Category Archives: Informative articles

Those of you who have been through IVF know that on the day of the procedure the male partner has to have between 2 and 5 days of sexual abstinence. The same is true if the man is going for semen analysis. What actually happens in the male body in those 2 to 5 days? Is there a connection between sexual abstinence in men and pregnancy rate?

Unlike ovulation in women, which is cyclical (usually once every 28 days), spermatogenesis is a constant process. Spermatozoa are stored in the epididymis and during ejaculation mix with secretions from the male accessory glands. These include mainly the prostate and seminal vesicles. It is logical to assume that the longer the period of sexual abstinence in a man, the more sperm will accumulate. However, the World Health Organization (WHO) reference values for sperm concentration, motility and morphology were determined for 2 to 5 days of abstinence. The reason is that this abstinence period is within physiological limits. Outside those limits the sperm accumulated in the epididymis could overflow and is flushed with urine.

There is some evidence that abstinence longer than the mentioned above could result in deterioration of sperm quality, in spite of the fact that semen volume and sperm concentration are usually higher. This deterioration is thought to be due to an increase in DNA fragmentation. It is hypothesized that when sperm are stored in the epididymis for long periods of time, they are exposed to free radicals, which increase the percentage of sperm with fragmented DNA. As the smallest cell in the human body with a very small amount of cytoplasm, the spermatozoon has limited mechanisms for neutralization of free radicals. Therefore, it is not recommended for spermatozoa to be left for a long time in the epididymis or once they are ejaculated.

According to a study published in 2017 in the prestigious American journal Fertility and Sterility, IVF cycles in which the male partner had less than 5 days of abstinence have on average higher pregnancy and live birth rates.

Sperm freezing allows long term storage and later use of your spermatozoa.

WHO NEEDS SPERM FREEZING?

1. Men or teenage boys who are about to undergo a treatment toxic to their spermatozoa. In most cases this is chemotherapy or radiotherapy. In 2018 the Center for Assisted Reproduction, governmental body providing funding for IVF, started funding egg freezing for medical reasons, as well as the subsequent IVF procedure. The purpose of this new policy is to allow women below 35, diagnosed with cancer, to preserve their fertility following chemo/radiotherapy. Unfortunately, the government does not fund sperm freezing for men with cancer. In spite of this, men must be informed of the option for fertility preservation well in advance of the start of their chemo/radiotherapy.

Men/teenage boys who are about to undergo pelvic or testicular surgery should also be advised to freeze sperm for the purpose of fertility preservation. The same is true for men, whose jobs could negatively influence their sperm quality (e.g. exposure to heavy metals, irradiation or high temperature).

2. Men who will be absent/ abroad on the day of the IVF procedure. Whether due to work or other commitments, sometimes the male partner cannot be present on the day of the procedure. In such cases, having frozen specimen(s) is the only way to do the procedure. It is important to know that fresh sperm is always better than frozen due to the fact that some of the spermatozoa do not survive the freezing process. Therefore, frozen material is used only when there is no alternative.
3. Men with very low sperm parameters or those having difficulty with ejaculation. This is especially important for men who sometimes have no sperm in their ejaculate. Even if other times there are single spermatozoa in the ejaculate, spermatozoa are frozen before the procedure as a back-up. Men with diabetes or other conditions causing erectile dysfunction are also advised to have back-up frozen sperm on the day of the IVF procedure.

WHAT does THE SEMEN ANALYSIS TERM “Oligozoospermia” mean?

The term “Oligozoospermia” is composed of the prefix “Oligo-” (from Greek – few), the word “zoo” (existing) and “spermia” (seed, semen). “Oligo-” refers to the number of spermatozoa in the ejaculate. The connecting word “zoo” in this case refers to the spermatozoa themselves, not the semen. “Spermia” is the only part that is always present in the conclusion of a semen analysis.

Thus, the term “Oligozoospermia” means that there is a reduced number of sperm in the whole ejaculate or a reduced concentration (number of sperm / ml of semen). The reduced number / concentration of sperm is determined by comparison with the reference values. New Life Clinic uses reference values ​​for concentration, motility and morphology that are in accordance with the 1999 World Health Organization Manual for the Processing of Human Sperm.
The reason is that the Center for Assisted Reproduction medical indications for financing of male factor infertility couples are also in line with this manual.

