10 Genes Affecting Male Fertility and Embryogenesis

Episona’s advanced sperm quality test looks at more genes for insights about your fertility than any other test available. We examine genes for aberrant DNA methylation where our study data show an association with increased risk of male-factor infertility, and with increased risk of poor embryo development.

Below are 10 of the most interesting and impactful genes we look at for abnormalities which can affect male fertility.Read More

What Causes Miscarriage?

A miscarriage is the spontaneous loss of a pregnancy before the 20th week of gestation. Most miscarriages occur in the first trimester, before the 12th week of pregnancy. Read More

What is Recurrent Pregnancy Loss?

Recurrent Pregnancy Loss

Recurrent pregnancy loss is the term used when a woman has 2 or more clinical pregnancies which end in miscarriage before the pregnancies reach 20 weeks of gestation. Clinical pregnancies are pregnancies that have been confirmed on ultrasound by a health-care provider.

Read More

Preparing for IVF

9 Questions as You Prepare for IVF

Read on for 9 important questions to consider as you start preparing for IVF. As always, none of this is a substitute for advice from your doctor, but it can help you identify questions you need to ask.

Read More

The Modern History of Fertility Treatment and Innovation

Humans have always been interested in getting pregnant. Our earliest art revolves around depictions of fertile women. Our earliest myths and legends tell stories of miraculous births or people having hundreds of children. But until the mid-to-late 1800s, a person’s fertility wasn’t generally seen as a matter for doctors. Instead, if you were a man or woman facing difficulty getting pregnant, you were better off going to a religious authority.Read More

What is a normal sperm count?

A normal sperm count is approximately 48 million sperm per milliliter of semen, with a normal sperm count range being 40 to 300 million sperm per milliliter of semen.  A low sperm count which would indicate subfertility or infertility would be less than 15 million sperm per milliliter of semen.

What is a good sperm count?

Ultimately, a “good” sperm count could be considered anything in the normal sperm count range of 40 to 300 million sperm per milliliter of semen. It is worth noting however, that sperm count is not typically considered a problem by the American Society for Reproductive Medicine until it is below 15 million sperm/mL. A count between 15 and 40 million is “indeterminate” and must be looked at in the context of a particular patient.

What is a low sperm count?

Again, a low sperm count isn’t simply anything below the normal sperm count range. 20 million sperm/mL may be plenty if everything else is in good shape. A sperm count isn’t considered low by medical guidelines until it falls below 15 million sperm per milliliter.

A low sperm count (called oligospermia) generally means that a man may need extra time or some medical assistance to conceive. For a mild case of oligospermia, intrauterine insemination (IUI) is often the treatment of choice. For a more severe case of oligospermia, it is likely that IVF will be necessary to conceive.

A complete absence of sperm in a man’s semen is called azoospermia.

Sperm count isn’t everything.

There’s a pretty wide range for normal, but it can be misleading. A sperm count that falls below the normal sperm count range doesn’t necessarily mean you’ll be unable to conceive. You may just need extra time to conceive, or a little help from a reproductive specialist. While a high sperm count doesn’t necessarily mean you’re fertile. Count is just one semen parameter looked at in a semen analysis. A man’s sperm motility and morphology must be considered as well. Additionally, a semen analysis could look completely normal, and a man still may have fertility problems. This is why it is important to see a male fertility specialist who can help with the specifics of your case. Get in touch with us for recommendations for clinics we trust.

Sources:

  1. https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/practice-guidelines/for-non-members/diagnostic_evaluation_of_the_infertile_male_a_committee_opinion-noprint.pdf
  2. https://www.nejm.org/doi/full/10.1056/NEJMoa003005
  3. https://www.sciencedirect.com/science/article/pii/S1110569011000719

FSH Levels in Men and Why it Matters for Fertility

Normal FSH levels in adult males are typically between 1.5 to 12.4 mIU/mL. A high FSH level in a male may mean the testicles are not functioning correctly. While low FSH levels in males may indicate problems with the pituitary gland in the brain.

FSH in Males

Follicle stimulating hormone (FSH) is a hormone released by the pituitary gland in the brain. In men, it stimulates testicular growth and helps produce a protein that plays a vital role in male fertility by aiding in the creation of normal sperm cells and maintaining them until they are ready to be released. Without normal FSH levels, it may be difficult or impossible to create normal sperm, leading to infertility.

FSH levels can be detected using a simple blood test. Normal FSH levels in adult males are typically between 1.5 to 12.4 mIU/mL (although what counts as a normal value may differ slightly from lab to lab, as some labs have different testing standards).

High FSH Level

A high FSH level in a male may mean the testicles are not functioning correctly. Causes of this may include damage to the testicles (from radiation, trauma, or alcohol abuse), genetic problems, advancing age, hormonal disorders, certain medications (like pain medications or steroids), diseases such as HIV/AIDS or Type 2 diabetes, or (in rare cases) tumors of the pituitary gland.

