Authored by Dr. Lori Hulsing

Historically female fertility has received the spotlight (and blame) around baby-making and male fertility has been largely ignored by doctors and scientists alike. Only recently have researchers investigated how the health of the sperm influences conception, pregnancy outcomes, and the health of the baby. The omission of sperm health in studies and medicine has been a huge blunder considering that 50% of the genetic information is coming from the sperm. Focusing on this would likely prevent many couples from experiencing miscarriage and infertility—especially “unexplained infertility”— because many of these cases are likely caused by DNA damage or other sperm issues that are not measurable on a traditional semen analysis. Spending at least three months prior to conception focused on nutrition, healthy lifestyle choices, and a sperm-safe environment is an absolute must for every father-to-be and sperm donor.
 
Here are some steps for improving the health of sperm based on the latest research. This is not an exhaustive list but I included bullet points from a few of the most relevant fertility categories.
 
Diet & Nutrition

• A healthy anti-inflammatory diet is critical for sperm production. Deficiencies in vitamins, minerals and fatty acids have a detrimental impact on sperm health and deficiencies are very common in the United States. Aim for eating 3+ cups of vegetables and 2 servings of fruit per day. If you aren’t hitting this goal you may need additional nutrient supplementation. If you are on a more restricted diet including vegan, vegetarian, dairy-free, keto, paleo or autoimmune paleo you may need additional nutrient supplementation as well.
• Avoid sugary beverages like soda and sports drinks which decrease sperm motility.
• Avoid trans fats aka partially hydrogenated oil and polyunsaturated fats like soybean, corn, and sunflower oil. They have a negative impact on sperm and embryonic development.

 
Lifestyle

• If you smoke, quit. Smoking decreases male fertility, decreases IVF/ICSI success, and increases risk of complications if a pregnancy does occur. Some people may think smoking marijuana doesn’t count. Or maybe it doesn’t count if you eat it. No matter the delivery method, marijuana is not good for sperm either. Evidence shows it can lower motility and function of sperm. Quitting is hard so invest in a lot of support here. The effects of smoking do seem to be cumulative as well so if quitting isn’t an option cut back as much as possible.
• Exercise, but not too much. Studies show frequent intense exercise has a negative impact on sperm health as well as not moving enough.
• Heat can damage sperm and decrease sperm count so it’s important to avoid hot tubs, lots of biking, cell phones in the pocket, and computers in the lap.

 
Environment

• A focus on environmental factors is critical for improving sperm health and fertility. Eliminate all hormone-disrupting chemicals from your environment. These chemicals are found in plastics, cans lined with BPA, furniture covered in fire retardants, non-stick pans, lead paint and high VOC paint.
• Invest in a quality water filter to filter medications, heavy metals, and microbes from your water source.
• Invest in a quality HEPA air filter for your bedroom to improve the indoor air quality and reduce exposure to pollution.

 
Making lifestyle and dietary changes, taking targeted nutrients, and practicing self-care to boost fertility is not always easy. It can be so helpful to get support. If you are interested in learning more about how to boost fertility with an integrative approach, join me in the fall at my Fertility Class series designed for men and women wanting to conceive. We will cover these topics in a lot more detail with additional fertility optimizing discussions on diet and nutrition, hormone balancing, epigenetics, detoxification, environment factors, and treatment. It is never too soon to start planning!
 
P.S. If you were able to read this article without getting the Footloose soundtrack in your head for a week—nice work! I cannot say the same. “Let’s Hear it for the Boy[s] . . . “
 
Resources
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Hum Reprod. 2014 Jul;29(7):1575-84. Epub 2014 May 8. Sugar-sweetened beverage intake in relation to semen quality and reproductive hormone levels in young men. Chiu YH, Afeiche MC, Gaskins AJ, Williams PL, Mendiola J, Jørgensen N, Swan SH, Chavarro JE.
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Marijuana, phytocannabinoids, the endocannabinoid system, and male fertility. du Plessis SS1,2, Agarwal A3, Syriac A4.
Am J Epidemiol. 2015 Sep 15;182(6):473-81. doi: 10.1093/aje/kwv135. Epub 2015 Aug 16.
Association Between Use of Marijuana and Male Reproductive Hormones and Semen Quality: A Study Among 1,215 Healthy Young Men. Gundersen TD, Jørgensen N, Andersson AM, Bang AK, Nordkap L, Skakkebæk NE, Priskorn L, Juul A, Jensen TK.
Andrologia 50:1 2018 Feb Sperm DNA fragmentation as a result of ultra-endurance exercise training in male athletes.Vaamonde D Follow, Algar-Santacruz C Follow, Abbasi A Follow, García-Manso JM Follow
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Authored by Dr. Hulsing

Are you thinking about starting or growing your family in the future? Perhaps you wonder if you are doing everything you can to enhance your fertility and increase the chances of a healthy pregnancy and baby. Even if you have never considered the health of your eggs or sperm don’t feel bad. Many times we only consider our health when we don’t feel good or things aren’t working. This is especially true around fertility but there are so many things you can do to prevent problems in pregnancy, optimize the health of your future children, and increase the likelihood of getting pregnant by following a pre-conception health plan.