WHAT do “OligoASTHENOzoospermia” and “OligoTERATOzoospermia” mean? The reduced number / concentration of sperm is only one of the possible deviations. In addition, sperm motility could also be impaired. Motility deviations are marked by adding the prefix “astheno-“.Similarly, deviations from the reference interval for the third major parameter – morphology is marked by adding the prefix “terato-“. “Terato” comes from the ancient Greek word for “monster”. Morphology is, generally speaking, the shape of the spermatozoon. Therefore, having а large number of “abnormal / monstrous” sperm is termed Teratozoospermia.
It is very important to understand that the result of a semen analysis is not a diagnosis. Sperm parameters vary between different samples of the same patient, sometimes considerably. They are affected by a variety of factors, including the number of days of abstinence, and are subject to improvement

WHICH FOODS can IMPROVE YOUR SPERM QUALITY?

A study published last year by scientists at Hadassah University Hospital in Jerusalem showed that there was a sharp drop in the quality of sperm among Western men. The data collected from 7,500 publications in the medical literature showed a 52.5% reduction in sperm concentration between 1973 and 2011.

Scientists argue that supplementing the diet may improve sperm functioning. Adding nuts to your diet, especially almonds, rich in omega-3, vitamin B and folic acid, can improve sperm quality and quantity in a matter of weeks.  The research was presented at this year’s annual meeting of the European Society of Human Reproduction and Embryology (ESHRE) in Barcelona.

“The medical literature is rich in evidence that a lifestyle change that includes a healthy diet increases the chance of pregnancy,” said Dr. Albert Sallas Huatus of the University of Rubiera Virgili in Spain.

The researchers also noted that low sperm count may predict an increase in mortality and morbidity among men. In previous studies, it was found that low sperm counts are associated with environmental and modern lifestyle factors, including exposure to prenatal chemicals, exposure to pesticides, smoking, stress and obesity.

A Harvard study published this month found that the chances of successful fertilization decrease not only with maternal age but with paternal age, as well. The study found a decrease in fertilization rate if the male partner is over the age of 40.

In conclusion, even though female fertility decreases more sharply after the age of 35 and especially after the age of 40, bear in mind that male fertility diminishes as well. Switching to a healthier diet, including nuts and anti-oxidant-rich foods, and exercising regularly can ameliorate this decrease in male fertility. These measures could prove useful for young men with abnormal sperm parameters as well.

If there are serious deviations from reference values, however, the cause has to be sought and if possible treated/removed. Greatest improvement in semen parameters is observed in men, in whom the underlying condition is successfully treated or the occupational hazard removed.

Marijuana has been known to mankind for millennia. For the first time, it wasmentioned in manuscripts from Ancient China dating from 2373. BC. It was used both as a recreational drug and as a medicine. Marijuana is banned in many countries, including Bulgaria. In others, it is decriminalized in some form (for example, medical marijuana). Today, marijuana is more widespread than ever before, which makes us wonder if its use can affect fertility.

It is known that chronic use of marijuana can lead to addiction and, in the worst case scenario, to psychiatric problems. Precisely because it is forbidden in so many places, there are not many studies about its  connection to infertility, but experts believe that it may have an impact.

MARIJUANA AND MALE FERTILITY

The effects of marijuana on fertility are better studied in men. Regular use can reduce libido and lead to problems with erection and ejaculation. Semen analyses of these men also show abnormalities. They usually have a smaller number of sperm cells whose motility is also altered. Exposed to THC (tetrahydrocannabinol – the substance that makes you high), sperm initially show hypermotility (move very quickly). Consequently, their speed decreases and, as a result, they can hardly reach the egg.

WHAT ABOUT FEMALE FERTILITY?

In women, marijuana also reduces libido. Its frequent use is also associated with irregular ovulation. After smoking marijuana, THC is found in the female reproductive which affects sperm and thus the chances of fertilization to occur. The use of marijuana is also associated with an increased risk of miscarriage due to its effects on rapidly dividing cells such as the embryo’s cells. THC can indeed relieve the feeling of nausea, but its embryotoxicity makes it contraindicated in pregnant women.

THC can be found in the body for up to 8 days after a single marijuana use. Regular “consumers” need 2-3 months to clean marijuana from their bodies. If you plan to become pregnant, it is important to stop using marijuana. If you or someone you know has a problem with marijuana or other illegal substances, you can find help.