Healthy sperm: Optimizing your fertility

Your lifestyle and your exposure to certain environmental factors may affect your sperm and your fertility. Here are some things to boost your sperm quality and improve your fertility.

Do your sperm pass muster? Despite several months of effort, you and your partner haven't yet conceived. You're not ready to seek an infertility evaluation, but you might be wondering whether you're doing all you can to contribute healthy sperm.

Sperm quantity and quality varies among men and can be affected by a variety of things — some you can impact, others you can't. While you may not be able to control all the factors that may improve your chances of achieving a pregnancy, there are steps you can take to make sure your sperm are top performers.

Sperm life

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Male reproductive system

Sperm are made in the testicles which are housed in the scrotum beneath your penis. Because of the scrotum's location, the temperature is a little cooler — creating the ideal environment for healthy sperm production.

Just as important as the sperm itself is the semen — the fluid that nourishes and carries the sperm. The semen is made from a mix of fluids produced in the prostate gland and seminal vesicles. Semen and sperm are stored in the seminal vesicles until ejaculation.

To achieve its goal, sperm must have three things going for it: quantity, quality and motility.

Quantity. You're most likely to be fertile if you have more than 20 million sperm per milliliter of semen. However, researchers are finding that having healthy sperm (the quality) may be just as important as the total amount of sperm you produce. Of the millions of sperm in the ejaculated semen, only about 200 actually reach the egg in a woman's fallopian tube. But, just one is needed to fertilize the egg.
Quality. It's not enough just to have enough. Sperm shape and structure (morphology) are equally important. Youare most likely to be fertile if more than one third of your sperm are of normal shape and structure. A normal sperm has an oval head and a long tail that propel it forward. Sperm with large, small, tapered or crooked heads or kinky, curled or double tails are less likely to fertilize an egg.
Motility. To reach the target, your sperm have to move.Riding the semen wave will only take the sperm so far. To reach the egg, sperm have to move on their own — wriggling and swimming the last few inches to reach and penetrate the egg. Sperm movement (motility) is an important characteristic of healthy sperm. You're most likely to be fertile if at least half of your sperm are moving.

What can you do to get high-quality sperm?

It takes only one sperm cell to fertilize an egg. With millions of sperm vying for the chance, you'd think each act of intercourse between you and your partner would have excellent odds of resulting in pregnancy. In fact, it may take many attempts before you succeed, even if you're both healthy and your timing is right — that is, you have sex in the days leading up to ovulation (when the egg is released from the ovary).

Here's what you can do to increase your chance of contributing enough hardy, energetic sperm to get the job done.

Take a multivitamin. A daily multivitamin can help provide selenium, zinc and folic acid — trace nutrients that are important for optimal sperm production and function. A multivitamin also usually contains antioxidant vitamins such as C and E, which may help protect sperm from damage.
Reduce stress. Researchers are investigating whether stress might interfere with certain hormones needed to produce sperm. Stress can also impair sexual function.
Get regular exercise. Physical activity is good for reproductive health as well as your overall health. But don't overdo it. Men who exercise to exhaustion show a temporary change in hormone levels and a drop in sperm quality.
Watch your weight. Too much or too little body fat may disrupt production of reproductive hormones, which can reduce your sperm count and increase your percentage of abnormal sperm. You're most likely to produce lots of high-quality sperm if you maintain a healthy weight.

Caution: Hazardous to sperm

Even under the best circumstances, only 50 percent to 70 percent of a man's sperm are viable enough to fertilize an egg. This suggests that sperm may be especially vulnerable to environmental assaults, such as exposure to excessive heat or toxic chemicals. To protect your fertility:

