instruction for patients

  • Introduction
    This booklet contains information about a number of different conditions and treatments that relate to infertility.Not all of the information will be relevant to your particular needs and circumstances but some will and we hope you find this useful.
    This book is not intended to replace the information given to you during consultation or by staff at your centre but should compliment that received at consultation and other visits.
    More detailed information about specific treatments, for example IVF, will be provided separately according to your specific needs.
    All efforts are made to keep the information contained within this booklet up-to-date and accurate. However this is a fast moving field and if new information becomes available which is material to your treatment and that is not provided here it will be issued as supplementary information.
    We would welcome your comments about this booklet and any type of information we provide to enable us to continue to improve our services.

    Comments should be sent to
    Quality Manager
    Asian Reproductive Medicine Centre (ARMC)
    3rd Floor, BMT Centre, Puthiyara, Kozhikode, Kerala, India.
    Tel: +91 495 2724101,102
    E mail:

    NB: If you would like this information available in large print, Braille, audiocassette, video or translated into another language, please contact the centre as above.
    Managing Director, ARMC, Kozhikkode, India.


Fertility & your Health

  • Whether you’re just starting to try and get pregnant, or been trying for a long time, making lifestyle changes to increase your fertility is essential. Lifestyle habits are rarely the sole cause of infertility. However, making changes could possibly push you over the “infertile” line if your sperm health is borderline. They may even help fertility treatments work better.

    Consider Adding Some Antioxidants to Your Diet
    You’ve probably heard of antioxidants as cancer and heart disease fighters. They may also increase fertility.
    In short, antioxidants are substances that prevent cell damage from free radicals. Free radicals are produced naturally by your body when it breaks down your food, but are also created when you’re exposed to things like toxic chemicals, radiation, cigarette smoke, or pollution.Remember that sperm are also cells, so it makes sense that adding antioxidants to your diet may help improve their health. In fact, researchers have found that men who took antioxidants in supplement form had less DNA damaged sperm than men who did not take antioxidants. Some researchers found that couples had higher pregnancy rates if the men took additional antioxidants.
    There are many antioxidants, but the ones that have been specifically studied in regards to improving sperm health are:
    Zinc – found in oysters, crab, red meat, poultry, and beans.
    Vitamin C – found in many fruits and vegetables, with the highest levels found in red peppers, kiwi, oranges, and grapefruit.
    Selenium – found in high amounts in brazil nuts (1 oz provides 780% of your daily recommended value). Also found in tuna, cod, beef, turkey and chicken.
    Vitamin E – found in nuts, seeds, oils, and leafy greens.
    Folic Acid – found in beef liver, leafy green vegetables, fruits, beans, and peas, and often in fortified grains.
    Lycopene – found in tomatoes, apricots, pink grapefruit, and watermelon.
    You can try to add more of these foods into your diet, or consider taking a supplement. As with all things, moderation is still best.

    Watch Your Soy Intake
    Too much soy may impact your sperm counts, according to a research study that looked at eating habits.Soy is found in a number of foods today, including fake meat patties, energy bars, and health drinks. You may be surprised at how much soy you’re eating if you take a close look at your diet.
    So what should you do? The study on soy and sperm counts found that men who were overweight or obese had a stronger reaction to the soy. Also, the higher the soy intake, the lower the sperm concentration was.
    If you’re overweight or obese, go real easy on your soy intake. And for everyone else, just don’t eat loads and loads of it. (Don’t have soy milk with your cereal, a soy-based health shake, and then soy burgers all in one day.)

    Quit Smoking
    Now you have one more reason to quit smoking: Quitting smoking may increase your fertility.
    Studies on smoking and semen quality found that smoking affects many aspects of sperm health, including decreased sperm counts, decreased sperm motility (the swimming ability of the sperm), and sperm shape.
    If you’re going through fertility treatments, it doesn’t mean you’re off the hook and can keep on smoking. Researchers have also found that smoking had a strong effect on treatment success when undergoing IVF

    Avoid Toxic Chemicals in the Workplace
    If you’re having difficulty conceiving, you may want to look at your job. Farmers, painters, and varnishers as a group have a much higher chance of infertility and significantly lower sperm counts, compared to men who work in other fields.
    Metal works and welders, as a group, had higher incidences of poor sperm motility.
    The cause of these higher incidences of infertility and poor sperm health are not known. But one possibility is that the chemicals found in paint, varnish, metal working, and farming (pesticides, for example) may damage sperm.
    For metal workers, it could also possibly be a problem with overheating, which can lower sperm counts.
    What should you do if you work in one of the above fields? It’s a difficult question with no easy answer. While researchers found poor sperm health for men who worked in these occupations, they have not looked at what will happen if they change jobs, or whether or not there are ways to avoid damaging your fertility health while still working in these positions.
    Common sense dictates that avoiding contact with toxins in the workplace as much as possible would be vital, whether that means wearing a mask, wearing gloves, or just keeping your body well covered and clean from chemicals.

