What Causes Infertility In Men
Introduction: What Causes Infertility In Males?
Infertility is defined as the inability of couples to have a baby after one year of regular unprotected intercourse, affecting 10-15% of couples. According to the latest WHO statistics, approximately 50-80 million people worldwide suffer from infertility, and male factors are responsible for nearly ⅓ or around 20-30% of all infertility cases. (R) It appears that there are multiple potential contributing factors including; heavy metal toxicity, gastrointestinal dysfunction, sunlight under/overexposure, poor sleep, elevated testicular temperature, thyroid dysfunction, low fat intake, excessive cardiovascular activity, nutrient insufficiency (nitrates, folate, zinc), non-native electromagnetic radiation, mouth breathing, and much more. With the above bombardment on male fertility, it is not a surprise that some researchers show that the quality of human semen has deteriorated by 50-60% over the last 40 years. (R)
In this article, we will explore and examine the major contributing factors to male infertility. With useful strategies to support and regain fertility.
Heavy Metal Exposure Causes Male Infertility
Heavy metals are naturally occurring elements that have a high atomic weight and a density at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical, and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. (R) Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. (R)
Since the testicles are highly susceptible to oxidative stress, heavy metals pose a major risk to proper functioning. For example, when a cohort of 210 fertile and infertile men was exposed to cadmium, significant drops in sperm motility and viability were observed in a time-and dose-dependent fashion. (R) Similar negative effects are noted with barium, cadmium, arsenic, and mercury.
These heavy metals also impact indirectly on methylation pathways occurring in nearly every cell of the body which produces end products such as glutathione, biopterin, dopamine, melatonin, and much more. Heavy metals interfere with various enzymatic cofactors acting as a bully, blocking the flow or transfer of the biochemical modifications / epigenetic transcription factors which influence cell replication and differentiation. The consequences of heavy metal exposure which is not detoxified appropriately give rise to higher homocysteine, blockade of glutathione, build up of uric acid and even hydrogen sulfide. All having an indirect impact on how the testicles function and interact with the nervous and circulatory system conducting the operations of events such as erections with vasodilation and muscular contractile from the autonomic vagal tone.
Whilst most health influencers state fish and seafood intake is a huge issue for heavy metal exposure, which is true, they do not appreciate that the body counteracts these heavy metals with the help of the nutrient abundance of zinc, copper, iodine, vitamin B12, vitamin A, iron, selenium, and manganese in these foods, which show improvements in male fertility/sex drive in both males and females. Ironic. Perhaps, it is more to do with the general health state of the individual, the brain-gut-liver axis health, or the state of redox chemistry within the cells.
Excessive Cardiovascular Exercise Causes Infertility
Several key studies were published which reported men involved with endurance exercise training had substantially lower resting testosterone levels and/or HPG axis disruptions potentially affecting testosterone levels. (R)
Evidence exists that a subset of endurance-trained men, particularly runners, present with subclinical changes in their reproductive hormone profile. These changes include a reduction in total and free testosterone, alterations in luteinizing hormone release, and alterations in pituitary responses to gonadotropin-releasing hormone and other pharmacological perturbations.
Perhaps the continuous and excessive pounding of running impacts the testes with small microtears in the vascular? Perhaps the sympathetic state which the brain perceives is not the right biological signal to reproduce.
Less attention has been directed towards identifying changes in spermatogenesis and fertility capacity as a result of endurance training. The semen ejaculate of some endurance trained athletes presents with nonspecific modifications including a low normal sperm count, decreased motility, and several morphological changes that may compromise fertility. (R)
Poor Sleep and Infertility
Daytime testosterone levels are decreased by 10-15% in young healthy men who had 1 week of sleep restriction to 5 hours per night, a condition experienced by at least 15% of the US working population. By comparison, normal aging is associated with a decrease of testosterone levels by 1-2% per year. Interestingly, this drop in testosterone was associated with lower vigor scores but NOT with increased levels of cortisol, a stress-responsive hormone that can impair gonadal function.
