There is not one kind of ‘good sperm’ — it depends on other qualities in the male

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In a study published in Behavioral Ecology researchers from Uppsala University show that the same type of sperm is not always the best for all male birds. Depending on how attractive or dominant you are you might be more successful with longer or shorter sperm.

Getting a big family can be a difficult business in nature. If you are a male bird, you have to work hard to secure a territory where you will find food for your chicks and convince a lady that you are both good looking enough and also will be a good dad. But getting a mating partner is not the end of the story, you also need to fertilize her eggs, preferably all of them!

For this, you will need good sperm: sperm that is good at fertilizing eggs, but not only, it also has to be BETTER than the sperm of your potential rivals, that is other males your partner might be copulating with before laying all of her eggs. This happens often in nature, because females do not want to put all of their eggs in the same basket and it might be advantageous instead to have some genetic variation among your offspring.

Determining what makes for a good or attractive male is not always easy, and measuring what makes a good sperm is even harder. Now these two important components of fertilization success are often also measured separately, and we do not really understand how they are linked.

The researchers studied this in collared flycatchers (small black and white birds), by catching close to 120 different males over 4 years, measuring their white forehead patch (used to attract females), their sperm morphology (under the microscope), and their paternity success (i.e. how many of the chicks in their nests were theirs, by analyzing the blood of over 400 six-days old nestlings).

The team found that different categories of males have different sperm morphology, depending on if they manage to secure a territory and have a social mating partner, but also on their age and attractiveness. But most interestingly, the researchers found that the type of sperm that allows them to maximize the number of nestlings they father is different for different types of males. For males that have small forehead patches and are thus less dominant and less attractive, having long sperm is beneficial. This could be because they are more exposed to sperm competition and long sperm are likely to swim faster and reach the egg first.

But longer is not always better! For more attractive males, it is quite the opposite, and having smaller sperm allows them to sire more eggs in their nest.

“Many studies have attempted to link attractiveness and sperm quality, trying to figure out if “sexier” males also have better sperm, with very inconsistent results between studies. Our study shows that what makes a good quality sperm might instead depend on how attractive, competitive, and how old a male is, so there is not one single kind of “good sperm”, and we should more often look at the full picture and actually measure which phenotypes result in the highest fertilization success”, says lead author Murielle Ålund, now researcher at Michigan State University.

 

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Low sperm count not just a problem for fertility

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A man’s semen count is a marker of his general health, according to the largest study to date evaluating semen quality, reproductive function and metabolic risk in men referred for fertility evaluation. The study results, in 5,177 male partners of infertile couples from Italy, will be presented Sunday at ENDO 2018, the Endocrine Society’s 100th annual meeting in Chicago, Ill.

“Our study clearly shows that low sperm count by itself is associated with metabolic alterations, cardiovascular risk and low bone mass,” said the study’s lead investigator, Alberto Ferlin, M.D., Ph.D. He recently moved as associate professor of endocrinology to Italy’s University of Brescia from the University of Padova, where the study took place in collaboration with professor Carlo Foresta, M.D.

“Infertile men are likely to have important co-existing health problems or risk factors that can impair quality of life and shorten their lives,” said Ferlin, who is also president of the Italian Society of Andrology and Sexual Medicine. “Fertility evaluation gives men the unique opportunity for health assessment and disease prevention.”

Specifically, Ferlin and his colleagues found that about half the men had low sperm counts and were 1.2 times more likely than those with normal sperm counts to have greater body fat (bigger waistline and higher body mass index, or BMI); higher blood pressure (systolic, or top reading), “bad” (LDL) cholesterol and triglycerides; and lower “good” (HDL) cholesterol. They also had a higher frequency of metabolic syndrome, a cluster of these and other metabolic risk factors that increase the chance of developing diabetes, heart disease and stroke, the investigators reported. A measure of insulin resistance, another problem that can lead to diabetes, also was higher in men with low sperm counts.

Low sperm count was defined as less than 39 million per ejaculate, a value also used in the U.S. All the men in the study had a sperm analysis as part of a comprehensive health evaluation in the university’s fertility clinic, which included measurement of their reproductive hormones and metabolic parameters.

