Dear Ovia, How do I tell my hubby that he’s the one who needs to get tested now?

This is such an important issue, and a surprising challenge for many people with a male partner. It’s been ingrained in our culture for so long that infertility is very likely a woman’s “fault.” And many people are genuinely shocked to learn that about half of all known cases of infertility have what’s called a male factor. Infertility is no one’s fault, and identifying medical issues that impact your struggle to conceive shouldn’t carry stigma, but I live in the real world with you, so I know that stigma is alive and well.

My advice is to be as dry as you can about it. If this is a first attempt, go basic, “Hey, doctors say the next step is a sperm analysis, they gave me the info for a provider for you.” Even though there are big emotions involved, this is a medical and clinical step. Keeping the conversation simple and medical can help. 

That said, you know your hubby best. Would it work best to make the appointment and tell him when it is? Or maybe to have your doctor explain that it’s the next step if he’s said he doesn’t think he needs to go get tested? Or to reassure him this is what everyone does at this stage? 

Again, we live in a culture that often connects fertility and feelings of pride. If he’s having trouble believing he may need medical help to conceive, there’s probably some grieving and acceptance that has to happen. 

More from this series

• Dear Ovia, My partner isn’t sure if he wants kids
• Dreams of a big family

Here, we’ll break down the basics of male fertility and what to do if you and your male partner are having trouble getting pregnant.

What typically happens when sperm meets egg

A healthy male produces tiny reproductive cells called sperm, which are made in the testicles. When he ejaculates, the sperm mixes with fluid from the prostate, forming semen. During vaginal intercourse, ejaculation carries the semen into the vagina where it travels through the cervix and into the uterus and fallopian tubes. During ovulation, an egg is released from the woman’s ovary and, if fertilized by the sperm, a ball of cells (called the oocyte) is formed. Fertilization occurs in the fallopian tube and the embryo then implants inside the uterus. If the egg is not fertilized, it disintegrates and sheds during the next menstrual period.

When to see a doctor

It’s generally recommended to see a doctor for a fertility evaluation if you and your partner have been trying to conceive for at least a year with regular, unprotected sex with no success. Depending on your and your partner’s medical history, your doctor may decide to check one or both of you for a fertility workup. You may want to seek care sooner if the female partner is over 35 years old or if the male partner has certain medical conditions such as:

• Past surgery on the groin, testicle, scrotum, or penis
• A history of testicular or prostate problems
• Problems with erection or ejaculation, low sex drive, or other issues with sexual function
• Pain, lumps, or swelling in the testicular region

What to expect when seeking care

For men having trouble with infertility, a doctor may order tests to  measure the amount and quality of the sperm. This is called a sperm analysis. Your partner will provide a semen specimen at the doctor’s office and the doctor will look at the sperm under a microscope. There are 3 factors doctors look for in a sperm analysis. 

• Sperm count: This shows the amount of sperm produced in an ejaculation. A healthy number is 20 to 150 million sperm per milliliter of semen.
• Sperm motility: This test shows how well sperm are moving. At least 60% of sperm should have normal forward motion. Sperm that move erratically or not at all can affect the ability to conceive.
• Sperm morphology (size and structure): Normal sperm have an oval head with a long tail. Damage to any part of the sperm can affect fertility by decreasing the ability to reach and penetrate an egg. Many conditions affecting the shape of sperm are genetic.

Remember that infertility is no one’s fault. It can be difficult and frustrating to experience any kind of fertility troubles on your journey to getting pregnant. Communicating and empathizing with your partner can help make the journey to parenthood a little easier.

Reviewed by the Ovia Health Clinical Team

Sources

“How common is infertility?” National Institutes of Health. National Institutes of Health. February 8, 2018. https://www.nichd.nih.gov/health/topics/infertility/conditioninfo/common

Mayo Clinic Staff. “Male infertility.” Mayo Clinic. Mayo Clinic. August 13, 2021. https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773

“What is male infertility?” Urology Care Foundation. American Urological Association. n.d. https://www.urologyhealth.org/urology-a-z/m/male-infertility

Cedars-Sinai Staff. “Optimizing male fertility.” Cedars-Sinai. Cedars-Sinai Medical Center. May 31, 2017. https://www.cedars-sinai.org/blog/optimizing-male-fertility.html

Bradley D. Anawalt & Stephanie T. Page. “Patient education: Treatment of male infertility (beyond the basics).” UpToDate. UpToDate. November 11, 2020. https://www.uptodate.com/contents/treatment-of-male-infertility-beyond-the-basics

Sex Ed. class 2.0

Here, we’ve rounded up five things you should have learned from sex ed. class before reading this article, but will be useful to you long after you close it.