Symptoms and signs of low testosterone include low energy, reduced libido, poor concentration, and increased sleepiness, all of which may be the result of sleep deprivation in healthy individuals. (R) In addition, short and long sleep durations and later bedtime can reduce sperm count, survival, and motility, partly through increasing anti-sperm-antibodies. (R)
Low Fat Intake Lowers Testosterone Levels And Might Cause Infertility?
Dietary fat intake has been shown to affect male testosterone levels. A study of 39 middle-aged, white, healthy men (50-60 yrs of age), utilized differing amounts of total fat intake. After diet modulation, mean serum testosterone (T) concentration fell (P < 0.0001), accompanied by small but significant decreases in serum-free T (P = 0.0045), 5 alpha-dihydrotestosterone (P = 0.0053), and adrenal androgens (androstenedione, P = 0.0135; dehydroepiandrosterone sulphate (DHEA-S), P = 0.0011). Serum estradiol and SHBG showed smaller decreases. Parallel decreases in urinary excretion of some testicular and adrenal androgens were demonstrated. Metabolic clearance rates of T were not changed, and production rates for T showed a downward trend while on low-fat diet modulation. The authors conclude that reduction in dietary fat intake (and increase in fibre) results in 12% consistent lowering of circulating androgen (testosterone) levels. (R) (R)
Does Low Testosterone Cause Infertility?
Yes, directly and indirectly - there are a host of downregulated processes in the setting or as a result of low testosterone. Low-fat diets can impact our testosterone levels but so can everything else discussed in this article.
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Does Heat Cause Infertility?
A study conducted by Procopé found that exposure to warmth in the groin region caused a maximum decrease in sperm counts roughly 4-5 weeks after heating, and studies by Rock and Robinson found that it took ten to twelve weeks for sperm counts to return to normal after heat cessation. (R) One of the best studies on the recovery of sperm after heat exposure was done in 1963 by Tokuyama. He found that “thirty minutes of scrotal heating to 43 to 47°C induced a fall in sperm counts some 5 to 7 weeks later in 18 normal subjects, which was followed by a rapid recovery to pre-treatment counts in 4 weeks”. (R)
What can be done? Ice your balls (press an ice pack against your underwear) for 10-15 mins, three times per day. Also, if doing a lot of intense sauna sessions - bring in some ice or an ice pack to help your testicles maintain the ideal body temperature.
Does Dysbiosis and Leaky Gut Cause Infertility?
What modern science knows about the link between the health of our microbiota and infertility issues is that there is a disruption of certain key species. A 2021 study in 37 participants with 25 infertile and 12 healthy males was tested for their taxonomic and functional profiles of the gut, semen, and urine microbiomes.
“Infertile men harbored increased seminal α-diversity and distinct β-diversity, increased seminal aerococcus, and decreased rectal anaerococcus. Prevotella abundance was inversely associated with sperm concentration, and pseudomonas was directly associated with total motile sperm count.” (R)
In addition, in semen samples, certain bacteria strains were associated with a beneficial or negative impact on sperm quality.
“Lactobacillus was associated with improvements in semen parameters. Enterococcus faecalis, mycoplasma and prevotella appeared to exert a negative effect on sperm quality and motility”. (R)
Candida, a fungal resident in the digestive tract, is typically maintained and controlled in small numbers. However, in the setting of poor metabolic health, lack of sleep, and excessive use of antibiotics throughout life, candida is allowed the opportunity to gain access to and invade a large share of the digestive tract. (R) (R) (R) As a result, the downstream effects of candida or other bacterial infection and resulting inflammation are both powerful players in infertility. (R)
Finally, intestinal permeability or leaky gut can allow the translocation of small and large intestine lumen content such as bacteria endotoxins (also known as lipopolysaccharides), which can active the toll-like receptors (TLR2 and TLR4) locally in the GI tract and also in the reproductive tract of males. The pathway of toll-like receptor activation induces inflammatory signals and, as a result, may affect male fertility in terms of its influence on the testis and epididymis, reduction of sperm motility, inducing of sperm apoptosis, and significant impairment of the potential for fertilisation and sperm quality (R) (R).
