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Myth 1: Infertility is only a female issue
Infertility is commonly thought of as primarily a female disorder. However, studies reveal that up to 50% of infertility has a significant male component and about 20% of infertility is purely male-related. Although women typically initiate the evaluation of their infertility with their gynecologist or reproductive endocrinologist, it is critical to test the male with a semen analysis to see whether there are any male-related fertility issues that need to be addressed.
Myth 2: Men are fertile forever
This is not true. Aging is associated with a significant decline in semen parameters including ejaculate volume, sperm motility, and sperm morphology beginning at age 35 and with a progressive decline over time. This is also reflected in decreased pregnancy rates (25-35% lower in partners of older men) and a longer time to conceive. The risk of miscarriage is higher if the man is over 45. There has also been a direct link found between the man’s age and an increased risk for autism, schizophrenia, and some genetic mutations in their offspring.
Myth 3: Frequent ejaculations decrease male fertility
Not true. In men with normal semen quality, sperm concentrations and motility remain normal, even with daily ejaculations. In fact, in men with significantly reduced sperm counts, the sperm concentrations and motility may be highest with daily ejaculations. Longer intervals of abstinence are actually associated with poorer semen parameters.
Myth 4: Taking supplemental testosterone can enhance a man's fertility
Taking testosterone reduces male fertility; testosterone has been studied as a male contraceptive. In men who are symptomatic with low testosterone levels, and who are not planning on creating a pregnancy with their partner, taking supplemental testosterone can be helpful by improving libido and energy levels. But it suppresses the pituitary gland and shuts down sperm production often resulting in very low or absent sperm in the ejaculate, which can last for many months after discontinuing the testosterone supplementation. Men who are planning on creating a pregnancy should not take testosterone. There are alternative medications that can be used for those men that will increase the man’s testosterone level without suppressing sperm production.
Myth 5: Smoking doesn’t affect fertility in the male
Smoking increases the chances of male infertility by 30 percent. While most men know that quitting smoking has obvious health advantages, many don’t realize how harmful cigarettes can be to fertility. Smokers have a significantly lower chance of creating a pregnancy each month and smoking as few as 5 cigarettes per day has been associated with lower fertility rates. It has been shown that there are toxic substances in cigarette smoke that result in lower sperm concentrations and decreased sperm motility. Cigarettes are the major source of human cadmium exposure (a heavy metal) and cadmium is a proven reproductive toxicant that results in poorer sperm parameters.
Bonus Myth 6: Weight does not affect fertility
Being overweight or obese presents many health issues, but its effect on male fertility may not be obvious. Obesity causes elevated estrogen and low testosterone levels, which can result in lower sperm counts. Overweight males may also experience a decreased libido and morbidly obese men may have difficulty having effective intercourse. Diet and exercise are important in trying to bring down the BMI (body mass index) to a more normal level which will improve the semen parameters and the libido.
Barry Witt, M.D. is the Medical Director of WINFertility and Greenwich Fertility. He is a board-certified reproductive endocrinologist who has been offering reproductive care for more than 25 years.