Watch out for toxins. Experts think certain workplace and household substances might have an effect on sperm quantity and quality. These include heavy metals, and pesticides and chemicals in solvents. Use protective clothing, proper ventilation and face masks to reduce the risk of absorbing such toxins.
Quit using tobacco. The sperm of men who smoke may be misshapen and may move more slowly than those of nonsmokers. Smoking can also damage your sperm's DNA. Experts suspect such damage could even affect fetal growth and development and increase a child's chance of having certain health problems, including cancer. And chewing tobacco isn't safe either — it also may cause low sperm counts and damage. As if that weren't enough, tobacco use can increase erectile dysfunction. Research shows men who both smoke and drink alcohol have lower sperm counts and motility than do men with either habit alone.
Limit alcohol. Heavy drinking may reduce the quality and quantity of sperm. Limit alcohol to no more than one or two drinks a day. The combination of tobacco and alcohol is particularly harmful.
Steer clear of recreational drugs. Marijuana can decrease sperm density and motility and increase the number of abnormal sperm. Cocaine and opiates can contribute to erectile dysfunction, and amphetamines can decrease sex drive.
Skip the tub. To maximize the quality and quantity of your sperm, avoid hot tubs and baths. Spending more than 30 minutes in water 102 F (40 C) or above may lower your sperm count. Saunas and steam rooms may have a similar effect.
Avoid hormone havoc. Anabolic steroids, usually taken illegally, can shrink the testicles and drastically reduce fertility. Anti-androgens used to treat prostate enlargement and cancer interfere with sperm production. Testosterone supplements also decrease fertility.
Stay cool. Increased scrotal temperature can impair sperm production. Experts know that hot work environments, tight-fitting underpants, prolonged sitting, and use of laptop computers can all increase scrotal temperature. They are still studying how these activities affect fertility.
Avoid lubricants during sex. Personal lubricants, lotions and even saliva can interfere with sperm motility.

Medications and fertility

Many medications can temporarily reduce your fertility. Review your medications.

If you take medication to control a chronic condition such as high blood pressure, inflammatory bowel disease or gout, or to suppress your immune reaction to a transplanted organ, ask your doctor how your treatment may affect sperm development.
Avoid cimetidine (Tagamet, others), a stomach-acid-suppressing drug available without a prescription. Instead, use ranitidine (Zantac, others), famotidine (Pepcid, others) or nizatidine (Axid), which decreases stomach acid without affecting fertility.
A few medications, including several common chemotherapy agents, may cause permanent infertility. So can radiation treatment for cancer. If you'll be undergoing cancer treatment, talk with your doctor about saving and freezing your sperm (semen cryopreservation) before treatment.

Separating fact from fiction

A number of sperm-related stories have made the rounds in recent years, including groundless rumors that menthol cigarettes and certain soft drinks can make men sterile. Here are a few others with no basis in fact — and some that turn out to be true.

Fiction: Coffee jangles more than nerves. Not true — as long as you don't drink too much. In fact, one recent Brazilian study showed that caffeine might actually increase motility. However, moderation is the key. Large amounts of caffeine had the opposite effect and caused sperm to swim slower.
Fact: The flu slows sperm production. An illness that causes a fever can affect sperm production and sperm quality. But it won't affect fertility for two to three months, since it takes sperm 75 days to mature.
Fact: Bicycling can sabotage the system. Sitting on a bicycle saddle for more than 30 minutes at a time — especially if you also wear tight fitting bicycle shorts — may raise your scrotal temperature and affect sperm production. In addition, prolonged cycling can cause genital numbness — a sign of damage to delicate nerves and arteries. Choose a seat that's not too hard or narrow, and make sure it's adjusted to minimize pressure on your perineum. Take frequent rests while biking.
Fact: Pollution affects sperm. Experts think environmental toxins may have something to do with falling sperm counts. One culprit may be estrogen-like chemicals widely used in agriculture and industry. These substances are found in places ranging from drinking water to household products. Other environmental toxins that might affect male fertility are growth hormones used in livestock.
Fact: The calendar also matters to men. Sperm counts are higher in the winter and lower in the summer. This may be because cooler temperatures are associated with increased sperm production. Sperm counts are also higher in the morning than at other times of day. However, experts aren't sure that time of day or time of year makes a notable difference in fertility.

Adopting healthy lifestyle practices to preserve your fertility — and avoiding things that can damage it — may improve your and your partner's chances of conceiving a child. But you still may not become a father on your first — or even 51st — try. If you and your partner haven't achieved a pregnancy after a year of unprotected intercourse, see your doctor and get a semen analysis. About 25 percent of couples have trouble conceiving at some point, and this number increases with age. Forty percent of infertility can be traced to the man alone, but often it's a combination of both the man and woman. A fertility specialist can identify the cause of the problem and provide treatments that may help place you and your partner on the road to parenthood.