Sunlight Or Vitamin D Cause Infertility?
As you might be aware, vitamin D deficiency is an epidemic. It should be no surprise to hear that in this 103 patient study aged between 20-40 years old “Vitamin D deficiency was detected in 89 (86.4%) patients of the study group and 33 (66%) of the control group. A significant difference of vitamin D deficiency rates was detected between the groups (p0.05).” The lower vitamin D status in the study group had decreased semen quality (R).
In 2016, another study involved 1427 infertile men. The male subjects with 25-OH D >75 nmol/l had higher sperm motility and 66 had 111% higher total numbers of motile spermatozoa after 45 and 262 min, respectively than men with 25-OH D <25 nmol/l. In addition, lower ionized calcium levels had higher progressive sperm motility. The researchers summarised,
“The associations between vitamin D deficiency and low calcium with semen quality and sex steroids support the existence of a cross-link between regulators of calcium homeostasis and gonadal function in infertile men.” (R)
Too much sun? For infertile males, sperm DNA damage from UV radiation is more susceptible and more pronounced compared to fertile sperm samples. Note that this was with semen samples 1 metre from an artificial ultraviolet light source - technically not the same as the sun. (R)
What I take from this is that the combination of excessive UV exposure on the testicles and increased local heat to the testes from sunlight exposure (causing thermal heat locally in the testes) could possibly be detrimental to fertility. (R) The ‘more is better’ approach is questionable and can also be applied to excessive use of red light exposure and sauna therapy, which might also be considered by those wishing to conceive. Ideas for ways around this would be to protect your junk with a minimal effective dose and to also ice your balls when exposing them - that way you will create a further effect from the contrast in temperatures, which has unique biophysical properties in terms of how our mitochondria and cells work.
Does Mouth Breathing Impact Male Infertility?
Breathing through the nose from a young age can impact facial structure development - it should be noted that restriction of oxygen delivery to the mitochondria causes pseudo hypoxia. This means there is no energy being made due to oxygen acting as the final terminal acceptor of electrons to create ATP, water, Co2, and light/heat.
The long-term consequences have not been investigated in regards to infertility. However, what we do know is that chronic mouth breathing can lead to an associated incidence of sleep apnea (R). In a Taiwanese study of just over 4500 subjects, obstructive sleep apnea was associated with a 1.24-fold higher risk of developing infertility (R).
Additionally, a mice study investigated whether Chronic Intermittent Hypoxia Mimicking Sleep Apnea reduced fertility. The researchers took 18 mice and mimicked a pattern of periodic hypoxia (20 sec at 5% O2 followed by 40 sec of room air) 6 hours/day for 60 days or normoxia.
Intermittent hypoxia significantly increased testicular oxidative stress and resulted in a reduction in the expression of Gpx1 and Sod1 by 38.9% and 34.4%, respectively, as compared with normoxia-controlled subjects. Progressive sperm motility was significantly reduced from 27.0 ± 6.4% with the controlled group having no statistical impact (R).
A simple win to improve mouth breathing at night and to influence blood flow and oxygen delivery especially to the extremities is mouth taping. I really like Somnifix mouth strips, which are the most appealing and well-designed out there.
Do Nutrition Deficiencies Cause Infertility?
There is an array of micronutrients important for health and most people need to take every supplement under the sun to get their daily amount. The reality is that humans didn’t evolve understanding these minerals and vitamins - they just ate, reproduced, survived or unfortunately died if they couldn't adapt.
We will not go through every single nutrient associated with infertility, but what we do know is that
“40%- 50% of male infertility cases in general and up to 80% in men with idiopathic infertility cases are caused by oxidative stress and decreased level of seminal total antioxidant capacity.” (R)
This doesn't mean you should go out and load up on antioxidants from supplements perse but think about nutrition and lifestyle first. Don’t run before you can walk.
