Let’s talk about male infertility – Toronto Star

Posted: August 12, 2017 at 7:45 pm

(Infertility) can be a very painful thing for a lot of people and it was for us, Herbert says. But our pain was short-lived . We were very lucky.

Thats because couples can go through numerous IVF cycles and never have a baby.

The meta-analysis didnt examine the cause for the decline, but the authors say the fact that its occurring in the West suggests chemicals used in commercial products play a role. They warn the decline has implications beyond fertility and reproduction, saying it may be a canary in the coal mine for male health across the lifespan.

In the industrialized world were seeing a very definite and clear decline in sperm counts, in quality, even among fertile men, and as the world becomes more toxic, the effect will be greater, says Dr. Art Leader of The Ottawa Fertility Centre and a board member of Conceivable Dreams, an Ontario-based infertility patient advocacy group.

I think as well as The Handmaids Tale were going to have a sequel to it called The Manservants Tale.

Although men cant change the burden of global pollution there are things they can do to optimize fertility, says the professor of Obstetrics, Gynecology and Reproductive Medicine at the University of Ottawa.

He suggests minimizing alcohol, smoking and exposure to smoke, increasing exercise, maintaining a healthy weight, eating organic foods, taking an adequate dose of Vitamin D and not using anabolic steroids. And be mindful of endocrine disruptors, which are chemicals found in everyday products that interfere with the bodys naturally occurring hormones. Examples include bisphenol A (BPA), dioxins, phthalates and fire retardants.

Even medications used by men to stop hair loss finasteride and minoxidil have been shown to lower sperm counts. But once men stop taking these drugs, sperm counts bounce back.

Men should also be wary of reproductive hazards on the job, says Leader. For instance, bakers and chefs who work in hot places; mechanics and industrial workers who handle the metal degreaser Trichloroethylene (TCE), and farmers who work with herbicides and pesticides may be at risk.

If someone is really concerned, they can freeze their sperm before age 40, says Leader, noting: Men have a best-before date of 40.

For Herbert, learning in 2014 that he had a low sperm count was a difficult blow. The normal range is 15 million to 200 million sperm per millilitre of semen he had about one million.

But infertility wasnt something he felt comfortable talking about with his buddies.

There is a taboo attached, he says. Whats the stigma? That youre shooting blanks. It just doesnt feel manly. This is the one thing that should be easy for us to do.

We go through so much of our life trying not to get somebody pregnant ... And then you get to this stage and its like, What? I need help? Its not working? I dont have enough?

In hindsight, Herbert says, it would have been a lot more helpful for me to talk about it. But he didnt, except with his wife, who happens to be a psychotherapist.

Jan Silverman, a fertility counsellor who also works at Create Fertility Centre in Toronto, says men dont easily open up about infertility. But when given the chance they will.

We get all kinds of guys coming out with sperm issues, says Silverman, who runs an infertility support group. Wives will say Oh, hell never talk. And you get them in the room, with a couple of other guys there, and before you know it they are talking.

Often what surfaces are feelings of shame, embarrassment and sexual inadequacy. And theres guilt because even though theyre infertile, its their female partners who undergo the invasive and uncomfortable fertility treatments.Ill never forget having this huge police officer a six-foot-five, big, burly guy who found he had a sperm count of zero. He sat in my office weeping, asking Me?

That was so poignant and telling because you never know. Thats the interesting thing about sperm. Just because you ejaculate you dont know whats in there. So for men, there is such a sense of shock.

Even popular culture is tackling the topic. Recently on the HBO hit Ballers, the main character Spencer Strasmore, a retired football player portrayed by Dwayne The Rock Johnson, is worried he may not have swimmers and seeks a referral to a fertility specialist. Its still unclear how that storyline will unfold because moments before he goes into a collection room to ejaculate, he gets called away for work.

Dr. Keith Jarvi, director of the Murray Koffler Urologic Wellness Centre and Head of Urology at the Mount Sinai Hospital, says a sperm test should be the first thing a couple undergoes as part of fertility testing.

Its not any statement about your manhood, says Jarvi, who heads the biggest centre in Canada for male infertility. The frequency with having a lower sperm count is not uncommon.

The test checks to see if there is sperm, how much of it there is, how it moves and if it appears healthy and normal. The test is covered by OHIP, relatively easy to do and may spare the female partner from undergoing treatments.

Guys are often ignored, says Jarvi. But if you ignore the guy you might not find a fertility problem that could be fixed.

Sometimes the fix is simple. Avoiding regular exposure to heat, such as hot baths and saunas, wearing looser underwear and keeping the genital area cool have all been shown to help.

Theres a whole series of new techniques and new treatments that we can now offer men that we couldnt offer them 15 years ago, he says. Were now taking on more and more patients who we thought before had no hope.

For the Herberts, fertility doctors suggested a type of IVF called Intracytoplasmic Sperm Injection, which is commonly used to treat severe male factor infertility. Its a laboratory process involving eggs extracted from the female, and semen retrieved from the man. An embryologist takes a single healthy sperm and injects it into the egg to create an embryo that is then transferred to the uterus.

Herbert and his wife also made lifestyle changes. He started taking vitamins, improved his diet, stopped doing hot yoga, started acupuncture and eliminated soaps, shampoos, deodorants, toothpaste and household products with potentially harmful chemicals.

In total, they spent about $30,000 during that first IVF attempt.

Once we said, Were going for this, then we were all in, says Herbert.

But it wasnt enough. In November 2015 they were devastated to learn that first cycle of IVF didnt work. They tried again in 2016. By then the Ontario Fertility Program was up and running and they were eligible for provincial funding, which cut their costs by half. The procedure is covered, but not the drugs. Conceivable Dreams, where Herbert is a member, is trying to persuade insurance companies to add the drug cost to their standard plans.

About 8,200 patients have received government funded IVF treatments since it was introduced in December 2015, says the health ministry. There is a database tracking how many funded IVF cycles are the result of male infertility, but the figures are not yet available.

Doctors warned that IVF was a crap shoot, but the Herberts hit the jackpot on their second attempt.

If it had been unsuccessful, I wouldve spent the rest of my life having to carry that: We spent our lives childless because of me. Thats pretty intense.

But then Ori came along. Herbert now looks forward to a life filled with discovering the joys of fatherhood: Playing with her, teaching her to walk, speaking with her.

Shes like a book that Im anxious to read.

Protecting your Sperm

Source: Environmental Working Group

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Let's talk about male infertility - Toronto Star

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