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The question: My wife and I are trying to get pregnant and she's told me that I should avoid alcohol, quit smoking and wear looser boxers. Is there truth to this in helping me have "good sperm"?

The answer: Trying for pregnancy can be stressful and there's a lot of information out there that can be overwhelming. You may be vulnerable and want to try everything suggested, but the reality is that some things are true and others are just hype.

To understand how to improve sperm health, let's review the basics first:

After ejaculation, sperm enters the vagina and travels into the uterus and searches for the egg to fertilize. While this seems like a straightforward process, its likelihood of occurring depends upon both female and male factors.

Focusing on male fertility, there are three things to consider: sperm quantity, quality and motility.

If your ejaculate contains more than 15 million sperm per millilitre that is considered a healthy quantity. A couple of days of abstaining in between ejaculation will allow the quantity to replenish so it's best to have intercourse every other day.

In order for sperm to make the long journey to meet the egg, they have to be of high quality and be able to move quickly. They should have normal oval heads, long tails and more than 40 per cent of them should move well.

It can take about three months to improve sperm health and about 72 days for sperm to mature from "birth" to becoming fully functioning.

To optimize sperm health:

  • Eat a balanced diet rich in fruits, vegetables and antioxidants. Many studies have also shown that vitamin E (400IU/day), Zinc (up to 70mg/day) and co-enzyme q10 (200mg/day) are beneficial.
  • Get active and maintain a healthy body weight. Being overweight can cause a shift in the ratio of female to male hormones (estrogen and testosterone) that can affect sperm quality. Exercise is also great for relaxation which is important when trying for pregnancy.
  • Your wife’s suggestions are valid as sperm can be vulnerable to environmental factors such as exposure to heat or toxins. The scrotum sits outside of the body to allow the sperm to remain at cool temperatures. If they are warmed due to being held close to the body by tight underwear or by heat from saunas, hot tubs or biking for long periods of time, sperm production can be negatively affected.
  • Smoking has been linked to low sperm count and reduces motility as well.
  • Alcohol in moderation is acceptable but avoid consuming large amounts regularly.
  • Use caution with the type of lubrication you use. Most lubricants create a barrier for sperm to pass when travelling to the uterus. You can try Pre-Seed lubrication or peanut or vegetable oil, which works well without interfering with your sperm’s movement.

Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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