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What lifestyle changes can be made to optimize sperm quantity and quality?

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There are a number of lifestyle factors that can significantly affect the quality of sperm. Here are several lifestyle changes that men can make when preparing for conception.

Quit Smoking. Smoking and its associated toxins cause a 23% decrease in sperm density (concentration) and 13% decrease in motility (when averages are taken from nine separate studies). To a lesser extent, smoking causes an increased number of sperm with abnormal morphology (shape). Smoking causes toxicity to the seminal plasma (the fluid ejaculated with the sperm): sperm from non-smokers were adversely affected (had significantly decreased viability) when placed in the seminal plasma (hormonal) of smokers.

Smoking affects the hypothalamic-pituitary- gonadotropin axis, most commonly affecting levels of estradiol and estrone (estrogens, which are hormones found in higher concentrations in women). The Leydig Cells, which are in the testes and produce testosterone, may have secretory dysfunction. Most worrisome is that there is evidence that suggests that paternal smoking may also be associated with congenital abnormalities and childhood cancer, though the relative risk in most studies is less than two. Stop Taking Recreational Drugs.

Marijuana (cannabinoid) often causes a decreased average sperm count, motility, and normal morphology. It affects the hormonal axis (HPG), causing decreased plasma testosterone. It may also have a direct negative effect on the Leydig Cells.

Cocaine, even infrequent cocaine use, causes decreased sperm counts, motility and normal morphology. These effects can be found in men who have used cocaine in the two years preceding their initial semen analysis. Cocaine also decreases the ability of sperm to penetrate cervical mucous, making it difficult for them to enter the uterus.

Anabolic Steroids (male hormones) use has reached almost epidemic proportions. 6.6% of 12th grade male use or have used them to build muscle mass and improve athletic performance. These male hormones suppress the testes ability to make testosterone. This decreases the intratesticular testosterone level. Anabolic steroids also depress testicular production of testosterone and, thus, levels of testosterone inside the testes itself. This may cause severely diminished spermatogenesis or complete absence of sperm (azoospermia). When taken, these steroids cause a persistent depression of the hypothalamus and pituitary that may be irreversible, even when the steroids are stopped.

Reduce Alcohol. Moderate alcohol use does not affect male fertility. Excessive alcohol use affects the hormonal axis and is a direct gonadotoxin. It may cause associated liver dysfunction and nutritional deficiencies that are also detrimental for sperm production.

Avoid Lubricants. Most vaginal lubricants, including K-Y Jelly, Surgilube, and Lubifax are toxic to sperm. Couples should avoid their use during the fertile time of a woman's cycle.

Exercise. Aerobic and resistance training helps to increase testosterone levels, which leads to increased sperm production. Moderate amounts of exercise can only be helpful. However, long distance runners (men who run greater than 100 miles per week) and distance cyclers (men who ride greater than 50 miles per week) have decreased spermatogenesis. These activities should be moderated when a sub-fertile man is attempting conception. Avoid High Temperatures Environments that increase the overall scrotal temperature can have a negative effect on sperm production. Men should avoid the increased temperatures of saunas and hot tubs.

Take Vitamins (antioxidants). Molecules called reactive oxygen species (ROS) are normally present in semen. When ROS are present at excessively high levels, their cumulative effects can result in significant damage to sperm. The following vitamins and minerals help to neutralize ROS, thus preventing their harmful effects. Vitamin C is essential for the synthesis, development and maintenance of normal sperm. It also appears to reduce sperm agglutination (clumping of sperm). Vitamin E is believed to reduce free-radical damage by protecting polyunsaturated fatty acids (which are components of cellular membranes) and other oxygen-sensitive substances such as vitamin A and ascorbic acid (vitamin C) from oxidation. Vitamin B9 (folic acid) deficiencies have been linked to low sperm count and low sperm concentration. Zinc is important for the normal function of the prostate, which makes a portion of the seminal fluid.

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