The researchers found a 12-fold increased risk of hypogonadism, or low testosterone levels, in men with low sperm counts. Half the men with low testosterone had osteoporosis or low bone mass, a possible precursor to osteoporosis, as found on a bone density scan.

These study findings, according to Ferlin, suggest that low sperm count of itself is associated with poorer measures of cardiometabolic health but that hypogonadism is mainly involved in this association. He cautioned that their study does not prove that low sperm counts cause metabolic derangements, but rather that sperm quality is a mirror of the general male health.

The bottom line, Ferlin stressed, is that treatment of male infertility should not focus only on having a child when diagnostic testing finds other health risks, such as overweight, high cholesterol or high blood pressure.

“Men of couples having difficulties achieving pregnancy should be correctly diagnosed and followed up by their fertility specialists and primary care doctor because they could have an increased chance of morbidity and mortality,” he said.

Article Source: https://www.eurekalert.org/pub_releases/2018-03/tes-lsc031418.php

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Can Having Sex More Frequently Lower A Man’s Sperm Count?

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Common word around frequent sex is that it may lead to infertility in men due to lowered sperm count. But how true is the commonly believed statement? Find out here.

Excess of everything is bad. Or not?

Sex is so much fun that you just feel like doing it over and over again. The desire to do it again and again is never-ending. But how much sex is good for you? How often can you have sex without the fear that it may affect your fertility? For a woman, fertility refers to her ability to get pregnant and for men; it is about his ability to impregnate a woman. But the question that stays is, ‘Does frequent sex affect a man’s sperm count?’ Let’s find out!

You may have heard that having sex once a week is good for you and does not harm fertility. Too much sex may eventually lower a man’s sperm count which eventually leads to infertility. Well, it’s just a myth!

Myths like having sex too much and too often can lead to physical weakness and fatigue and most importantly lowering of sperm count are all around us. But what happens is, sperms inside the testicles pass through the testes during masturbation. If not released, the sperms stay here for as long as 15 to 25 days.

What happens when sex becomes infrequent?

When sperms are stored inside the body for too long, it causes damage to DNA. Sperms in the body are too sensitive to heat and exposure. When released after a long time, their mobility is affected by heat and radiation. As a result, the sperms released are of an abnormal shape, low in count and have low mobility which together contributes to male infertility.
How does frequent ejaculation affect sperm count?

The body needs anything between 24-36 hours for creating more sperms. So apparently, frequent sex can lower sperm count. But here’s a catch, fresher the sperm, higher the motility! Fresh sperms are more live and have higher motility improving fertility. Hence, if sperms are stored inside the body for too long, it can lead to lower fertility as they become more sensitive to harm from heat and exposure. Experts explain that infrequent ejaculation can put a man’s fertility at risk and a man can stay without ejaculation for as many as 7 days.

So, if you are trying to conceive, having sex every 2-3 days is good for you. This way, fresh sperms are available for the ovum and it can lead to higher chances of conception. Also, having sex daily before ovulation is an added advantage as it improves fertility to a great extent.

So gentlemen, time to get over the fear that too much sex will harm your fertility and bring your sperm count to a low level. Quit counting numbers and engage in passionate love-making with your partner to bond and get rid of too much stress as well.

Article Source: https://doctor.ndtv.com/mens-health/frequent-sex-leads-to-infertility-in-men-fact-or-fiction-1771734

 

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As Men’s Weight Rises, Sperm Health May Fall

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A widening waistline may make for shrinking numbers of sperm, new research suggests. Indian scientists studied more than 1,200 men and found that too much extra weight was linked to a lower volume of semen, a lower sperm count and lower sperm concentration.

Dr. Ronald Klatz, President of the A4M, Sept. 29, 2017 remarks, “I’ve been aware of this fact for decades. We have been attempting to educate doctors and patients of the horrific effects of being overweight or obese for over 20 years. Isn’t it interesting that Indian Scientists seem more aware of this fact than Americans? One has to wonder if the quality of sperm also effects the overall genetic health of people through life?”

