Treating Male Infertility: Priming the Pump

Infertility affects about 15% of all couples in the world. But approximately 50% of all infertility cases could be attributed entirely to male factors, something we often overlook. To make this issue even more alarming, we have considerable evidence that there is a global decline in sperm and testosterone in men. For more information on this major issue, you can watch a video of Dr. Robinson speaking on this topic from a presentation he gave in London, England this past summer. CLICK HERE to watch.

It is not uncommon for couples to go through infertility treatment and monitoring, and for the initial 6-12 months of unsuccessful pregnancy, never consider testing the man. Don’t make the mistake of not “priming the pump.”

For men, they need to consider fully preparing their body for the process of getting their partner pregnant. This is what we call priming the pump.

We should consider this wonderful process as an opportunity for a few things:

  1. You improve your sperm count (the actual number), how fast they move (motility), and how optimally shaped they are (morphology), all important to pass on healthy sperm for a successful conception.

  2. You discover any underlying health issues that are affecting your entire body that then in turn is affecting your sperm and ability to conceive.

  3. You improve your natural testosterone! This process improves overall testicular function and health, which helps with sexual desire, a major aspect of “priming the pump.”

  4. You improve your health NOW, that includes not just optimized sperm, but improvements in your immune system, your ability to detoxify, and your metabolism. This serves to energize yourself before the baby comes, helping to foster the superpowers you will need to be the best father you can be!

Here are some things to consider for male fertility, a large part of what we do to help counsel men through improving sperm health and conception outcomes.

Step 1: Get Tested

You should start with testing as soon as possible. If you have had no issues in the past or do not suspect any issues, you should still consider a Sperm Count just in case. This provides a baseline to work with and alerts you early on if there are any issues. At the very least, never go longer than six months of trying without getting a sperm count test.

If you have low sperm count, then you should also consider the other tests listed here.

Sperm Count & Morphology

There are special clinics such as a sperm bank where you can go to have this test done. It is very simple to do. Evidence is mounting that sperm levels are lowering. Therefore, the standards of what is considered optimal sperm count continues to lower.

Sperm Volume: 1.5 mL (Optimal: 2 mL)

Concentration: 15 million/mL (Optimal 20 million/mL)

Progressive Motility: 32% (Optimal 52%,)

Normal Forms (morphology): 4% (Optimal 15%, Note: Bull, ram, mouse have a 90%)

Serum Inhibin B 

Serum Inhibin B has emerged as a sensitive marker of male fertility. Analysis of serum inhibin B reflects the relationship between inhibin B, Sertoli cell function and spermatogenesis. Serum inhibin B levels have been shown to correlate with testicular volume and sperm density. Very low levels of inhibin B are found in men with no or negligible sperm production. A combined measurement of inhibin B and FSH has been shown to be a better indicator of spermatogenesis adequacy than either marker alone.

> (greater than) 92 pg/ml is normal.

Omega 3 Index

Omega 3 fatty acids increase stimulation to Sertoli cells where omega 6 fatty acids and trans fats decrease stimulation to Sertoli cells. Remember that Sertoli cells is where sperm is produced.

>8% is optimal and

Hormone Panel

Total and free testosterone, estradiol, prolactin, and progesterone levels should all be considered and optimized if deficient as they all play a role in the sexual response and sperm health. At The Hormone Zone, we specialize in creating an optimal hormonal environment for your body.

Step 2: Diet & Nutritional Supplements 

We largely recommend an Ancestral Diet based on the work of Weston A. Price. This diet focuses on high quality foods that are helpful for sperm and testosterone production.

Here is a summary of the basics:

  • Organic meats ONLY: It is important to decrease the hormone and pesticide load that comes from conventionally raised animals.
  • Increase Organic fats: protein and fats help to increase sperm count and health.
  • Use only Organic fruits and vegetables to decrease pesticide load. Pesticides harm sperm.

Here are some of the key nutrients to consider. There are others, but this is a great start.

  • Omega 3 Fatty Acids (Fish Oil) improves SPERM PRODUCTION
  • Carnitine improves SPERM MORPHOLOGY
  • Glutathione improves SPERM MORPHOLOGY AND MOTILITY
  • Zinc improves SPERM COUNT AND TESTOSTERONE
  • Iodine with Selenium, BOTH INCREASE SPERM AND PROSTATIC FLUID
  • A powerful antioxidant blend. We have one of the best available for physicians. Antioxidants INCREASE SPERM MOTILITY, MORPHOLOGY AND COUNT

Step 3: Detox

One of the main reasons we are seeing a global decline in sperm is environmental toxicity exposure. Simple cleanses can help improve toxicity that may be affecting your sperm count. Here are a couple suggestions:

  • Liver Cleanse: A simple and easy way to decrease toxin load and improve sperm. There are many available on the market, but not all are created equally.
  • Clay Baths: Another simple and effective way to decrease toxins particularly heavy metals such as lead and mercury. This is an ancient method to detoxify and improve health.