1. It is normal and healthy to masturbate

Masturbation is not just expected by boys and men, but encouraged. Yet, common cultural narratives tell girls and women that masturbation is dirty and wrong.

Here’s the thing: Nothing could be further from the truth. For people of all genders, masturbating is both normal and healthy! Benefits of masturbating include: reduced stress, boosted mood, and increased self confidence long term. And beyond being healthy, masturbating also feels good, which is absolutely reason enough to partake!

In summary: You should have been taught that masturbation is healthy. Further, you should have been encouraged to touch yourself in whatever locations, using whatever pressures, at whatever speeds, for however long, and however often you want.

2. STIs can be transmitted during oral sex

Despite the fact that many sex education curriculums rely on fear-mongering, few programs acknowledge sex acts other than penis-in-vagina intercourse exist, and therefore do not touch on potential risks of such acts. Like, oral sex for example.

From fellatio and cunnilingus to analingus, oral sex can bring Big Time pleasure for the giver and receiver alike. Still, important to know the potential risks. Ready?

While the risk is lower than it is during vaginal or anal intercourse, an STI can be transmitted during oral sex from a mouth or throat, to a penis, vagina, vulva, or anus — and vice versa. That means that, yes, an STI can infect body parts other than the genitals.

When oral STI symptoms do appear, they may include: sore throat, pain during swallowing, sores around the lips, sores and blisters in the mouth, and swollen lymph nodes. But as is true with STIs located elsewhere in the body, the most common symptom of an oral STI is no symptom at all. And that’s why it’s so important to get tested for oral STIs, between (oral sex) partners or once a year (whichever comes first). Oral STI testing involves a simple mouth or throat, and treatment typically involves an oral antibiotic or prescription mouthwash.

What can you do to reduce risk of STI transmission during oral hanky-panky? Glad you asked. With a partner who’s STI status you don’t know or who has an STI , you can use an external condom or dental dam to reduce risk of transmission.

3. PReP can be taken by all genders

PReP (pre-exposure prophylaxis) is a daily oral medication that can be taken by HIV-negative people to greatly reduce their risks of contracting HIV, if exposed to the virus. Highly effective, PrEP is one of the best additions to the sexual health space…ever.

While there is more that can be done to spread awareness about PReP to all people, cis-women in particularly tend to be less likely to take PReP. The problem is that people of all sexual orientations, genders, and genitals are susceptible to HIV, if exposed to the virus through sex, intravenous drug use, contaminated blood transfusion, or pregnancy. In fact, globally more than half (52%) of HIV-positive people in the world are women.

No matter your gender, to figure out if you’re a good candidate for PrEP read the federal guidelines put out by the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) and/or talk to your healthcare provider.

4. Sex is not supposed to be painful

No, not the first time you have it. No, not during anal sex. No, not postpartum. Pain is the body’s way of telling you that something is wrong — and it’s a message worth listening to.

Sometimes pain during sex is a sign that you need additional lubrication or that your not-yet aroused-enough for what’s happening. In these instances, slowing down and adding lube can turn your sex session from “ouch” into “ooh!”.

When sex is consistently painful, however, or you experience these symptoms outside of sex (for example: while urinating or inserting a tampon) there may be an underlying condition. Pain during sex is a common symptom of conditions like hypertonic pelvic floor, endometriosis, vaginitis, vulvodynia, vaginismus, and pelvic inflammatory disease.

If you’re experiencing pain during sex, stop. If you want to continue having sex, try slowing down and/or add a store bought lubricant. If the pain becomes more chronic, bring it up with your healthcare provider or seek out the guidance of a trauma-informed pelvic floor specialist.

5. Consent is an informed, ongoing, and enthusiastic agreement to engage with someone that can be withdrawn at any time

As of 2020, only 9 states required consent be taught in sex education curriculum. That means that a whopping 41 states don’t teach students the importance of receiving “Y-E-S”, nor validated the decision to say “N-O” at any point during a sexual encounter.

The failure of this absence becomes obvious when looking at the responses from a recent survey of people ages 18 to 25. In it, 53% admitted that they didn’t realize that consent can be withdrawn once someone is already naked (it can!) and just 13% said they’d feel comfortable discussing consent with their sexual partner.