(HealthDay News) — A widening waistline may make for shrinking numbers of sperm, new research suggests.

Indian scientists studied more than 1,200 men and found that too much extra weight was linked to a lower volume of semen, a lower sperm count and lower sperm concentration.

In addition, sperm motility (the ability to move quickly through the female reproductive tract) was poor. The sperm had other defects as well, the researchers added. Poor sperm quality can lower fertility and the chances of conception.

“It’s known that obese women take longer to conceive,” said lead researcher Dr. Gottumukkala Achyuta Rama Raju, from the Center for Assisted Reproduction at the Krishna IVF Clinic, in Visakhapatnam. “This study proves that obese men are also a cause for delay in conception,” he added.

“Parental obesity at conception has deleterious effects on embryo health, implantation, pregnancy and birth rates,” Rama Raju explained.

How obesity affects sperm quality isn’t known, he pointed out.

But in continuing research, the study team is looking to see if losing weight will improve the quality of sperm.

Although that study is still in progress, early signs look good that sperm quality improves as men lose weight, Rama Raju said.

One U.S. fertility expert said the findings have broad implications in America.

“About one-third of men in the United States are obese,” said Dr. Avner Hershlag, chief of Northwell Health Fertility in Manhasset, N.Y.

America is getting fatter and fatter, despite the proliferation of new diets and exercise routines. And about one-sixth of children and adolescents are already obese, Hershlag noted.

“Along with the growing obesity trend, there has been a steady decline in sperm quality,” Hershlag said. “The findings in this study, while not specifically related to infertility, represent a trend towards a decline that is worrisome.”

Recent reports have found that extreme weight loss after bariatric surgery reversed some of the sperm decline, he said.

“The message to men is don’t continue to abuse your body,” Hershlag said. “Comfort foods and excess alcohol are bound to make you uncomfortable and put you at a higher risk for diabetes, high blood pressure and heart disease, which are all life-shortening, and may also put a damper on your path to fatherhood.”

For the study, Rama Raju and his colleagues used computer-aided sperm analysis to assess the sperm of 1,285 men. Obese men, they found, had fewer sperm, a lower concentration of sperm and inability of the sperm to move at a normal speed, compared with the sperm of men of normal weight.

Moreover, the sperm of obese men had more defects than other sperm. These defects included defects in the head of the sperm, such as thin heads and pear-shaped heads.

All of these sperm abnormalities may make it more difficult for obese men to achieve conception, either through sexual intercourse or through IVF, the researchers said. But the study did not prove that obesity causes sperm quality to drop.

According to Rama Raju, this is the first study of abnormal sperm in obese men based on computer-aided assessment. The report was published online Sept. 19 in the journalAndrologia.

Computer-aided sperm analysis might be something doctors should do before IVF, he suggested.

Dr. Nachum Katlowitz, director of urology at Staten Island University Hospital, in New York City, pointed out that “the effect of obesity on sperm is another reason why Americans need to work on this epidemic.”

The idea that obesity affects sperm is well known, he said. “There’s no doubt we should take this information as another link in the chain to push us to help our patients obtain a healthy balance and a slimmer waistline,” Katlowitz said.

By Steven Reinberg HealthDay Reporter

Article Source: https://www.worldhealth.net/news/mens-weight-rises-sperm-health-may-fall/

 

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13 Foods You’re Better Off Avoiding Before Having Sex

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While most of us are aware of the foods that act as aphrodisiacs, only a handful are aware of the foods we should avoid at all costs. Not only will these make you feel bloated, unsexy and lethargic, they are likely to prevent you from getting it on!

#1. French fries

As tempting as reaching for those French fries are at all times fried foods (including the likes of pizza) are disastrous for your libido. They lower your testosterone levels, decrease blood circulation, and reduce your chances of maintaining strong erections.

#2. Hot dogs

Thinking of chomping on a hot dog towards the end of your grand night out before heading back for a raunchy session under the sheets? Although this super popular snack is great when paired with beer while watching your favorite sport it’s loaded with the kind of saturated fat that can clog the arteries that improve blood flow to your sexual organs. 

