Mark Zuckerberg took a bold step when, in 2015, he posted a statement about how he and his wife were struggling with infertility. He wrote, “We’ve been trying to have a child for a couple of years and have had three miscarriages along the way,” Zuckerberg shared in his post. “It’s a lonely experience. Most people don’t discuss miscarriages because you worry your problems will distance you or reflect upon you — as if you’re defective or did something to cause this.”
Hugh Jackman shard that he and his wife struggled with infertility in a sit down interview with Katie Couric on her now defunct talk show, Katie. “It’s almost secretive. But it’s a good thing to talk about. It’s more common and it’s tough, there’s a grieving process you have to go through,” Jackman said.
While Zuckerberg and Jackman omitted the cause of the infertility struggles, sharing it openly has helped many men and couples face the subject of male infertility, an often squeamish issue for most men. And some male celebrities have openly shared their struggle with male infertility, including Gordon Ramsay and Lance Armstrong. In a YouTube interview, Ramsay interviews fertility expert Zita West and Clinical Embryologist Sheryl Homa, along with other men who have suffered from male infertility, to discuss contributing factors, including (obviously) food and diet.
Lance Armstrong, who has five children, used sperm he froze prior to being treated for testicular cancer to conceive the first three, and was able to conceive two of his children with his current partner, Anna Hansen, naturally.
Female celebrities come forward with their fertility struggles, but it is rare to hear from men on the subject, even though infertility affects them equally. Male infertility affects up to 20-50% of couples struggling to have children. Here are six things you need to understand regarding male infertility.
1. Check your semen analysis. Many males assume that, because they’re able to ejaculate, that they must be fertile. What I try to (gently) point out is that, a microscopic evaluation of that ejaculation—to check for sperm—is crucial to determine if there’s any functional sperm. While there might be visible fluid on ejaculation, there might not be any or enough quality sperm present in the ejaculate to lead to pregnancy.
2. Lifestyle adjustments can improve sperm quality. Smoking, alcohol consumption and use of drugs like marijuana or steroids can all adversely impact sperm quality. Obesity can also be associated with poor sperm quality. Though it may be tough to make changes, I regularly counsel men to “clean up” their acts for the sake of their fertility (and their overall health).
3. Stay cool (literally). High heat exposure (i.e. hot tubs, saunas) can transiently lower sperm counts, according to Oxford University Press. Extremely high fevers associated with an acute illness can also lower sperm counts. Fortunately, in most of these cases, sperm counts recover to baseline within a few months.
4. Age matters. While men can and have conceived children well beyond their 40s-50s, it’s not uncommon for sperm quality to decline with age—semen volume, sperm motility (how well they move) and morphology (shape) can all worsen with age. These are crucial parameters that can affect sperm’s ability to fertilize eggs (and lead to pregnancy). There’s also growing awareness that offspring of older fathers are at increased risk for autism and certain genetic disorders. Now, is this enough to advise all men to bank sperm in their 20s or 30s? Debatable as many older men father healthy children without difficulty, but as this article in CNN illustrates, some men are banking sperm for the future.
5. Abnormal sperm quality can (sometimes) serve as an indicator for other health problems. Peter Stahl, Director of Male Reproductive & Sexual Medicine at Columbia University, cautions that “male infertility can be the presenting sign of serious health problems such as testicular cancer” or diabetes. So it’s worthwhile to check in with a urologist who specializes in reproductive health if repeated semen analyses are abnormal.
6. No sperm doesn’t necessarily mean no kids. Some men with azoospermia (no sperm on ejaculation) may still have the opportunity to conceive with their partners: in some instances, hormonal therapy may help stimulate sperm production or sperm may be recoverable via an out-patient surgery with a specialized urologist. Frequently, IVF (in vitro fertilization) is used in conjunction with ICSI (intracytoplasmic sperm injection) to help the sperm fertilize eggs in a laboratory setting. Resultant embryos can then be used to impregnate a female partner (or gestational carrier). Alternatively, a couple may opt to use donor sperm with a female partner in order to conceive a child. This helpful video produced by the American Society for Reproductive Medicine outlines the various options: https://www.youtube.com/watch?v=jC_dZEYAKM0