While the staggering sexual assault statistics cannot be blamed on any one thing — curriculums in sex ed. class suffer from widespread avoidance of consent, and it certainly isn’t doing anything to help reduce the number of people assaulted.

If you’re reading this and haven’t yet learned about consent, take the time to read The Consent Checklist by Meg-John Barker and/or Beyond Yes & No by Kai Werder.

Reviewed by the Ovia Health Clinical Team

Sources

• “Facts and figures: HIV and AIDS.” UN Women. UN Women. July 2018. https://www.unwomen.org/en/what-we-do/hiv-and-aids/facts-and-figures. 
• “Pre-exposure Prophylaxis (PrEP) Care System”. CDC. CDC. September 10, 2020. https://www.cdc.gov/hiv/effective-interventions/prevent/prep/index.html#About-PrEP. 

What artificial insemination is and the types to consider

It’s essentially when sperm is introduced into a female’s uterus or cervix with the hope of getting pregnant without sexual intercourse. You might think of it as a little bit of assistance with getting pregnant. Just how are these methods different?

IUI

IUI stands for intrauterine insemination. This insemination method injects the sperm directly into the uterus. Because this insemination method will place sperm closer to the egg that other insemination methods, IUI is believed to have a slightly higher success rate than other methods. Many people who undergo IUI (and the following two forms of insemination, ICI and IVI) do it while also taking fertility drugs to increase egg production and, as a result, increase the chances of getting pregnant. If you’ve heard about IUI leading to a higher chance of multiples, it’s likely because of accompanying fertility treatments, not the procedure itself.

ICI

ICI isn’t a tasty frozen treat you can get at your local movie theatre – it stands for intracervical insemination. Intracervical insemination happens when sperm is injected into the cervix, which is the tissue that connects the vagina and the uterus. Unlike IUI, you can perform ICI with unwashed sperm. There is a recommendation that IUI and ICI be performed by a healthcare provider, but some couples have found success performing these methods of artificial insemination at home.

IVI

IVI means intravaginal insemination, which is when sperm is injected into the vagina. Of the three methods of artificial insemination, this one places the sperm farthest from the egg and therefore has the lowest success rate. However, it’s the cheapest method and doesn’t necessarily require assistance from a healthcare provider. If you’d like to try intravaginal insemination at home, it can be done with a clean syringe or a cervical cap.

IVF

You’ve probably heard of IVF, which stands for in-vitro fertilization, but this procedure isn’t actually a method of artificial insemination. IVF is sometimes confused with the above methods and believed to be a kind of artificial insemination, but it’s actually another type of assisted reproductive technology. For IVF, semen and an egg are combined to form an embryo, and that embryo is then implanted into the uterus.

So which method is best?

Each method of artificial insemination has its own set of benefits. The cheapest method of artificial insemination is IVI, and if you’re looking to inseminate at home, you might want to consider this method. But the most effective method might be IUI. And IVF is an effective form of assisted reproductive technology, but it’s expensive, and, like all of these methods, it isn’t guaranteed to work. Really, if you need a little bit of help getting pregnant and are considering one of these methods, it’s advisable to speak with your healthcare provider or a fertility specialist so that they can help you decide which method will be best for you.

The differences between an IVF and an ICSI

Articles and websites are known to use the two names (IVF and ICSI) interchangeably, without explanation, or definition. How are people supposed to know what these treatments are and how they’re different? Wait, are they different? Let’s start from the beginning.

In Vitro Fertilization (IVF)

You may already know a little about IVF because it’s probably the most popular form of assisted reproductive technology (ART) out there. It’s also the most expensive. One IVF cycle can cost anywhere from $8,000 to $30,000 depending on factors like age, health, or if you plan on using donor sperm or eggs. However, if IVF turns out to be the right choice for you, it may very well be worth the hefty price tag.

Many people who seek out IVF treatment do so because they have issues with fertility. These could include endometriosis, polycystic ovary syndrome (PCOS), problems with sperm function, and unexplained infertility. For people over 35, IVF may also offer a better chance of conceiving than traditional intercourse, ICI, or IUI. It’s always a good idea to speak to your healthcare provider when you are thinking about moving forward with any ART or other fertility treatments.

How IVF works

The IVF process can take up to two weeks, and there are several different ways to prepare the body for treatment based on individual health. These preparations include taking hormone-encouraging drugs to boost ovulation and improve chances of producing a high number of mature eggs. There are also medications to help prepare the uterine lining for fertilized embryos. Specialists work closely with patients to help develop a game plan.