#3. Processed foods

Whether it is the aforementioned hot dog or the savory cupcake, the trans fat and sugars in processed food items can weigh down your digestion and slow your blood flow; hampering your sex drive.  Over time this can cause a loss of muscle mass, increase in fat and a dip in your testosterone levels.

#4. Canned or packaged foods

Canned or packaged foods are loaded with crippling levels of sodium. When we say crippling we mean that it can elevate your blood pressure to unfavorable levels and blockade the flow of blood to certain parts your body, like your genitals, leaving your limp.  

#5. Beer

If your night out entails having sex, later on, make sure it doesn’t include cracking open pints of beer in the build-up to it. Although it might give you the buzz you seek the phytoestrogens present in beer stand a good chance to alter the hormones that tamper with your libido. 

#6. Energy drinks

These bottled up potions of liquid give you instant energy due to the caffeine and sugar they are loaded with, but they do just the opposite to your sexual stamina. Once the caffeine and sugar burn off in your system they leave you with lesser energy than you had before. Studies also suggest that it lowers the level of the hormone serotonin that impacts your mood.

#7. Tonic water

 

Although this makes for a perfect combination with gin it doesn’t fair that well with your testosterone levels. The chemical quinine present in the water not only kills your sex drive and lowers your sperm count but it also can cause gas and bloating. 

#8. All sorts of beans

 

Love your rice and beans? Science has it that beans contain oligosaccharides (sugar molecules that the body cannot fully breakdown), which create gas and excessive cramping. And these are the last two things you want to be feeling down there when you’re setting yourself to get it on.

#9. Cruciferous vegetables

 

Sometimes the healthiest of vegetables can be just what you need to avoid in certain situations. Cruciferous vegetables like cabbage, broccoli and cauliflower create a lot of gas since our body cannot digest the natural sugars found in them. The methane, carbon dioxide and hydrogen produced by your body, as a result, can really stink up your surroundings.

#10. Tofu

Tofu has earned its name as one of the healthier options of protein for vegetarians and non-vegetarians as well, but not so much before a sexual encounter. Soy laden products increase your estrogen levels that have shown to decrease the estrogen levels in both sexes.

#11. Onions and garlic

If your food is loaded with onions and garlic, like most of our food is, try to avoid them in your meal prep before you engage in coitus. These pungent vegetables can affect your body odor for the worse; similar to how spices do. 

#12. Red meats

 

If you’re big on eating meats like lamb, pork or beef, especially on night outs where you’re looking forward to a romp in the sack, later on, swap it with seafood instead. Red meat is associated with the production of foul-smelling gas that can be downright offensive in nature!

#13. Cream-based sauces

Avoid cream-based sauces, such as the ones they use to make pasta in some restaurants; their heavy nature will put your system into a slump. The cream can upset your stomach and cause gas if you’re lactose intolerant dampening your elevated spirits.

 

Written By: REGI GEORGE JENARIUS

Article Source: http://www.indiatimes.com/health/healthyliving/13-foods-you-re-better-off-avoiding-before-having-sex-329846.html

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Exercise May Improve Male Fertility

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Infertility is recognized as a disease by the World Health Organization (WHO), American Society for Reproductive Medicine (ASRM) and the American College of Obstetricians and Gynecologists (ACOG).1

Defined as the inability to conceive a child after one year of unprotected sex, infertility affects approximately 1 out of every 8 couples.2

Approximately 90 percent of male infertility is due to low sperm count or poor sperm quality, and the remaining 10 percent are the result of structural abnormalities, hormonal imbalances, genetic defects or other problems.3 Sperm abnormalities are critical to infertility and the health of a resulting pregnancy.

While much media attention has been placed on the necessity for women to care for their bodies prior to pregnancy, research has demonstrated the need for men to care for themselves in the same way to prevent birth defects, miscarriages and infertility.