Low FSH

Low FSH levels in males may mean the pituitary gland in the brain is not functioning properly. (This is less common than high FSH.)

Treatment for Abnormal FSH Levels in Men

Treatment for male fertility problems related to FSH depend on the origin of the problem.

Generally, abnormal FSH levels will lead to further testing to determine the cause of the problem. In some cases, as with diseases or genetic conditions, the problem may already be known.

Often, testosterone therapy is given to men with high FSH levels, since high FSH can lead to low testosterone; this can help increase fertility in these men. In other cases, treating the underlying cause of the abnormal FSH levels will correct the problem. If this is impossible, fertility treatments (such as IVF) may be used to help achieve pregnancy.

You can read more about other male fertility testing options here.

Sources:

Fresh vs. Frozen Embryo Transfer for IVF

During a cycle of IVF, an embryo will be transferred into a woman’s uterus. This embryo may be fresh or frozen. The transfer of frozen embryos is called FET (frozen embryo transfer). The success rates of frozen and fresh embryo transfer are similar when it comes to producing pregnancy in women under 35, and recent large scale studies indicate that FET may result in more favorable outcomes.

Read More

IVF Sex Selection: How Does it Work?

IVF sex selection, often incorrectly referred to as “gender selection,” is a process where embryos are selected by their sex chromosomes during an IVF cycle in order to produce a male or female offspring, according to the wishes of the parents. Typically clinics will only offer sex selection for medical reasons linked to x chromosome disorders.

Read More

How Does Alcohol Affect Male Fertility?

Drinking alcohol – even in moderation – can have a dramatic effect on the reproductive system. It can impact hormone production and decrease semen parameters such as sperm count, motility, morphology, and concentration.

Alcohol and Male Fertility

A large Danish study of 1221 healthy young men between the ages of 18-28 found that even modest drinking habits – as little as 5 drinks per week – can negatively affect the amount of sperm produced, the concentration of sperm per milliliter of semen, and the morphology of sperm (a measure of how well-formed the sperm are).

As you might expect, the more alcohol a person drinks regularly, the more serious the effects on sperm quality. The same study showed that the most significant impairment in sperm quality was found in men who regularly drank more than 25 drinks per week.

Alcohol’s Effect on Testosterone Production

Excessive alcohol consumption has been shown to drastically reduce testosterone production and even shrink the testicles, where testosterone is produced in men. Because testosterone is directly involved in almost all parts of the male reproductive process, the reduction in testosterone caused by alcohol can cause a range of additional effects, including reduced fertility and impotence, or the inability to get an erection.

Some studies have shown a serious reduction in testosterone levels for days after even a single dose of alcohol. This is partially because alcohol increases the body’s ability to eliminate testosterone from the blood, and partially because alcohol also increases the body’s natural ability to convert testosterone into estrogen. (Despite their reputations as “male” and “female” hormones respectively, testosterone and estrogen are found in both men and women, and both hormones are necessary for healthy reproductive functioning. However, healthy men should have more testosterone than estrogen, and vice versa for women.)

Alcohol’s Effect on Sperm Quality

In order to produce healthy, normal sperm, the body must produce testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), and these hormones in turn help maintain certain cells in the testicle called Sertoli cells.

Sertoli cells produce a protein that nurtures sperm and helps them develop normally. However, alcohol reduces the production of all of these hormones, which leads to the deterioration of the Sertoli cells. This results in fewer sperm and more malformed sperm which cannot swim well to reach the egg – in other words, worse morphology and motility. One study followed a man’s semen analysis for 6 years as he gradually became an alcoholic. At first, the man had a moderate amount of deformed sperm and a reduction in the number of his sperm. Over time, this progressed to complete loss of sperm production (azoospermia).

Treating Alcohol-related Infertility

Even if you’ve been drinking regularly, the effects of alcohol on male fertility can be reversed if a man stops drinking. In the case of the man in the study just mentioned, after the man stopped drinking, a serious improvement in his sperm quality and sperm count was seen in just three months.

In another case of chronic alcohol abuse which led to a total lack of sperm, normal sperm count was observed in the man just 6 months after withdrawal. That man was able to conceive – with help from fertility specialists – within two years.

To summarize, alcohol can drastically reduce male fertility, but the effects are dose-dependent and reversible: the more a man drinks, the worse it will be for his fertility, and ceasing to drink regularly can dramatically improve his ability to conceive.

If you are experiencing infertility, a male fertility specialist can help you get a better understanding of the impact lifestyle factors have on sperm quality. Get in touch with us for a recommendation on trusted fertility doctors.

Sources:

  1. https://bmjopen.bmj.com/content/4/9/e005462.full
  2. https://pubs.niaaa.nih.gov/publications/arh22-3/195.pdf
  3. https://www.ncbi.nlm.nih.gov/pubmed/20117050