When a healthcare provider gives the green light, mature eggs will be carefully retrieved from the ovaries. These eggs (or donor eggs) are taken to a lab where they will then be put in a petri dish with fresh sperm (collected shortly before the procedure), or sperm that has been thawed and prepared beforehand. These close living quarters will allow sperm to mingle with eggs in a way that is isn’t really possible during traditional intercourse. Aside from the setting of the petri dish, the fertilization process is much the same as during intercourse. In the end, one sperm should match up with one egg. Then it’s a bit of a waiting game. If the procedure is successful, after a period of two to six days, the fertilized embryo or embryos will finally be transferred to the uterus, where, hopefully, implantation will be successful and result in pregnancy! With IVF and ICSI, it’s sometimes possible to find out if it worked by taking a pregnancy test as soon as two weeks after implantation.

Intracytoplasmic sperm injection (ICSI)

This treatment is also used when people are having trouble getting pregnant, or by people using donor eggs or sperm. The name “intracytoplasmic sperm injection” makes ICSI sound like a very complicated treatment, but when you break it down, the concept is pretty straightforward. In truth, the term is just a really formal way of saying that during the ICSI process, sperm will be directly injected into an egg to fertilize it. But, what exactly does that mean, and how is it possible?

How ICSI works

ICSI is a form of IVF treatment, often referred to as “IVF with ICSI,” so both processes take place in a IVF lab. As for preparation, traditional IVF and ICSI are very similar, if not identical in some cases. The real difference between the two happens after the sperm and eggs have already been taken to the lab. Unlike traditional IVF, ICSI samples are not mixed together in a petri dish and left to match up on their own. Through the ICSI process, you are able to make the connection for them. A single egg is delicately held in a specialized pipette, while a very small and hollow needle carefully selects a single sperm and immobilizes it by picking it up. Once both parties are secured, the needle is slowly brought through the shell of the egg (zona) before reaching its goal at the center of the egg (cytoplasm). The needle then places the sperm within the cytoplasm. After injecting the sperm, the process is complete, and the needle is removed. Eggs are checked after a day or so to see if the process of “normal fertilization” has begun. Just like traditional IVF, the successfully fertilized eggs are then implanted in the uterine lining once they are mature enough.

Other things to consider

In the end, there really isn’t a “qualifying factor” that can say for sure whether you should use traditional IVF or ICSI treatment (though ICSI may be more effective in cases of severely low sperm count and unexplained male infertility). The process of egg retrieval and insertion of embryos into the uterus are the same between both options. Both are mostly painless, and have mild side effects. In fact, because ICSI has become more popular over the last decade with a 70% to 85% fertilization rate, many clinics have begun to use the two procedures interchangeably, and some have even begun using ICSI for every treatment!

We all know that it’s sometimes difficult to get a straight answer from the internet. We’ve covered the basics, but nothing can replace your healthcare provider’s knowledge and advice. Asking them detailed questions may be the first step in beginning your IVF journey!

Read more

• Sperm donation 101
• Egg donation: thinking it through

Sources

• Mayo Clinic Staff. “In Vitro Fertilization (IVF)”. Mayo Clinic. Mayo Clinic. March 22, 2018. https://www.mayoclinic.org/tests-procedures/in-vitro-fertilization/about/pac-20384716
• “Intracytoplasmic Sperm Injection- ICSI and IVF. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/icsi.htm
• “Egg Donation Cost at the Advanced Fertility Center of Chicago”. Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/eggdonationcost.htm

There are many factors that might have you considering alternative insemination, and using a sperm donor to help you in start (or expand) your family.

If you’re thinking about sperm donation, here’s what you should know

Your primary care provider (PCP) will be able to give you a fertility evaluation, and this will help you decide whether using donor sperm, or other reproductive assistance, is right for you. During this appointment, you’ll be asked to provide information about your lifestyle, but don’t worry, this isn’t a test. You won’t “fail” the exam if you admit to being a couch potato every once in a while, and it’s important to be honest if you want a care plan that’s specific to your family’s health and needs.

Choosing sperm

After meeting with your PCP, your mind may shift to figuring out the type of sperm you’d like to use. “Known” sperm (the sperm of someone you know) and anonymous sperm are the two options you’ll find. Both can be the right choice, but each has different emotional and legal considerations that go with them, so take your time with this decision.

Remember, all donations (anonymous or not) are screened for sexually transmitted diseases, as well as any evidence of genetic disorders. In the case of anonymous donation, the sperm is usually frozen and kept for 6 months after it is deposited, before it is then re-tested and given to patients.