    To Increase Fertility: Keep Things Cool
    You may be able to increase your fertility by keeping cool “down there”. The male reproductive organs are outside of the body for a reason — to keep them at temperatures lower than 98.6 F, our normal body temperature. High temperatures can damage sperm.
    It’s best to avoid hot tubs or taking long hot baths. But even if you’re not the hot-tubbing type, there are other things you may do every day that increase your scrotal temperatures.
    Sitting for long periods of time increased scrotal temperatures, according to research. If you have a desk job, or even a long commute to work, be sure to get up and walk around now and then. This is good for concentration, too, so you can boost your fertility and your energy all at once!
    Speaking of long commutes, don’t turn on your seat heater in the winter. Seat heaters, a feature found in some cars that warms up the seat of your car for cold winter mornings, can lead to higher than normal scrotal temperatures.
    Also, don’t sit with your laptop in your lap. Both keeping your legs tightly together to balance the laptop, and the heat generated by the laptop itself, can lead to higher than normal scrotal temperatures. Instead, place your laptop on a desk or table.
    Whether or not boxers are more fertility-friendly than briefs is a matter of debate. I found one study that said it did make a difference, and another study that found no difference. As long as you’re not wearing extremely tight, non-breathable fabric, whether or not you prefer boxers or briefs probably doesn’t matter.

    To Increase Fertility: Aim for a Healthy Weight
    One way to increase your fertility is to bring your weight to a healthier level. Being over or underweight can upset hormone balance, leading to lower sperm counts.
    Not sure if your weight is within the healthy zone? Check your body mass index (BMI). Your BMI is a measurement of your weight that also takes into account your height.
    BMI Calculator
    In a study on thin men, they found that men with a BMI less than 20 had lower sperm concentration and a 28.1% lower total sperm count. They also found that FSH, a hormone that plays a role in the reproductive system, was higher in slim men.
    In a separate study, men with obesity had lower testosterone levels. Also, as BMI levels went up, the incidence of lower sperm counts went up. For example, for men with a normal BMI, 5.32% were found to have low sperm count. In overweight men, 9.52% had low sperm counts, and in obese men, 15.62% had low sperm counts.

    Go Easy on the Alcohol
    Too much alcohol can decrease your fertility.
    A study looking at alcoholics found that only 12% of the men had completely normal sperm counts and health, compared to 37% of non-smokers and non-alcoholics. They found that as the amount the men drank went up, sperm counts dropped, normal sperm shape decreased, and sperm motility worsened.
    Another study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.
    However, other studies have found no relationship between male fertility and just a few drinks.
    What should you do? Moderate drinking is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, you might consider cutting out alcohol for the time being.

    Treat Underlying Medical Conditions
    Treating underlying medical conditions may help increase your fertility.
    Untreated diabetes may lead to infertility, specifically causing retrograde ejaculation. Even if you’re without symptoms, you might want to get your blood sugars tested if you have been diagnosed with retrograde ejaculation. Up to one third of people with diabetes are unaware that they have the disease.
    An untreated infection of the reproductive system or urinary tract can cause infertility in men. For example, sexually transmitted diseases (STDs) may lead to reduced sperm motility, and repeated STD infection may lead to scarring, which can block the passage of semen. Some infections have no symptoms besides infertility.
    Other medical conditions that can lead to infertility are thyroid disease, Crohn’s disease, celiac disease, Cushing’s syndrome, and anemia. These diseases are also commonly missed. For example, it’s not uncommon for someone to walk around with thyroid problems for years before getting a diagnosis.
    Be sure to get a well-check with your primary care doctor before you start trying to conceive, and if you suspect something’s not quite right with how you’re feeling, voice these concerns. That nagging fatigue that never seems to leave may be something more.

    Keep Your Teeth and Gums Healthy
    Keeping your teeth and gums healthy may help increase your fertility. Who knew?
    Bacteriospermia, or the presence of bacteria in semen, has been linked to male infertility. In an interesting research study, 23% of men with bacteria present in their semen did not improve after treatment with antibiotics alone.
    The researchers conducted dental exams on some of the men who did not improve with antibiotics, and found untreated dental problems present in all of them.
    In a test group, the patients’ dental problems were treated. In a control group, the dental problems were not addressed.
    Six months after dental treatment, researchers tested the semen again. Two-thirds of the test group had improved semen health, while those in the control group who had not been treated still had poor semen health.
    Increasing your fertility is just one more reason to make the dreaded trip to the dentist every six months.

    To Increase Fertility: Have Frequent Sex
    You already know that if you want to have a baby, you need to have sex around the time of ovulation. Having frequent sex all month long, however, may help increase your fertility.
    Research studies have found that semen health is best when sex occurred less than two days prior.
    One study of about 3,000 men looked at sperm motility and morphology (shape) in relation to the number of days they abstained from sex. They found that in men with low sperm counts, peak sperm motility occurred after one day of abstinence. The peak sperm morphology occurred after zero to two days of abstinence.
    For men with normal sperm counts, sperm health was significantly decreased after 10 days of abstinence.
    To keep your sperm in tip-top shape, you should try to have sex at least twice a week, and not only around the time of ovulation.