Step 4: Lifestyle Changes

  • Decrease alcohol and smoking: both lower sperm and decrease testosterone production. Both are directly known to decrease sperm health.
  • No elicit drugs particularly marijuana: decreases sperm motility and morphology. Again, this should be obvious as these things inhibit optimal sperm health.
  • No tight underwear: constricts testicles and lowers sperm.
  • No Jacuzzis: heat destroys sperm.
  • Decrease exposure to household and work related chemicals if possible. When it comes to detoxifying from environmental exposure, the first step is to simply avoid things when possible.
  • Take cold showers. Using cold water helps to stimulate the body to produce more testosterone, growth hormone, and sperm. One strategy is to make the water as cold as possible at the end of your shower, for as long as you can take it. Even a minute or two is beneficial.
  • Get more sun exposure! HERE is an article talking about how important this is for testosterone.

Step 5: Hormone Therapy & Medications

Progesterone

Progesterone is an often overlooked hormone for men. It has the ability to help men with sperm motility but also particularly helps with anxiety and insomnia, two issues that when left unchecked actually have negative effects to sperm health.

Clomid (Clomiphene citrate)

This is a conventional medication that increases sperm count and motility in men. It is very effective in general, particularly when used in conjunction with a full nutritional and lifestyle protocol such as this.

HCG (Human Chorionic Gonaditropin)

HCG is a hormone that is produced during pregnancy in women. It has the effect of stimulating the testicles to produce both testosterone and sperm. HCG can be an excellent option to optimize testosterone and sperm during any fertility protocol or used in conjunction with Testosterone Replacement Therapy.

Herbal Medications

NOTE: It is extremely important when considering sperm and testosterone stimulating herbs that they are from the best sources and concentrated in such as way as to be truly medicinal.

Eurycoma Longifolia (Tongkat Ali)

This Malaysian root herb has been shown to increase total and free testosterone levels and works as an aphrodisiac, stimulating libido and sexual desire.

Tribulus Terrestis

A well documented herb that helps improved sperm motility and count. Tribulus also possesses potent antioxidant effects, something very important for sperm health. It also improves testosterone and stimulates libido.

Testosterone Replacement Therapy (TRT)

Generally, testosterone replacement therapy is contraindicated in men who are seeking to impregnate. Research suggests that men can have a 10-20% reduction in sperm count while on TRT. However, depending on the patient and his level of severity of testosterone deficiency, he may consider it anyway. Additionally, if TRT is prescribed in conjunction with other testicular stimulating tools, such as HCG and/or Clomid, and this entire protocol listed here, this risk becomes potentially mitigated clinically.

When testosterone levels are optimized, it also has generalized benefits on sperm health, sexual desire, cardiovascular health, and the entire body. These benefits may outweigh any possible risk of lowering sperm count. We have had patients on TRT while doing this protocol and have success at getting their partner pregnant and maintaining and achieving optimal sperm count. It is important to monitor labs constantly during TRT and fertility therapy.

Summary

Fertility can be tricky business. There are things you can start doing right now to improve your chances for conception that are found right here in this article. Sometimes there are unforeseen issues and complications that need special attention. If you are wanting and needing a physician to guide you through the process of conception, The Hormone Zone is here for you.

References:
Ahmadi S, Bashiri R, Ghadiri-Anari A, Nadjarzadeh A. Antioxidant supplements and semen parameters: An evidence based review. Int J Reprod Biomed (Yazd). 2016 Dec;14(12):729-736. Review. PubMed PMID: 28066832; PubMed Central PMCID: PMC5203687.
https://www.ncbi.nlm.nih.gov/pubmed/28066832
Andersson AM. Inhibin B in the assessment of seminiferous tubular function. Baillieres Best Pract Res Clin Endocrinol Metab. 2000; 14(3):389-397. PubMed 11517906
http://www.eje-online.org/content/172/6/669.full.pdf
Sellandi, T. M., Thakar, A. B., & Baghel, M. S. (2012). Clinical study of Tribulus terrestris Linn. in Oligozoospermia: A double blind study. Ayu, 33(3), 356–364. http://doi.org/10.4103/0974-8520.108822
Salgado RM, Marques-Silva MH, Gonçalves E, Mathias AC, Aguiar JG, Wolff P. Effect of oral administration of Tribulus terrestris extract on semen quality and body fat index of infertile men. Andrologia. 2017 Jun;49(5). doi: 10.1111/and.12655. Epub 2016 Jul 12. PubMed PMID: 27401787.
Coviello AD, Matsumoto AM, Bremner WJ, Herbst KL, AmoryJK, Anawalt BD, Sutton PR, Wright WW, Brown TR, Yan X, Zirkin BR, Jarow JP. Low-Dose Human Chorionic Gonadotropin Maintains Intratesticular Testosterone in Normal Men with Testosterone-Induced Gonadotropin Suppression. J Clin Endrocrinol and Metab. 2005. 90 (5): 2595–2602.
Hsieh TC, Pastuszak AW, Hwang K, Lipshultz LI. Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. J Urol. 2013. 189 (2): 647-50.

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