Nearly every female who is trying to conceive is told to take a folic acid supplement, even without testing or when their serum folic acid test comes back within range. The same could and should be possible for males too. However, I do not recommend folic acid, which is the synthetic version. Whilst it shows some efficacy in preventing neural tube defects and raising the folic acid blood marker, it might be counterintuitive to use a synthetic form. I would prefer to use a more active and naturally derived version such as methyl folate or folinic acid. You could also just consume liver a few times per week and also have leafy greens like arugula (wild rocket), broccoli, and pak choy.
The authors of a study on male subfertility and the role of micronutrient supplementation highlighted this great point. “It is also plausible that folate deficiencies do not exist alone, but rather coexist with other vitamins, mineral, and/or micronutrient deficiencies.” (R)
Supplementation of zinc and folate was investigated in a double-blind placebo trial of 47 fertile and 40 subfertile males. The intervention was to take folic acid (5 mg/day) and zinc sulfate (66 mg/day) or a placebo for 26 weeks. The results were that “intervention treatment significantly increased sperm concentration in subfertile males.” (R) This is yet another reason to eat oysters.
A 2017 systematic review of observational studies show us that the modern pseudo diet is setting us up to become infertile.
“Diets rich in processed meat, soy foods, potatoes, full-fat dairy and total dairy products, cheese, coffee, alcohol, sugar-sweetened beverages and sweets have been detrimentally associated with the quality of semen in some studies.” (R)
Some studies have shown selenium to be lower in infertile males than healthy subjects. For selenium food sources think seafood, shellfish, turkey, organ meats and brazil nuts. (R) (R)
It should be noted that though the above might point to a need for supplementation of zinc etc, the literature shows that tested blood samples in infertile and fertile males showed no statistically significant differences between the mean concentration of zinc and magnesium in normal and pathological semen serum. Zinc and magnesium levels did not show a correlation with the volume of the sperm and with the percentage of pathological forms (R). However, we can’t apply the results to everyone and there are nuances with serum markers, which do not show a true reflection inside the cell. In addition, when I run blood work on clients - we see an array of markers that connect primary or secondary to magnesium and zinc. Whilst also using red blood cell magnesium and zinc which has a better reflection.
A 2012 pilot study in Austria set out to see whether 132 subfertile males and 73 subfertile males being the placebo control would benefit from using a supplement containing 8 nutriceuticals (L-carnitine, L-arginine, zinc, vitamin E, glutathione, selenium, coenzyme Q10, and folic acid). The results were overall increases in median ejaculatory volume 33.3%, sperm cell density 215.5%, sperm motility (progressive 83.1% and total 36.4%), and normal morphology rate of 23.0%. The study resulted in no side effects and a total of 34 pregnancies were reported after the 6 months follow-up with the active treatment group, compared to 11 reported in the control group. (R)
This might be all well and good, but we should note that supplements aren’t always the magical fairy dust their manufacturers claim them to be. There are some subpar brands that produce products with major discrepancies between what’s on the label, and what the contents of the supplement actually are. (R)
Finally, a study from Oman looked at infertile males and copper and magnesium levels.
“Results from this study showed that there was a very significant decrease in the infertile seminal plasma magnesium levels of oligozoospermic patients (p=0.000) and azoospermic patients (p=0.000) and this may indicate that magnesium may be a good criterion for prostate function and for good sperm quality.”
The link between hyperglycemia and insulin resistance and magnesium deficiencies should be well known. Likewise, low vitamin D stores, which can also be the result of inadequate magnesium to activate storage and active vitamin D metabolites. “Seminal plasma copper level was decreased significantly (p=0.000) in the azoospermic group compared to the control group.” Copper was also decreased in the infertile group and there was an increase in a secondary marker of lipid peroxidation, malondialdehyde. We can find the most bang for our buck with copper in liver, dark chocolate, and shiitake mushrooms. To protect lipid peroxidation - we want to include fish, shellfish and whole eggs, for their vitamin E levels. (R)
Nutritional Therapy Can Support Infertility In Men
If you want to get to the root cause of your infertility issues. Then working with myself or other registered nutritional therapists can help you with the frustration, pain, and time.
I will be able to give you personalized nutritional and lifestyle recommendations. Utilize blood work, remove the guesswork and connect the dots. Stop wasting time with Dr. Google and self-acclaimed online gurus. I work remotely and personally with clients around the world, from all ages and demographics. This also includes female infertility.
