Debunking myths and legends about fertility for men and women.

14 07 29 fertility

We’ve all heard the one about briefs being detrimental to sperm count. And is it true that stress can cause female infertility? We separate fact from fiction so you can stop speculating and focus on the real truth of the reproductive matter.

Fact or Fiction: It’s just a female problem.

Fiction: Not true, according to Dr. Keith Jarvi, director of Toronto’s Mount Sinai Hospital’s Murray Koffler Urologic Wellness Centre. “We estimate between 33 and 40 per cent [of cases] having a male factor.”

Fact or Fiction:  Stress causes infertility.

Fiction: “That’s very difficult to prove,” notes Dr. Matt Gysler, past president of the Canadian Fertility and Andrology Society. “There’s plenty of evidence where women give birth in extremely stressful situations.” He emphasizes that “it’s unfair to say ‘you are stressed and that’s why you aren’t getting pregnant’” as it shifts the blame to that person. With male sperm counts, Dr. Jarvi notes that stress can lead to other bad habits such as not exercising or eating a poor diet, and can affect  overall wellbeing, which may affect sperm count. But thinking that you’re stressing out your sperm because you’re stressed is just not possible.

Fact or Fiction: Fertility issues only affect the older population of 50+.

Fiction: According to Dr. Gysler, “Women’s fertility, as a population, declines beyond the age of 38. To achieve pregnancy after 45 is not very common. If you look at the [childbearing] age of 10 to 15 years ago, the average [childbearing] age with their first baby was 23 or 24. It’s now over 30. We have drastically shifted the childbearing age. As we do this, more women will unfortunately fall at the extreme ends of the scale.”

Fact or Fiction: If you have had children previously, you won’t suffer from infertility later on.

Fact: Both doctors agree that the body changes and so does life. Illnesses, ovulation irregularities and side effects from new medications that you are taking play a part in your overall fertility, so you can’t assume that because you have had children, you are free and clear.

Fact or Fiction: Keeping the testicles cold will affect sperm count.

Fact: There have been numerous studies where testicles responded favourably to cooler environments, through exposure to either dampness or cold air. “Even a one- or two-degree [increase in temperature] difference will result in reduction in sperm count,” notes Dr. Jarvi. However, this has to be on a long-term basis. Spending 20 minutes in the hot tub won’t do anything. This leads to the whole boxers versus briefs/biker shorts debate. Both doctors concur that connecting that to sperm count is a bit of a stretch.

Fact or Fiction: Vitamins help sperm count.

Fiction: “Doubtful.” Dr. Gysler notes that the vitamin and sperm count connection is due to “great advertising, great sales and poor data.”

Fact or Fiction: Cellphones kept in the pocket (close to the testicles) radiate electromagnetic waves, which damage sperm quality.

Not Sure: Dr. Jarvi explains how he handles this common question. “We don’t know. It probably doesn’t make much of a difference. I tell my patients that ‘if you feel better about it, probably wear it somewhere else.'”

Fact or Fiction: Excessive cycling affects sperm count.

Fiction: This is another common question that Dr. Jarvi hears. “It’s a balance between exercise and heat. Try to reduce heat in the [testicular] area." He notes that there are bike seats that have holes in them to allow ventilation for the testicles. But don’t take it as an excuse to ditch the bike.  As Dr. Jarvi reminds us, “Exercise is very good for them because it increases blood flow."

TREATMENT OPTIONS

When it comes to tackling fertility issues, there are three popular treatment options. Note: Contact your doctor, as there may be government funding in place to assist with the costs.

1) Medication. They are specific to patients who don’t ovulate. Some are directed towards specific disorders. Some are used in general terms because human reproduction tends to fail more often than be successful. Some of the fertility medication is geared to releasing more than one egg during the cycle.

2) In Vitro Fertilization (IVf). The purpose is to recover 10 to 15 eggs in one cycle, fertilize them in the laboratory and put the best egg and sperm together. Allow for the embryonic period to develop before it’s placed back in the uterus. 

3) Intrauterine insemination (IUI). More commonly known as artificial insemination. Prepare the sperm by separating it from the seminal fluid. Place it into the body closest to the Fallopian tubes so that contact with the egg occurs. This is bypassing all the possible obstacles that may occur, fast-tracking the sperm and egg connection altogether. 

MALE FERTILITY ISSUES: The silent struggle

It’s more common than you think: Women talk about fertility issues. Men just don’t.  And that’s why it’s important for Dr. Jarvi to emphasize to his patients that male fertility issues are more common than his patients realize. “A lot of guys don’t appreciate how frequently this problem occurs. They don’t talk about it, so they don’t know how incredibly common it is. One in 10 or one in 14 has fertility issues, which is much more common than the guys who walk into my office may think.”

The hard numbers: Regular sperm count over 15 million per millilitre, with one in three active sperm. Anything under 15 million is considered "low."

Possible causes and treatments  for low sperm count:

Lifestyle. Dr. Jarvi believes that an overall lifestyle change can be for the better, including eating healthy, exercising and eliminating smoking and alcohol. “What’s good for your heart is good for your testicles.” Steroids can be a problem. “Taking anabolic steroids builds muscles but it doesn’t build testicles.”

Varicocele. Enlarged veins around the testicles occur in 40 per cent of men who have fertility issues, making it one of the more common diagnoses. It’s surgically treatable, with positive results showing in three months.  

Idiopathic Factors. The most common category of diagnosis. Sperm count issues could stem from medication side effects, chemotherapy treatments, or an underlying infection.

Both Dr. Jarvi and Dr. Gysler agree to treat this issue in the context of "a couple." Isolating one or the other is just adding undue stress to an already trying time. With the overall childbearing age for women being pushed to the mid-30s, combined with the fact that men’s sperm count starts to decrease from their mid-30s to their early 40s, it’s essential to appreciate that time may be of the essence, and other more efficient ways to conceive may be the best option, including IVF and IUI. Consult your doctor for more treatment options.