Father's Matter: How Healthy Is My Sperm?

Sperm health is starting to gain awareness in couples who are in the midst of family planning. Gone were the days when conceiving was a pure woman’s problem. We now know that in one-third of infertility cases are due to the underlying male factor. Good healthy sperms are required to effectively fertilise the ovum.

In this article, we want to understand the importance of having healthy sperm, factors that affect sperm quality and ways to improve and maintain good healthy sperm. 

Sperm health can potentially affect the health of future offspring

Beyond the role of impregnating the ovum, the sperm has a longer-term impact on the pregnancy and health outcome of the future offspring. This is a medical topic that is gaining popularity in research and understanding in the recent years. The epigenetic inheritance can be transferred to the future generation based on the sperm that successfully fertilizes the egg. The paternal effect can be subtle, yet significant over the growing years of the offspring. Studies have shown that poorer quality sperm can be associated with low birth weight and potentially has an effect on the metabolic health of the baby, affecting the development and performance of his later life.

How is sperm produced?

The sperm is produced by the male testicles. Once the sperm is produced, they will travel via the male reproductive tract, combined with semen fluid that is produced by the prostate glands and seminal vesicles. The sperm is then expelled/ ejaculated during orgasm.

What is considered a 'healthy sperm'?

The sperm production is healthy and efficient in fertilising the egg when

1. There is sufficient amount of sperm produced during a single ejaculation (semen discharged). This is quantified as at least 15 million of sperm per milliliter of semen fluid.
2. The motility (or movement) of the sperm is vital in ensuring the sperm is able to swim and survive through the female reproductive organ (the vagina, cervix, uterus, fallopian tube to meet the egg and fertilize it thereafter. At least 40% of healthy mobile and active sperm are required for better chance of conceiving.
3. The shape (or morphology) of the sperm is important to allow the sperm to move and propel forward. A healthy sperm shape has an oval head with a long wriggly tail.

What medical condition can affect sperm quality?

Sperm quality can be affected by underlying medical conditions. From a logical point of view, the production of a good sperm can be hindered if

• The brain is not producing sufficient male sexual hormones to stimulate testosterone and sperm production.
• The testis (the factor to produce sperm) is not working well.
• The transportation system (the tubes) that connect the testis to the urethral/outside world is blocked, abnormal and unable to transport the sperm.

The sperm quality also deteriorates with age, with lesser number of sperm produced as one ages, less ability of the sperm to move and swim.

In modern days, one of the common reasons for poor sperm quality is infection, in particular- sexually transmitted infections. This is a common and reversible (most of the times) cause of poor sperm quality. Following identification and treatment of the causative infections, the sperm quality improves. Nonetheless, if the infections have been chronic and in late stages with complications of scarring and inflammation of the reproductive organs (such as epididymitis/ testicle scarring/ tube blockages), one can have permanent poor sperm quality, or even reduced/ no sperm production.

Male performance conditions secondary to erectile dysfunction, retrograde ejaculatory disorder, pelvic/testicular surgery, spinal injury, and vein swelling of the testicles (varicocele) can affect the ability to produce good quality sperm.

Medical causes that can affect sperm production include poorly controlled diabetes, cancer treatment, endocrine disorders, brain surgery, and rare genetic conditions such as Klinefelter syndrome and cystic fibrosis.

What are the lifestyle causes of poor sperm health?

Factors	Sperm quality
Age	The older you are the quality, quantity, and movement ability of the sperms are poorer. Those who are over the age of 45 have less healthy sperms.
BMI	An overweight person tends to have poorer sperm quality. There are studies that show the sperm genetics of an overweight person can be passed on to the offspring, affecting the baby's weight and future health.
Smoking	Smoking affects a person's sperm and semen fluid production, resulting in lower sperm count and reduced semen fluid.
Alcohol	Excessive alcohol drinking can reduce the quality of sperm, reduce a person's testosterone level, affecting a person's sexual drive.
Occupation/ Environment	An environment such as hot spring/ onsen may affect the sperm quality. Work environments such as hot kitchen, exposure to chemicals such as pesticides, heavy metals, radiation can affect the sperm quality.
Medications	Medications such as steroids, testosterone hormonal replacement, cancer medication, radio/chemotherapy, recreational illicit drugs can be detrimental to sperm quality.
STDs	Untreated STDs such as herpes simplex virus, chlamydia, gonorrhea, trichomonas, mycoplasma genetalium, syphilis, and HPV infections can cause chronic inflammation of the male reproductive organs, leading to poor sperm quality and infertility.

What are the symptoms of poor sperm quality?

Often, one feels well and normal. A sign of poor sperm quality involves inability to impregnate after attempting for at least 6 to 12 months.

Other associated symptoms include

• Poor sex motivation
• Performance issues such as erectile dysfunction
• Pain over the testicle or genital region
• Blood in the semen
• Unable to ejaculate
• Painful ejaculation
• Other symptoms that can be associated with underlying medical conditions such as lesser body hair in those with hormonal imbalance.

You are advised to reach out to your healthcare provider if there is concern of fertility and poor sperm quality for evaluation and early treatment.

What do I expect from my doctor when I see him for concern of my sperm?

When you consult your healthcare provider on concern of sperm health, your doctor will obtain a relevant history including your sexual history/ ability to father a child in the past. This is mostly followed by a physical examination of the genital area to ensure no physical abnormalities. Semen analysis test can be offered to evaluate further the quality of the sperm.

Depending on individual medical history, sometimes your doctor may offer STD screening (in the form of blood tests and urine tests), hormonal blood tests, genetic testing or ultrasound of the testis and prostate to screen for reversible causes such as infection, hormonal imbalance or structural causes of the poor sperm quality. 

What is semen analysis?

Semen analysis is a laboratory evaluation test of the ejaculated semen sample that is produced by a man. The semen sample is analyzed under microscope and evaluated for its number of sperms that is contained, the shape (morphology) of the sperm and the movement of the sperms. 

How can I improve my sperm quality?

Taking care of a person's general wellbeing is vital in ensuring sperm are healthy. This is a common fact to most of us yet it is always taken for granted in our daily life until our health starts to show red signs.

Healthy living includes 

• Moderate healthy eating, with a balance nutritional diet
• Regular exercise to maintain an ideal weight
• Avoid smoking or vaping
• Moderate alcohol drinking (less than 14 units per week)
• Regular sexual health screening

Furthermore, to ensure the sperm production is not curtailed, maintaining a good environment for the male reproductive organs is vital. This includes pieces of advice such as

• Avoid chronic hot environment- kitchen/ hot soaks/ sauna, placing hot electronic devices on your lap/ genital region
• Avoid tight fitting underpants
• Avoid recreational drugs such as marijuana, steroids, testosterone boosters
• Avoid prolonged sitting
• Consider protective clothing if working/sports environment involves high physical trauma/ exposure to chemicals or heavy metals

Concerned About Your Fertility?

At Dr Ben Medical, we offer confidential and personalised assessments to help you gain clarity and take care of your reproductive well-being. Schedule a consultation at your convenience.

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