You can book your complimentary discovery call here.
Does Radiation Cause Infertility?
The short answer is yes. The radiation which I am referring to is non-native and non-ionizing radiation, which does not directly impact DNA damage, but has other cellular and mitochondrial effects. Remember, the way we make energy is predominantly via bacteria which an archae engulfed 650 million years ago and from there the eukaryotic kingdom began. As a result, we should be looking at non-ionizing electromagnetic radiation and we should also be looking at what happens with bacteria.
A 2018 review of available studies concluded that the most common sources of non-ionizing radiation included cell phones, laptops, Wi-Fi, and microwave ovens. The review stated that
“it is clear that radiofrequency electromagnetic fields (RF-EMF) have deleterious effects on sperm parameters (like sperm count, morphology, motility), affects the role of kinases in cellular metabolism and the endocrine system, and produces genotoxicity, genomic instability, and oxidative stress”. (R)
Mic drop. A 2021 review of radiofrequency radiation stated that
“people could not escape from such RF radiations as they have become the essential part of our routine life such as Wi-Fi, microwave ovens, TV, mobile phones, etc.” (R)
Whilst non-ionizing radiation does not directly cause DNA damage due to the strength, other infertility factors are affected, either with an “alteration in the germ cell, or its nourishing environment and RF affects both the parameters subsequently, leading to infertility.” (R)
What Kills Sperm Count?
We must be aware and do what we can to escape the matrix of indoor living and stop being attached to the grid 24/7 365 days of the year. Simply put: We need to stop radiating our junk:
“Constant exposure to non-ionizing radiations produced from a cell phone is one of the possible reasons for growing male infertility.” (R)
Your laptop is not designed to be placed on your lap. In a study of 50 male university students - 70% of them reported using their laptop for 2-4 hours per day and 32% reported using it on their lap for 1-2 hours, 2% for more than 2 hours. (R) This was further supported in a study with 29 participants, looking at scrotum temperature from laptop use for an hour increasing temperature causing possible infertility issues.
'Long-term exposure to LC-related repetitive transient scrotal hyperthermia is a modern lifestyle feature that may have a negative impact upon spermatogenesis, specifically in teenage boys and young men ” (R)
You might want to turn your wifi off at night too. An animal study showed decreases in sperm parameters in a time-dependent pattern with effects noted from 1 hour.
“We concluded that there should be a major concern regarding the time-dependent exposure of whole-body to the higher frequencies of Wi-Fi networks existing in the vicinity of our living places.” (R)
In another animal study Wi-Fi exposure with 2.45 GHz affected the testes of growing rats and led to DNA damage. (R)
What Can You Do To Protect Yourself From WIFI Radiation Which Causes Infertility?
A 2015 study showed a difference in semen parameters in subjects who used wired internet compared to wifi internet. “Total motile sperm and progressively motile sperm were decreased in a group who used a wireless internet compared with ones who used the wired internet.” Additionally, there was a decrease in total motile sperm, progressively motile sperm, and total sperm count with the increased wireless internet usage duration (R).
I have also shared my favorite way to protect my junk with underwear, a laptop protection shield and more below.
Does the Thyroid Affect Male Fertility?
Thyroid hormones produced by the thyroid gland are extremely powerful regulators of metabolic and translation factors in epigenetics and nuclear transcriptions. The testes have a high amount of thyroid receptors and transporters located in various cell types. Deficits or excess of thyroid hormones “not only alter the testicular functions but also interrupts neuroendocrine axis through the crosstalk between hypothalamic-pituitary-thyroid (HPT) axis and hypothalamic-pituitary-gonadal (HPG) axis.” (R)
These effects showed reductions in testosterone and also impacted semen quality. Thyroid hormones induce Leydig cell development and steroidogenesis. Thyroid hormones also impact redox chemistry offering a vital homeostatic balance of reactive oxygen species and antioxidant response elements.
