that propel the sperm but also provide communication for fusion with the egg. It can take sperm two days to reach the egg, travelling a distance equivalent to an interstate trip, so you can begin to appreciate just how much energy is needed. Once the sperm arrive, they need to bind to the outer layer of the egg, penetrate, adhere, and fuse with the internal lining of the egg and block other sperm from entering; only then can the stages of cell division begin.

Whilst there are many herbs and nutritional supplements that can support male fertility, there are a few key nutrients that cannot be overlooked—zinc, selenium, and ubiquinol, or CoQ10. Nutritionally, zinc is of paramount importance for all sperm parameters and has been shown to increase count, motility, and morphology, as well as overall fertility.7 Zinc deficiency is associated with reduced sperm numbers and testosterone levels, and men with normal sperm concentration have higher levels of zinc than those with reduced numbers.8 Zinc supplementation has also been shown to reduce the incidence of anti-sperm antibodies in semen.9

In addition to zinc, healthy semen is also rich in selenium, which is an essential source of antioxidant protection against free radical damage. Oxidative stress is devastating to all sperm parameters, including DNA fragmentation. Unfortunately, zinc and selenium are two of the most common mineral deficiencies in Australia and New Zealand, due to the ancient soils in these countries. There are other antioxidants that can help protect the sperm and mitochondria from damage. Selenium acts on Leydig cells, which produce testosterone, regulating the hormone’s production, improving sperm quality, and helping to prevent DNA fragmentation.10 Adequate selenium has been associated with reduced miscarriage risk.11

The enzyme CoQ10, which provides both ubiquinone and ubiquinol, plays an essential role in protecting the mitochondria, and research has shown that it’s associated with improved sperm count, motility, ejaculate volume, density, and morphology.12 Now, before you go out and buy any supplements, please wait until you have read the section on diet and nutrition. Not all supplements are created equal, and one topic I am particularly passionate about is quality—so please read on. Other essential nutrients include vitamins A, C, E, D, and B complex, essential fatty acids, glutathione, calcium, and other minerals. For food sources, refer to Appendix 2.

While there are certain nutritional supplements available that help to support healthy sperm quality, these need to be taken for at least six months to achieve improved sperm motility, sperm concentrations, and sperm volume, not to mention healthy “information” to help with the vitally important early cell division of the fertilised egg. The reason for this time frame is because sperm take up to three months to develop and mature. But it can take many more months to remove heavy metals and other chemicals from the body. Therefore, a period of at least six months is recommended for men to prepare their bodies (and their sperm) for conception, a viable pregnancy, and a healthy baby but longer if chelation is required.

Diets lacking in fresh fruit and vegetables may be contributing to elevated levels of oxidative stress. In addition to addressing nutritional deficiencies, correct supplementation may significantly improve a man’s sperm viability. Oxidative damage caused by free radicals may impair the sperm’s energy production pathways, disable other functions, and damage its DNA. The resulting low sperm count and/or quality impairs fertility and increases the risk of passing on genetic defects. I’ll explain more about oxidative stress, free radicals, and the effects of these on cell health in section III.

Male infertility is on the rise

Fertility expert Professor Peter Koopman at the University of Queensland says, “Since the 1970s, we have seen a huge increase in prevalence of male infertility and testicular cancer; this increase is directly attributable to environmental factors such as pollutants, cigarette smoke and exposure to chemicals.”13 In 2017, research found that, between 1973 and 2011, there was an average decline in mean sperm concentration of 1.6 per cent per year, and an overall decline of 59.3 per cent. A follow-up of the 2017 research revealed that sperm count is declining at an accelerated pace—2.64 per cent after 2000 and an overall fall of 62.3 per cent, representing an overall decline of approximately 4.70 million sperm per year.14 Obesity is also playing a key role, and this research showed that, with each five- kilogram increase in weight, there is a 5 per cent decline in sperm numbers and increase in DNA damage.