Preconception health is the health of men and women prior to conceiving. So a pre-conception health plan is a protocol to improve health with the goal of healthy eggs/sperm, a healthy pregnancy and healthy baby.

Pop Quiz Time! Who should be following a pre-conception health plan?
A)  Women over 35 trying to conceive 
B)  All Women trying to conceive 
C)  All Men trying to conceive 
D)  Men/Women who have been diagnosed with unexplained infertility or suboptimal fertility 
E)  Women/Couples undergoing fertility treatments including IVF and IUI 
F)  ALL of the above
The answer is F—all of the above. Are you surprised? If you chose answer “A” you aren’t alone. Many people think only women over age 35 trying to conceive should follow a pre-conception health plan. While age is one factor relating to egg health and fertility, it is certainly not the only factor and all women will benefit from improved fertility as well as healthy pregnancies and babies. Perhaps you knew this and chose answer B—which leads me to my next point.

Yes, all women should be following pre-conception health plans, but what about the men? Men are often forgotten about when it comes to fertility but ALL men trying to conceive should be following a pre-conception health protocol. The lack of knowledge and interest about all the ways men can improve the health of their sperm is absurd because sperm make up 50% of the equation and provide half of the genetics of the baby. Pre-conception health plans specific to sperm health can mean getting pregnant more easily and with fewer complications. Healthy sperm = healthy baby.

Perhaps you assumed that a preconception health plan would be too simple or basic to help men and women with unexplained infertility or suboptimal fertility but that couldn’t be farther from the truth. A pre-conception health plan that addresses the root cause could solve the unexplained infertility cases that make up 1/3 of the total cases of infertility. Comprehensive pre-conception plans that address healthy weight, toxicant exposure, adrenal hormone dysfunction, hormonal imbalance, endometriosis, autoimmunity, inflammation, nutrient deficiencies, nutrigenomics, and egg/sperm health at a cellular or even DNA level can often solve unexplained and suboptimal fertility issues.

In my experience, the previously listed items may not show up on conventional screening labs or perhaps are not addressed due to lack of familiarity by other health care providers. For example, there was research published in the journal Reproductive BioMedicine Online which showed 80% of the “unexplained fertility” cases in the study involved sperm DNA damage (This won’t show up on a basic semen analysis so it would be missed). A pre-conception health plan which addressed the health of the sperm at a DNA level by improving antioxidant status could be extremely beneficial in these situations and treat the underlying issue without resorting to more expensive and invasive treatments.

Another area which is often overlooked is the importance of incorporating a pre-conception health plan as part of fertility treatments such as Intrauterine Insemination (IUI) and In Vitro Insemination (IVF). Preparing for pregnancy and optimizing the health of the egg and sperm utilized in fertility treatments leads to more successful pregnancies. You just need to make sure you are woking with someone who is knowledgeable about combining natural and conventional therapies so you are enhancing and not interfering with fertility treatments. Integrative fertility treatment (combining conventional and natural therapies) is quickly growing in popularity because of better outcomes and there is a growing body of research published in peer-reviewed medical journals showing the efficacy of many botanical, hormone, nutrient therapies and lifestyle changes used alone and in conjunction with conventional fertility treatments. I am always happy to share these studies during appointments upon request.

Now that you know how important it is for all men and women trying to conceive to follow a pre-conception health plan, you may be wondering how far in advance you should schedule an appointment to create an individualized pre-conception health plan. This will depend on individual factors but the MINIMUM amount of time is 3 months. This is based on the amount of time it takes for the egg and sperm to complete a cycle. (It takes about 74 days for the sperm to complete a cycle and about 90 days for the egg.) It is pretty amazing that you can create healthier sperm and eggs in only 3 months. If you have known health issues or if health issues are diagnosed with basic screening tests it can take longer than 3 months so it is never too soon to schedule an appointment to create a pre-conception health plan.

Because the pre-conception health protocol is individualized to each person after considering health history, lab workup, age, lifestyle, fertility history, and goals, it is beyond the scope of this article to go into detailed treatment plans. Scheduling an appointment with Dr. Hulsing or another Naturopathic Doctor who specializes in fertility is the next step if you are interested in getting personalized and detailed recommendations to optimize fertility and achieve your goal of a healthy pregnancy and baby.