Recent research now indicates that exercise may improve quality and quantity of sperm in men who were previously sedentary.4

Exercise May Improve Sperm Quality and Quantity

In a study completed in Iran, researchers evaluated the effect of four different levels of exercise on sperm quality in sedentary men. Of the couples struggling with infertility, 1 in 3 are the result of poor sperm quality.5

In this study, researchers from Urmia University evaluated the sperm of 261 healthy men over six months.

The participants were first determined to be otherwise healthy, between 25 and 40 years of age, and didn’t regularly participate in an exercise program. They were then separated into the following four groups:6

  • No exercise
  • Three workouts a week of high-intensity training on a treadmill (HIIT)
  • Three workouts a week of 30 minutes moderate-intensity continuous training on a treadmill (MICT)
  • Three workouts a week of one-hour high-intensity continuous training on a treadmill (HICT)

The researchers used semen samples before, during and after the six-month exercise period to evaluate sperm motility, size, morphology (shape), count, semen volume and levels of inflammatory markers.

After 24 weeks, it was the MICT group who experienced the greatest improvements, although the HICT and HIIT groups also experienced improvement over the group who did not exercise.7

The MICT group had a greater than 8 percent rise in semen volume, over 12 percent improvement in sperm motility, 17 percent improvement in morphology and just over 21 percent more sperm cells on average.8

However, while the men enjoyed these improvements during the exercise program, the sperm count, concentration and morphology began dropping back to pre-workout levels within a week after stopping. Lead author of the study, Behzad Hajizadeh Maleki commented:9

“Our results show that doing exercise can be a simple, cheap and effective strategy for improving sperm quality in sedentary men.

However, it’s important to acknowledge that the reason some men can’t have children isn’t just based on their sperm count. Male infertility problems can be complex and changing lifestyles might not solve these cases easily.”

Moderate Exercise Increases Sperm Quality

The authors of the study theorized that although weight loss achieved by the men during the six months of the study was likely to have contributed to improving sperm quality, the men participating in MICT may have experienced the greatest impact as MICT reduces exposure to inflammatory agents and oxidative stress.10

Scientists have determined that exposure to electromagnetic fields, increased heat, poor nutrition, obesity, drugs, alcohol and bicycling may reduce sperm quality, and theorize that reducing these factors and improving health would then improve sperm health.

Another study of 31 men, 16 of whom were active (but did not bike) and 15 sedentary, underwent a shorter evaluation of sperm quality,11 using the WHO’s sperm quality parameters, including volume, count, motility and morphology.12

Researchers found physically active men had a higher concentration of sperm, semen volume and a higher percentage of sperm with normal morphology.

In a previous study, these same authors found men who engaged in intense exercise instead experienced a reduction in sperm quality, but moderate exercise appeared to be linked to improve sperm quality.

Researchers from the most recent study also found that moderate activity, as described in their study parameters, yielded better results. The researchers commented:13

“The present study adds to this body of evidence and shows seminal markers of inflammation and oxidative stress improved significantly after 24 weeks of MICT, HICT or HIIT, and these changes correspond with favorable improvements in semen quality parameters and sperm DNA integrity.

These results further indicate that MICT was more beneficial in improving markers of male reproductive function, compared to HICT and HIIT.

These observations suggest that the intensity, duration and type of exercise training could be taken into consideration when investigating reproductive responses to exercise training in men.”

Male Infertility Responsible for 30 Percent of Cases

Allan Pacey, Ph.D., and fellow of the Royal College of Obstetricians and Gynecologists (RCOG), is the British Fertility Society spokesman and professor of andrology at the University of Sheffield. He also commented on the research results and how they may affect fertility:14

“In this context, the study makes a good contribution to the knowledge base. It is a very well conducted and a strength is that it is a randomized controlled trial with extensive data collection.

Also, the study examines how exercise affects many of the parameters of male reproductive health, not just sperm quality. However, what is likely to be of most interest to men and their doctors are the results concerning sperm quality.

Importantly, these seem to show a statistical improvement to various degrees when the men embarked on their different exercise regimes compared to men who did no exercise at all. However, an important question is whether these statistical changes are enough to be of any clinical significance.”