Hyperthyroidism is known to impair fertility. The increased production of T4 is correlated with increases in sex hormone-binding globulin, thus decreasing the clearance of testosterone, reducing bioavailable testosterone, elevating estrogen, decreasing libido, causing erectile dysfunction, and more. Altered reproductive hormone levels affect sperm production and maturation, thus altering semen quality.
“Cell phone radiation harms male fertility by affecting the different parameters like sperm motility, sperm count, sperm morphology, semen concentration, morphometric abnormalities, increased oxidative stress along with some hormonal changes.” (R)
This is dynamite for our future generations and the quality of our offspring. This is also just our sperm, what else do you think is occurring within the billions of cells in our body? The study on the tweet I shared, clearly shows that a mobile phone in your trouser pocket causes a decrease in semen quality. (R)
The more time spent on your mobile phone, the higher the association with infertility. A 2008 study, which must have been using lower communication networks, but had limitations in using self reported questionnaires, showed clear linear consequences.
“The use of cell phones by men is associated with a decrease in semen quality. The decrease in sperm count, motility, viability, and normal morphology is related to the duration of exposure to cell phones. These effects may not depend on the initial semen quality of the subjects.” (R)
Hypothyroidism:
Hypothyroidism, which is classified as a decrease in circulating thyroid hormones - T3 and T4 and high thyroid-stimulating hormone (TSH) value is indicative of hypothyroidism. The total T4 and T3 hormone levels however might not represent the free active levels.
Hypothyroidism has been associated with lower testosterone levels, erectile dysfunction, hypoactive sexual desire and decreased semen quality. (R) (R). Several human studies have correlated the above factors with infertility although these studies with infertility have not directly investigated semen quality. (R) (R) (R). Human studies have indicated decreases in male spermatogenesis and sperm motility, although there are also mixed results. (R)
In summary, Hypothyroidism or hyperthyroidism might predispose a person to infertility in various ways - poor energy production with reduction of oxygen availability, a correlation with endocrine-disrupting chemicals known to impair thyroid function, increased binding of thyroid and androgens as a result of elevated sex hormone-binding globulin and also nutritional insufficiencies particularly iodine, selenium, vitamin A and D or excess of halogens which interfere with the binding sites of iodine.
How To Support And Improve Infertility?
You will find a selection of products that have been shown to either directly or indirectly improve and combat the effects of infertility problems and optimize your health and life. The products are affiliated and support with discount codes below to save money off blue light blocking glasses, magnesium, red light therapy device, and radiation protection underwear.
Wrapping it up:
It should go without saying that factors like smoking and alcohol are just as concerning for male fertility. As well as other factors, which we have not covered here. Phthalates (R) and other environmental toxins “many of these are known toxins, such as phthalates, polycyclic aromatic hydrocarbons, aromatic amines, and organophosphate esters, and have been banned or significantly restricted by other countries as they carry known carcinogenic effects and are reproductively toxic” (R), air pollution (R), mould exposure, possible genetic influences, obesity (R), medications, drugs (R) autoimmunity disorders and of course inadequate sleep cause fertility issues.
Conclusion: What Causes Male Infertility
We live in a very toxic world. We do not need to be afraid and confine ourselves to a box, never leaving home or eating food, just popping multivitamins. But we need to be aware and have a proactive attitude and mindset towards what we can control and change and what is out of our control.
Ensure you are being mindful of the above factors, which can predispose you to infertility. Fertility can take time to reverse, so be patient with yourself. You can further avoid overwhelming and information overload by working with me as your practitioner. I work as a Registered Nutritional Therapist to support males and females to conceive healthy and optimal babies. Invest in yourself for your future generations. Additionally, Lucas has a course designed to improve testosterone, which will impact fertility in itself.
The following affiliated links can also be helpful to counteract the harmful effects of artificial light, sleep disruption, radiation (non-native electromagnetic frequency) and help support fertility and vibrant health.
If you have any further comments or questions. Please leave a comment below.
The content of this article was created by Lucas Aoun and Ryan Carter
Lucus Aoun - Founder of Ergogenic Health. A registered naturopath, researcher, and podcast host.