In addition to deciding whose sperm to use, there is also the matter of what form of sperm you’re going to use. As with insemination procedures, there are few different options that are available:

• ICI-ready sperm: Semen in this category is used for intracervical insemination. This process is probably the closest to the movie and TV representations of sperm donation. These specimens are not “prepared” or altered before they are frozen (but of course they go through the same thorough screening process). Often, this sperm is injected into a patient at a clinic or doctor’s office, but this type of sperm can also be used for private home insemination. ICI is the least invasive form of alternative insemination, and has success rates of anywhere from 10% to 18% (tracking your cycle can help give you the best odds).
• IUI-prepared sperm: These samples are prepared for intrauterine insemination. The seminal fluid is removed or, “washed” from the donor’s semen to isolate sperm, and all dead swimmers are removed before the sample is frozen. This option is more expensive  than ICI sperm because of the process the semen goes through, and because by eliminating seminal fluid and dead sperm, there is a better chance of fertilization.The IUI procedure is also a little more invasive than ICI because the sperm is directly inserted into the uterus rather than the cervix. This process is always performed in office, and has a success rate of 18% to 30%.
• IVF-prepared sperm: This is the cheapest form of prepared sperm, but it isn’t offered by every sperm bank. These samples have a lower sperm count than ICI or IUI prepared sperm. This is because it is believed that less sperm is needed to conceive through IVF, and that saves you some money. But despite saving a couple of bucks on sperm, IVF is one of the most expensive options for alternative insemination. This process involves taking already fertilized embryos and inserting them into a uterus. And again, this increases the success rates to 13% to 41%.

The varying success rates within methods are due to a lot of situational factors including medication, health, age, and lifestyle.

Because the cost of donor insemination can range from $300 to $4,000 depending on what sperm is used, and an average cost of $12,000 per IVF cycle, be sure to ask your provider how many vials of sperm you’ll need!

Preparation

Sometimes people are prescribed medication to help prepare the body by encouraging fertilization. Every case is different, but many medications prescribed in these situations are follicle stimulating hormone (FSH) treatments. FSH is a naturally occurring hormone in your body that helps mature an egg living in the ovaries, while also causing a follicle to grow around that egg as it continues to mature before ovulation. The medications prescribed by healthcare providers encourage this process in the same way.

The day of

Traditionally ICI, IUI, and IVF are all outpatient procedures. IVF can be a little different because the process may involve two outpatient procedures. In those cases, there is a standard egg retrieval and a seperate embryo transfer performed after the eggs have been fertilized. Though all of these procedures may be a little different, a benefit of all three options is that once the insemination process is over, you’ll be able to resume your day as normal.

After insemination

After these outpatient procedures, you’ve made it! And despite popular belief, there’s no need to lay on your back with your legs in the air. You may be asked to lay down or relax for a while, but your legs won’t be airborne, and this downtime could help you process your excitement or calm your nerves. After insemination, you may experience some mild cramping or bloating. This is normal, and shouldn’t be too intense. Then, you may be able to take a pregnancy test as soon as two weeks after insemination! On the other hand, some healthcare providers may suggest waiting a longer period of time. Waiting a little longer will be hard, but if you can do it, you’ll get a more accurate reading on whether or not the insemination was successful.

The bottom line

Alternative insemination is a procedure without many physical risks, and is a great option for people looking to expand their families. Because there are varying success rates to each procedure, your PCP can offer a great deal of guidance and support when making this decision. Be sure to keep all of your personal needs in mind, and take everything at your own pace.