Male infertility contributes to 30 percent of all infertility cases.15 Of the four major causes of male infertility, between 40 percent and 50 percent of poor sperm quality is attributed to unknown factors. Male infertility is a complex condition encompassing both the health of the sperm and the mechanical functioning of the male reproductive system.16

Testing for male infertility includes a semen sample analysis, blood work, physical examination and an evaluation for any current infections or structural damage from past infections. Although frustrating to a couple trying to conceive a child, the risk of poor sperm quality extends beyond the inability to conceive.

Risks Associated With Poor Sperm Quality

Sperm motility, or the ability of sperm to move quickly and in a straight line, is one factor associated with sperm quality. Sperm that are sluggish or move poorly may be associated with DNA fragmentation, and the potential risk for passing genetic diseases.17There is also some evidence that male infertility may be a risk factor for testicular cancer.18

Recurrent miscarriages may be attributed to chromosomal damage to either the egg or the sperm,19 and reduced sperm quality is associated with congenital deformities.20 Chromosomal abnormalities in the sperm may contribute to poor sperm quality.

The risks of poor quality sperm also extend to the health of the man. Defects in sperm quality are linked to a variety of health concerns, including high blood pressure, diabetes, heart disease and skin and glandular disorders.21 Lead researcher Dr. Michael Eisenberg, assistant professor of urology and director of reproductive medicine and surgery at Stanford School of Medicine, commented that “[i]t may be that infertility is a marker for sickness overall.”22

A study evaluating more than 9,000 men with fertility issues found a correlation between defects in a man’s sperm and the likelihood he suffers from other health conditions.23 A previous study Eisenberg co-authored also indicated that men who experienced infertility issues had an overall higher rate of mortality in the following years. According to Eisenberg:24

“A man’s health is strongly correlated with his semen quality. Given the high incidence of infertility, we need to take a broader view. As we treat men’s infertility, we should also assess their overall health. That visit to a fertility clinic represents a big opportunity to improve their treatment for other conditions, which we now suspect could actually help resolve the infertility they came in for in the first place.”

Natural Sperm Boosting Options

While moderate exercise may help to improve sperm quality, there are other lifestyle choices that may help to enhance the improvements you experience. Infertility is a complex condition that is intimately incorporated the rest of your health. You may improve your sperm quality as you also improve your overall health and wellness.

Use Moderate-Intensity Continuous Exercise While Trying to Conceive

Although HIIT is a healthy adjunct to an exercise program, the increased heat and oxidative stress on your body may produce time-limited changes to your sperm quality, and reduce your potential to conceive.

Reduce Exposure to Toxic Chemicals

Unprecedented decline in fertility rates and semen quality in the past decade may be attributed to exposure to phthalates in your environment.25 Animal studies have demonstrated an association between phthalates and testicular toxicity26 and lowered sperm count.27 Other chemicals to avoid include paint fumes, pesticides, formaldehyde, organic solvents and dry cleaning chemicals.

Optimize Your Vitamin D Level

Low vitamin D levels have been linked to infertility in both men and women. In men it is essential for the healthy development of the nucleus of the sperm cell, and helps maintain semen quality and sperm count.

Vitamin D also increases levels of testosterone, which may boost libido. Aim to maintain a level of 40 to 60 nanograms per milliliter (ng/mL) year-round.

Maintain Your Weight Within Normal Limits Through a Whole Food Diet

Obesity changes male hormone levels, which has a direct impact on sperm molecular composition and function.28 Use fresh foods as often as possible, ideally organically grown, to avoid pesticides. Seek out pastured, organic meat and dairy products, raw nuts, seeds and vegetables, and avoid dangerous trans fats found in many processed foods and vegetable oils.

Reduce or Eliminate Smoking, Alcohol and Drugs

Each of these creates an added stress on your body with demonstrated reduction in fertility, sperm motility and quality.

Avoid the Heat

Sperm require a specific temperature to remain active and viable. Avoid wearing tight underwear and tight pants, taking hot showers or baths and sitting in hot tubs. Keep your laptop off your lap as the increased heat from the machine also increases the temperature of your scrotum.29

Your body will naturally keep your sperm at the right temperature when you avoid circumstances that abnormally increase the temperature of your scrotum.