How best to deal with these environmentally destructive effects on sperm

When a cell is affected by oxidative stress, the resultant damage is likely to affect every part of it. This can include all the cell’s critical functions including the energy-generating mitochondria, the protective membranes, key enzymes, and the DNA within the genes. Prevention is always better than treatment, so avoiding as many toxins as possible is highly advisable. You can read more about some of the most potent environmental toxins later in this section, but ensuring your body has good levels of antioxidants is essential. One of the most powerful antioxidants in the body is superoxide dismutase (SOD), which protects sperm as they mature. Helping the body to regulate the antioxidants required has been shown to be a far more effective approach, rather than randomly taking high doses of vitamins. The best way to achieve this is to adopt a nutrigenomic strategy to support the body’s own cellular defences. See the topic of diet and epigenetics for a more detailed discussion of nutrigenomics.15 The power of SOD is such that it can extinguish between four and six million damaging free radical molecules per minute! Compare this with the effect of other more well-known antioxidants such as vitamins C and E and polyphenols such as grape seed and green tea, which extinguish just one free radical per molecule!

How lifestyle impacts male fertility

Lifestyle factors, especially those things you do daily or on a regular basis, have a huge impact on male reproductive health. Here are just a few of the most common:

•Smoking. Sperm concentrations in male smokers are 13 to 17 per cent lower than those in non-smokers, and cigarette smoking affects all sperm parameters, as well as lowering testosterone.

•Chronic alcohol intake affects male hormones by lowering testosterone and raising oestrogen, has a detrimental effect on semen quality and quantity, and raises inflammatory markers.

•Cannabis, opioids, and anabolic steroids lower testosterone and decrease sperm concentration, motility, and function. The effects of CBD oil on sperm quality are still being assessed.

•Caffeine at high levels lowers testosterone and sperm volume (this includes soft drinks, energy drinks, and some sports drinks).

•Advanced paternal age (APA) begins at age thirty-five in males, with an age-related decline in semen volume, normal sperm morphology, and sperm count and an increase in DNA fragmentation. APA is associated with lower pregnancy rates, miscarriage, and birth defects in the baby.

•General heat stress. Cycling as a sport has a strong association with increased testicular heat and subsequent oxidative stress. A study of male road cyclists found suppressed sperm parameters after a sixteen- week trial. Heat stress can also result from tight synthetic clothing or taking hot baths and saunas.

•Unhealthy diets consisting mainly of processed foods, such as cereals, breads, processed or deli meat, dairy, alcohol, coffee, soft drinks, fast foods, and low fresh fruit and vegetable intake are associated with poor semen quality and lower fertility rates.

•Insufficient sleep of less than six hours per day lowers sperm motility and contributes to DNA damage.16

•Exposure to electromagnetic frequencies (EMF) may alter both DNA and cellular integrity, as well as causing heat stress. Keep all electronic equipment such as laptops, mobile phones, and tablets well away from your lap.17

•Environmental chemicals, including herbicides, pesticides, petrochemicals, paints, solvents, and lots more, can impact sperm as you’ll see in chapter 4, “Environmental Toxins.”

It’s all about the nutrients

The good news is that there is clinical evidence that several herbs, as well as good nutrition can help to improve fertility in men. A sperm’s structure is basically made of nutrients, which means it can be positively influenced by good diet and antioxidants. Nutrients and foods that provide these are listed in Appendix 2. Remember, it takes three months for sperm to develop. Keep this in mind when deciding to start a family, as you will need to support your system for at least three months, but preferably six to twelve months, if you are seeking to father a healthy baby. Every chemical you can avoid is one less toxin for your body to deal with. If you have been exposed to a number of chemicals or have a high heavy metal load in your body, you may need to allocate at least twelve months to properly clear these toxins from your body before considering having a baby. Food is our body’s source of nutrients, so it is important that you select only organic, unsprayed produce and animal products that come from unsprayed pasture-fed farms. Another common source of toxins is work-related chemical exposure. So always wear protective clothing and equipment. The Australian adage of, “She’ll be right, mate,” and taking the “tough bloke” stance won’t protect your sperm from toxin damage. Wear the protective mask, gloves, and whatever protective clothing is implicated in any work you do— whether on the job or around the home.

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❖The four most crucial impacts on sperm quality are smoking, alcohol, radiation, and toxins.18

❖A full 40 per cent of miscarriage cases are the result of poor sperm quality.

❖Insufficient sleep of less than six hours per day lowers sperm motility and contributes to DNA damage.

❖Exposure to electromagnetic frequencies (EMF) may alter both DNA and cellular integrity, in addition to causing heat stress. Keep all electronic equipment such as laptops, mobile phones, and tablets wellaway from your lap.