Sources

• Office Andrology. Illustrated Edition. Battaglia, David E. and Patton, Phillip E.. Human Press. 2010. Web. https://books.google.com/books?id=WMazHT_VXrcC&printsec=frontcover&dq=Office+Andrology&hl=en&sa=X&ved=0ahUKEwjh9tXSqJfcAhVDn-AKHZDTCcYQ6AEIJzAA#v=onepage&q=Office%20Andrology&f=false
• “Single Cycle IVF Cost Details – Advanced Fertility Center of Chicago.” Advanced Fertility Center of Chicago. Advanced Fertility Center of Chicago. 2017. https://www.advancedfertility.com/ivfprice.htm
• Mayo Clinic Staff. “Female Infertility”. Mayo Clinic. Mayo Clinic. March 8, 2018. https://www.mayoclinic.org/diseases-conditions/female-infertility/diagnosis-treatment/drc-20354313
• Seattle Sperm Bank Staff. “Demystifying IUI, ICI, IVI, and IVF”. Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/demystifying-iui-ici-ivi-and-ivf/
• Seattle Sperm Bank Staff. “How to Inseminate at Home Using Donor Sperm.” Seattle Sperm Bank. Seattle Sperm Bank. 2015. https://www.seattlespermbank.com/how-to-inseminate-at-home-using-donor-sperm/
• Pacific Fertility Center Staff. “Donor Sperm.” Pacific Fertility Center. Pacific Fertility Center. 2018. https://www.pacificfertilitycenter.com/treatment-care/donor-sperm
• “In Vitro Insemination: IVF”. American Pregnancy Association. American Pregnancy Association. 2018. http://americanpregnancy.org/infertility/in-vitro-fertilization/
• “Artificial Insemination (Intrauterine Insemination, IUI)”. University of Wisconsin Hospitals and Clinics. University of Wisconsin Hospital and Clinics. 2018. https://www.uwhealth.org/infertility/intrauterine-insemination-iui/26136

Jennifer Heinen, MS, RDN, LDN Founder, Nourish for Life

As couples begin their journey toward pregnancy, they may consider making changes to their lifestyle. Many are aware that a nutritious diet, exercise, stress reduction, and improving sleep habits are keys to preparing the body for reproduction. However, after 6 months to a year of trying without becoming pregnant, it’s time to start looking at what each partner can do to improve their chances of conceiving. As information directed at women and fertility is abundant and readily-available, we are going to focus instead on what male partners can do on their own.

If you’re looking to boost male fertility, consider these diet changes

According to research, male factor infertility is the cause of infertility about 40% of the time, and yet less than 15% of people in this category seek independent medical advice for infertility. Considering that it takes both partners to make a baby, male lifestyle and diet also play a role in TTC. The good news is that men can take some control over their reproductive health by making simple changes to daily habits.

Maintaining a healthy weight is one way to improve fertility for men. Obesity and being overweight are acknowledged risk factors that can impact male fertility, as they can lead to lower testosterone levels and reduced semen quality. According to one study, the chances of infertility increase by 10% for every 20 pounds a man is overweight. Following a healthy eating plan and getting regular exercise to help manage weight can be a first step towards improving a couple’s chances of getting pregnant.

But not all men struggling with infertility are overweight. Even those at a healthy weight can practice unhealthy behaviors. For instance, smoking, drug use, and excessive alcohol intake can negatively affect chances of conception. Men at a normal BMI that do not eat a well-balanced diet may not reap the benefits that good nutrition could have on their fertility.

Add more produce to the mix

So what is a fertility-friendly meal plan for men? Begin by eating more fresh produce. This can easily be done by getting at least one serving at each meal and snack, or filling half the plate with fruits or vegetables. Focus on the most colorful veggies, which are packed with antioxidants like Vitamin E, Vitamin C, and beta carotene. Also, enjoy fatty fish, like salmon, sardines, and mackerel on a regular basis. They are high in DHA, a fatty acid that is found in sperm. Other healthy foods to focus on are chicken, low-fat dairy, and whole grains.

Reduce consumption of processed meats

Some research suggests that certain foods have a negative effect on fertility in men. These include processed meats (like hot dogs, deli meats, bacon, and canned meats), sweets, fatty foods (especially trans-fats and saturated fats), and other highly processed foods. Replacing these with healthier options may increase sperm motility and quality.

Although the research around male fertility and diet is limited, following a healthy eating pattern and managing weight is a solid recommendation – not only to benefit conception, but the overall health for the father-to-be. Men play an important role in baby-making, so discuss ways you can help make changes and support each other in your journey towards starting a family.

Reviewed by the Ovia Health Clinical Team

Read more

• Finding a fertility specialist
• What you need to know about fertility and perimenopause