Avoid Placing Your Mobile Phone in Your Front Pants Pocket

Research shows mobile phone radiation increases DNA fragmentation and reduces sperm motility.30

Written By: Dr. Mercola http://fitness.mercola.com/sites/fitness/archive/2016/12/23/exercise-improve-male-fertility.aspx

 

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Male birth control shot found effective, but side effects cut study short

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Both men and women are responsible for pregnancy, yet the burden of preventing it often falls on one gender. Women can choose from a variety of options to control fertility while for generations, men have been limited to withdrawal, condoms and sterilization. But someday soon, a new method may allow men to shoulder a greater share of responsibility.

A new hormonal birth control shot for men effectively prevented pregnancy in female partners, a new study found.
The study, co-sponsored by the United Nations and published Thursday in the Journal of Clinical Endocrinology and Metabolism, tested the safety and effectiveness of a contraceptive shot in 320 healthy men in monogamous relationships with female partners. Conducted at health centers around the world, enrollment began on a rolling basis in September 2008. The men, who ranged in age from 18 to 45, underwent testing to ensure that they had a normal sperm count at the start.
The injection, given every eight weeks, consisted of 1,000 milligrams of a synthetic form of testosterone and 200 milligrams of norethisterone enanthate, essentially a derivative of the female hormones progesterone and estrogen referred to as “progestin” in the synthetic form.
According to Dr. Seth Cohen, a urologist at NYU Langone Medical Center, when a man is given a shot of testosterone, “basically, the brain assumes the body is getting enough,” so the body shuts down its own production of testosterone — specifically “the testicle’s production of testosterone as well as the testicle’s production of sperm.”
The progestin “further drives the brain malfunction, so it stops the testicle’s production of both testosterone and sperm,” explained Cohen, who was not involved in the new study.
The researchers used a combination of hormones in order to reduce the testosterone dose to a level that they believed, based on previous studies, would effectively lower fertility yet still be safe.

Study terminated early

During the ramp-up pre-efficacy stage of the study, the couples were instructed to use non-hormonal birth control methods, while the men participants received shots and provided semen samples until their sperm counts dropped to less than 1 million per milliliter in two consecutive tests. At that point, couples relied on the injections as contraception.
Throughout the study, the men provided semen samples to ensure that their sperm counts stayed low. Once the participants stopped receiving the injections, they were monitored to see whether and how quickly their sperm counts recovered to levels described as “fertile” by the World Health Organization.
The researchers discovered that the shot effectively held the sperm count at 1 million per milliliter or less within 24 weeks for 274 of the participants. The contraceptive method was effective in nearly 96% of continuing users.
Four pregnancies (resulting in three live births) occurred among the men’s partners, all during the phase where other contraception was required. All the babies were normal, noted Doug Colvard, co-author of the study and deputy director for programs at the nonprofit research organization CONRAD, Eastern Virginia Medical School, a co-sponsor of the study.
Serious negative effects resulting from the shots included one case of depression and one experience of an abnormally fast and irregular heartbeat after the injections stopped. The researchers considered one intentional overdose of acetaminophen possibly related.
“It is possible that the fluctuations in the circulating progestin following bimonthly injections could haveresulted in the reported or observed mood swings, such as occurs in women, whether on a hormonal contraceptive or not,” Colvard speculated.
Overall, 20 men dropped out early due to side effects. A total of 1,491 adverse events were reported by participants, including injection site pain, muscle pain, increased libido and acne. The researchers say that nearly 39% of these symptoms — including one death by suicide — were unrelated to the shots.
However, due to side effects, particularly depression and other mood disorders, the researchers decided in March 2011 to stop the study earlier than planned, with the final participants completing in 2012.
“I immediately thought of the recent findings on female birth control,” Elisabeth Lloyd said of a study published last month in the journal JAMA Psychiatry. A faculty scholar at the Kinsey Institute, she is a professor of biology and an adjunct professor of philosophy at Indiana University Bloomington.
The study she refers to found an association between the use of hormonal birth control and depression. It looked at prescriptions filled during an 18-year period by more than 1 million women included in Denmark’s national registry.
According to the lead author, Dr. Øjvind Lidegaard of the University of Copenhagen, among women both with and without a psychiatric history who were using hormonal contraceptives, about 10% to 15% got a prescription for an antidepressant during a five-year period.
Annually, the risk of antidepressant use among the youngest group of women taking hormonal contraception amounts to between 2% and 3%. Two or three out of every 100 women between 15 and 19 years old who take hormonal contraceptives will become depressed over the course of a year. “Adolescents seemed more vulnerable to this risk than women 20 to 34 years old,” the researchers noted in their study.
Lidegaard said doctors need to tell women about the benefits and risks of hormonal contraceptive products when deciding which birth control to use.

