It Takes 2 to Tango...

Although certainly some of our patients are single women or single-sex couples, the vast majority are married couples seeking to start (or add to) their family. As such, infertility is unique in that there are always 2 patients in every setting. Some of the men have been a bit shy of the spotlight to say the least...Why? I think that for many men the concept of being reduced down to a number is very anxiety provoking. It seems like keeping track of batting averages. Every man who has been told that his sperm count is great, suddenly puffs out his chest a bit more and acts like he has won the lottery. Women do not respond to FSH levels in this way...thank God.

Men with low sperm counts always want to know why and how they can make them better. Unfortunately, there is not a whole lot that we can do but work with what we have in most cases. However, sperm counts really do vary quite a bit. My beloved wife, Allison, is a REAL doctor with a PhD in engineering who laughs at how we make medical assessments based upon a single data point. She is right. If we want a line we take one additional data point and then stop... But reproductive medicine is not like engineering unfortunately. There are few straight lines and very few right angles. The best we can do is ride the ups and downs and try our best to guide our patients appropriately.

So here is the Question of the Day from that soon to be bestselling book "100 Questions and Answers about Infertility."

32. Is there anything my husband can do to improve his sperm count, such as wearing boxers and not briefs or taking vitamins?

Sperm parameters demonstrate considerable variation from sample to sample, so researchers have not been able to identify any specific diet or lifestyle change that might potentially improve sperm quality. Although the presence of a varicocele has been suggested to play a role in male infertility (see Question 30), the benefit of varicocelectomy remains controversial. Some studies have suggested that wearing boxers instead of briefs can improve a man’s sperm count. The avoidance of extremely high temperature may also improve sperm counts, so care should be taken to avoid prolonged exposure to extremely high temperatures, such as within a sauna or a hot tub. The effects of a variety of nutritional supplements on semen have been studied. Some researchers have suggested that antioxidants may improve sperm quality, thereby leading to im- proved pregnancy rates (the desired outcome). Although the data on nutritional supplements with antioxidant properties are somewhat limited, a commercially available product based on this research is available (Proxeed, Sigma-Tau Pharmaceuticals). This nutritional supplement is available for purchase only over the Internet. Although it has been frequently pre- scribed by some urologists, additional studies are required to confirm its benefits.