Sources

• Myriam C. Afeiche, et al. “Meat intake and reproductive parameters in young men.” Epidemiology. 2014 Oct. 1. 25(3): 323-330. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180710/.
• Phil Berardelli. “Sugar and Sperm Don’t Mix.” Science. American Association for the Advancement of Science, May 3 2007. Retrieved September 19 2017. http://www.sciencemag.org/news/2007/05/sugar-and-sperm-dont-mix.
• Giahi L, et al. “Nutritional modifications in male infertility: a systematic review covering 2 decades.” Nutr Rev. 2016 Feb;74(2):118-30. https://www.ncbi.nlm.nih.gov/pubmed/26705308.
• Katib, A. “Mechanisms linking obesity to make infertility.” Cent European J Urol. 2015; 68(1): 79–85. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/25914843.
• Sallmén M, et al. “Reduced fertility among overweight and obese men.” Epidemiology. 2006; 17: 520–523. Retrieved September 19 2017. https://www.ncbi.nlm.nih.gov/pubmed/16837825.
• Nancy Shute. “Fatty Foods Bad for Sperm.” NPR. NPR, March 14 2012. Retrieved September 19 2017. http://www.npr.org/sections/health-shots/2012/03/13/148540108/fatty-foods-bad-for-sperm.
• “Infertility FAQs.” Centers for Disease Control and Prevention. U.S. Department of Health and Human Services, March 30 2017. Retrieved June 7 2017. https://www.cdc.gov/reproductivehealth/infertility/index.htm.
• “Less processed meat, more fish and exercise may boost sperm count, quality.” Harvard School of Public Health. The President and Fellows of Harvard College. Retrieved September 19 2017. https://www.hsph.harvard.edu/news/hsph-in-the-news/less-processed-meat-more-fish-and-exercise-may-boost-sperm-count-quality/.
• De Jonge CJ, Gellatly SA, Vazquez-Levin MH, Barratt CLR, Rautakallio-Hokkanen S. Male Attitudes towards Infertility: Results from a Global Questionnaire. World J Mens Health. 2023 Jan;41(1):204-214. doi: 10.5534/wjmh.220099. Epub 2022 Aug 16. PMID: 36047077; PMCID: PMC9826912.

Healthy snack alternatives to help with fertility

Whether your getting ready to eat for two, or eating just for you, you’ll want to keep your snacking healthy and part of a regular nutritious diet. But, of course, sometimes it’s easier to reach for something that’s a little less than healthy. Having healthy snack alternatives in mind to swap in can help you satisfy your not-so-healthy cravings while giving you a fertility boost.

When you’re craving something savory, try:

• Popcorn: Certainly if it’s covered in butter and salt, the nutrition can be questionable, but popcorn can actually be very healthy! Popcorn is a whole grain that provides a wealth of fiber, which helps to increase fullness, reduce blood sugar spikes, decrease constipation, and improve digestive health and mobility. It also includes a ton of vitamins and minerals – like various B vitamins, iron, magnesium, potassium, zinc, and manganese – and polyphenol antioxidants. And you can spring for healthy toppings like a drizzle of olive oil, a pinch of salt, herbs, or grated parmesan cheese.
• Nuts: These snack all-stars provide fiber, protein, and a ton of healthy, unsaturated fats – including omega-3 and omega-6 fatty acids – which are an important source of energy, help you metabolize a number of important vitamins, and can help lower cholesterol.
• Whole wheat pretzels with flax: The complex carbs found in whole grains provide not only fiber, but also long lasting energy. Whole grains can also provide nutrients like the antioxidant vitamin E and the mineral selenium. And the addition of flax can provides good unsaturated fat.
• Baked sweet potato fries: These might take some prep, but sweet potatoes are more than tasty – they also provide fiber, folate, vitamin-C, and beta-carotene, which converts to vitamin A in the body.
• Whole grain toast with hummus, plain Greek yogurt, nut butter, or avocado: Again, there are lots of goodies to be found in those whole grains, and all of these creamy options you can spread on top provide even more of a nutritional boost. The garbanzo beans in the hummus, much like other all beans, provide you with protein, which helps provide amino acids, fiber, and a number of other nutrients, like large amounts of folate (B9), iron, calcium, and zinc. The yogurt provides calcium, phosphorus, various B-vitamins, magnesium, and zinc. It also provides probiotic bacteria, which supports digestive health. Nut butters have all the health benefits of nuts, and the avocado contains unsaturated fats, folate, potassium, vitamin C and vitamin B6.
• Hard boiled eggs: Eggs are a powerhouse, providing you with protein, healthy fats and amino acids, and vitamins and minerals like choline, potassium, magnesium. Eaten with a pinch of salt, herbs, or hot sauce, they’re a tasty snack option any time of day.
• Edamame: Soy beans provide all the goodies mentioned when talking about hummus, as well as a ton of antioxidants, and vitamins C and A.
• Hummus or guacamole with vegetables or whole grain crackers: Again, you’ve already heard about the wonders of hummus, guac, and whole grains, but veggies are real stars, too. They provide not just great flavor and satisfying crunch, but a wealth of vitamins and minerals. Aim for a variety of color – green, red, orange, yellow, and purple!
• Cheese: Is packed with calcium, protein, and vitamin D. (Just skip soft, unpasteurized cheese because of the risk of Listeria if you’re TTC.)