Effects on fertility

After the men stopped receiving shots, most returned to fertility during a recovery period.
“The minimum recovery time was about 12 weeks after the last injection, and the average time was about 26 weeks,” said Colvard.
Still, there were problems. After 52 weeks in recovery, eight participants had not returned to fertility. The researchers continued to follow these men individually, and five eventually regained normal sperm counts over a longer period of time. One volunteer did not fully recover within four years, though he did “partially recover, so whether he is actually fertile is not known,” Colvard said.
“It shows that it’s a risk, a low-probability risk of it, and it’s not to be sneezed at as a risk of it, surely,” said Lloyd, who is unaffiliated with the new study.
Lloyd said, adding that this risk needs to be compared with those involved in hormonal birth control for women, such as potentially fatal strokes and blood clots.
“These risks of fertility damage are not fatal risks like the women endure with their birth control,” said Lloyd. “You have to compare what women are doing in terms of taking hormones with what men are doing in terms of taking hormones. Are they taking their life in their hands when they take the hormones? Women are. And that needs to be put right up in front when considering the risk.”
Colvard and his co-authors say more research is needed as they work to perfect their cocktail of hormonal contraceptives in an attempt to reduce the risk of side effects, including depression, increased sex drive and acne.
Despite the side effects of the male birth control shot, more than 75% of participants reported being willing to use this method of contraception at the conclusion of the study.
Cohen believes at least part of the reason for this is that they were getting testosterone.

Looking to the future

“Testosterone makes men feel pretty good,” Cohen said. “Testosterone is not a stimulant per se, but it is a steroid, and like a lot of steroids, it can give you a boost of energy. It can give you a boost of muscle mass. It can help with weight loss. It can help with mentation,” or mental activity.
Lloyd believes that if 75% of the men said they’d be interested in getting the shot if it were available, there’s real interest in the product. “That’s unbelievable. That’s fabulous. I’m very very impressed with that number,” she said.
Cohen, who says he he sees patients who face infertility or other hormonal problems, worries about the safety of this method. “Let’s just say, when I read it, I was highly alarmed,” he said, explaining that putting men on testosterone who have normal testosterone levels is not safe and amounts to a violation of the “ethical clinical practice guidelines.”
However, Lloyd thinks this product is a long time coming.
“It’s been a long time since people have been talking about male birth control. This goes back to the 1950s at least.” When scientists first began talking about hormonal birth control for women, they also discussed the same for men, explained Lloyd, but hormonal contraceptives for men were not acted on or investigated.
Cohen questions the general safety of hormonal birth control — for anyone.
“We’re talking about young people, and the scary thing is messing around with young people’s hormones, and that can be detrimental for the rest of their life, right?” Cohen said. “You take an 18-year-old girl or a 20-year-old boy and mess around with their hormones, you’ve really altered possibly how they go through their life.
“If anything, this may wake us up to finding out better hormonal contraceptives for women, right? Because certainly, I know that a lot of young women don’t get the type of counseling that maybe they deserve when it comes to contraception,” Cohen said. “Just a (prescription) and a visit to Duane Reade is all they get, and that may not be enough.”

Article Source: http://www.cnn.com/2016/10/30/health/male-birth-control/index.html?sr=fbCNN103116male-birth-control1030AMStoryGalLink&linkId=30515664

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