A Brief History of the Mighty & Motile
The World Health Organization has the very influential job of determining the reference ranges for semen analysis. These reference ranges were overhauled in 2010 from the previous 1999 ranges, which were much higher. There is no doubt that sperm quality has declined over the past 50 years. Some may argue that it’s due to emerging standards of scientific evidence, but in my opinion the strongest evidence is the western lifestyle: poor diet, toxic exposure, xenoestrogens, electromagnetic frequencies, obesity, sedentary habits, the list is endless.
The 2010 standards are based on the semen of fertile men who fathered children within the 12 months preceding the study. The ranges represent the lowest 5th percentile of these men. Meaning:
1) 95% of men should have higher sperm parameters than the reference range
2) Values deemed “normal” are in fact suboptimal for natural conception
The 5 Ws of Semen Analysis
Who: All men wanting to conceive
What: You ejaculate into a cup. It’s not comfortable, but it’s important. You need to abstain from ejaculation 2 days prior to collecting your sample, but you need to have ejaculated at least 5 days before your sample. This is to prevent DNA fragmentation and death of the sperm, if they sit around for too long they actually kill themselves…
When: Your doctor may advise you to try for a year before going for a semen analysis. This doctor says 6 months is enough waiting, especially if you’re over 35 (it’s not just women who age you know!) Once you’ve completed one semen analysis, repeat testing is recommended in two weeks. Semen is ever changing and one snapshot is not enough.
Where: Most likely in a private room at a fertility clinic (bring your own “motivation”), but you may be given the option of home. If you’re obtaining your sample at home you essentially have to sprint like Road Runner to the lab afterwards because the sperm do not survive long outside of body temperature. It’s not recommended.
Why: To determine if you have sperm (in your semen) capable of natural conception, or if they’re going to need a little help getting to their destination.
The Numbers At a Glance
|Parameters||WHO 2010 Criteria – 5% percentile||What if you want sperm that’s 50% better than your friends?|
|Volume of semen (ml)||1.5||3.7|
|Concentration of sperm (per 1ml of semen)||15 million||73 million|
|Progressive motility *forward moving sperm||32%||55%|
*normal sperm forms
Other Important Tests For Your Semen
- Liquefaction – Your semen should liquefy within 15 minutes so that the sperm can be free to swim
- Colour – Semen is grey and opaque. The more translucent it is the less sperm is in it.
- pH – Semen has a basic pH of 7-10, this is to help the sperm survive upon ejaculation.
- DNA Fragmentation – This is a measure of damaged sperm DNA. A value > 50% is very poor DNA integrity and is linked to poor conception and miscarriage.
- Sperm antibodies – These are antibodies the sperm develops against itself. Antibodies affect the sperm’s ability to bind to the egg and for the embryo to develop normally.
Beyond Semen: Tests for Whole Body Health
Sperm health depends on whole body health. Blood pressure, blood sugar, cholesterol, thyroid hormones, adrenal hormones, liver health, and weight are all contributing factors to sperm health. Other hormone tests can be run as well.
What do the Numbers Mean?
If you score lower than the 5th percentile, the next step is hormone testing and a referral to a urologist to determine the root cause. The most common causes of low sperm counts include:
- Retrograde ejaculation – semen enters bladder instead of urethra
- Hypospadias – opening of urethra on underside of penis
- Cryptorchidism – undescended testes
- Absent vas deferens – congenital condition
- Klinefelter syndrome – extra X chromosome without symptoms
- Varicocele – testicular swelling and block of blood flow
- STI – chlamydia, gonorrhea
- Endocrine dysfunction – hypogonadism
- Metabolic dysfunction – diabetes, high blood pressure, high cholesterol
- Lifestyle factors – smoking, alcohol, medications, poor diet, sedentary etc.
- Age – semen parameters decline around age 35-38
What Are Your More Invasive Treatment Options?
Based on sperm concentration:
- IUI – between 5 and 10 million/ml
- IVF – less than 5 million/ml
- Hormone therapy – less than 5 million/ml
- TESE (testicular sperm extraction) – undetectable sperm but normal testosterone
What Are Your Less Invasive Treatment Options?
It takes 90 days for sperm to mature. Lifestyle has the potential to change EVERYTHING
- Ejaculate often – every 3 days to prevent DNA fragmentation. Your semen volume may decrease but your sperm concentration will not
- Wear protection…when playing sports – injury causes the production of sperm antibodies
- Brush your teeth – periodontal disease is linked to poor sperm quality
- Sleep well – melatonin is an essential antioxidant for sperm protection
- Buy organic & filter your tap water – pesticides and chemicals distrust hormones
- Use a sperm friendly lubricant, like: Yes Baby, Astroglide TTC, and Pre-Seed
- Foods to incorporate on a daily basis for sperm production & protection: pumpkin seeds, eggs, olive oil, garlic, POM juice, oats, barley, walnuts, almonds, brazil nuts
Lifestyle: NOT SO MUCH
- Chemical sunscreens – contain benzophenones, which are harmful to your testes
- Direct Wi-Fi – the frequencies and heat from your laptop are damaging, turn your laptop into a standing desk
- Extreme heat- the scrotum likes a breeze! Avoid seat warmers, hot tubs, long stretches of sitting, skinny jeans, tighty-whities, long distance biking etc.
- Extremely strenuous exercise – don’t decide to compete in an Iron Man or train for your first marathon while trying to conceive
- Smoking – including marijuana, it impairs sperm count and motility
- Alcohol – no more than 3 drinks a week
- Coffee – no more than 200mg daily (that’s 1 small Starbucks/ Tim’s)
- Processed meats – they’re full of crap, need I say more
Book an appointment . As a Naturopathic Doctor, I use herbs, supplements, nutrition, and acupuncture to help you produce more sperm and optimize the sperm you already have.
- Your sperm needs fuel just like any other cell in your body and sometimes it needs a little supplemental support
- Your sperm also needs anti-oxidants and vitamins to protect it from damage
- Herbs and acupuncture can improve your libido and decrease erectile dysfunction
- Most of all, I can answer all of your questions and support you through the conception process. Simple solutions can make all the difference