All of these options will help you bypass the large amount of trans fats and high amounts of sodium that can be found in chips and dip.

When you’re craving sweets, try:

• Fresh fruit: From bananas and apples to cherries and grapes, fruit provides fiber along with vitamins and minerals like folate, vitamin C, potassium, and beta carotene.
• Dried fruit: These provide all the same nutrients as the fresh stuff, but sometimes can travel more easily. Mango, apricots, and dates are all great choices!
• Dark chocolate: If you really want a chocolate fix, go for a small piece of dark chocolate, which is typically lower in fat and sugar than other kinds of chocolate, contains some good fats, provides antioxidants, which improve immunity, and also contains nutrients like iron and magnesium.

When you’re craving sugary drinks, try:

• Ice water with fruit: You already know that staying hydrated is a healthy part of any diet, but the addition of fruit can add a touch of flavor and sweetness to jazz up your usual H2O.
• Iced tea with honey: Whether you opt for caffeinated or caffeine-free, tea sweetened with a touch of honey, which provides some vitamins and minerals – can be a real sweet treat and a far healthier option that the amount of sugar in soda. (As above, if you’re TTC, just make sure your honey is pasteurized.)

When you’re craving something cold, sweet, and creamy, instead of ice cream, try:

• Fruit with yogurt and honey
• A blended fruit and Greek yogurt smoothie
• Pureed frozen fruit with yogurt: You’ve already heard about all the good in yogurt and fruit, but a chilled treat like this will provide you with a tasty bowl or glass full of fiber, calcium, and vitamins.

When you’re craving a sugary breakfast cereal, try:

• Oatmeal with fruit and honey: The fruit and honey? Yummy and nutritious. The oatmeal? It provides you with more of those same goodies in whole grains, plus the oat bran can help lower cholesterol levels.

Eating healthy isn’t all-or-nothing, it exists on a scale, and the more nutrients, and the less empty calories, you can fit into every snack, the further towards the “healthy” end of the scale you’re going to move.

Sources

• Mayo Clinic Staff. “Pregnancy nutrition: Healthy-eating basics.” Mayo Clinic. Mayo Foundation for Medical Education and Research, February 15 2015. Retrieved August 28 2017. http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20046955.
• Mayo Clinic Staff. “Pregnancy diet: Focus on these essential nutrients.” Mayo Clinic. Mayo Foundation for Medical Education and Research, February 15 2015. Retrieved August 28 2017. http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082?pg=1.
• Mayo Clinic Staff. “Prenatal vitamins: Why they matter, how to choose.” Mayo Clinic. Mayo Foundation for Medical Education and Research, September 13 2016. Retrieved August 28 2017. http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082?pg=1.
• “Good Nutrition During Pregnancy for You and Your Baby.” Cleveland Clinic. The Cleveland Clinic Foundation, June 15 2015. Retrieved August 28 2017. https://my.clevelandclinic.org/health/articles/good-nutrition-during-pregnancy-for-you-and-your-baby.
• “Nutrition During Pregnancy.” The American College of Obstetricians and Gynecologists. American Congress of Obstetricians and Gynecologists, April 2015. Retrieved August 28 2017. https://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy.

How age affects male fertility

How smoking might impact fertility

While there are definitely smokers who conceive every day, according to the American Society for Reproductive Medicine, infertility rates in both male and female smokers are about twice what they are in non-smokers who are trying to conceive.

Cigarette smoke can damage and kill off eggs, as well as decrease sperm quality, sperm count, and sperm motility, which is sperm’s ability to move until it reaches the egg. This means that women who smoke may go through menopause one to four years earlier than women who don’t, and that the sperm of men who smoke is far less likely to fertilize eggs. Smoking can also make IVF treatments for infertility less effective, and after conception, women who smoke are also more likely to miscarry or have ectopic pregnancies.

Having your fertility as a reason to quit smoking isn’t necessarily going to make quitting any easier, but your healthcare provider may be able to suggest a program that could. Once you’ve quit, be sure to balance your nutrition, eat lots of antioxidant-rich food, and consider starting to take a multivitamin to get your body more prepared for conception, pregnancy, and labor.

Sources

• “Smoking and infertility.” Reproductivefacts. American Society for Reproductive Medicine, 2014. Web.