Many of you are here because you want to become Mothers or Fathers. All of you will have had an interest in this as you may have had problems conceiving. For some, the journey down the road to parenthood is easy. But for others, conception can be an immensely challenging process for both body and mind.

The natural approach to treating infertility looks the at the root causes of infertility, by addressing all body systems, rather than just focusing solely on the reproductive system.
I’ve talked a lot about diet so far and things we have more control over. Some things like environmental toxins we have less control over, however we can make some choices about most of these issues once we know what we are dealing with.

A recent report in the UK from the Royal College of Gynaecologists confirmed many of the concerns I have as a nutritionist around limiting your chemical exposure during pregnancy. The truth is this journey should really start before conception instead of the advice given of which chemicals to avoid during pregnancy.

I often refer to environmental toxins with clients as the silent accumulators as they can be responsible for sub fertility. Accumulated toxins from our diet or environment can build up over time and unfortunately, they will stop nutrients from getting to a woman’s reproductive organs and interfere with sperm health.

According to Natural Health Concepts, “More than 80,000 chemicals permitted have never been fully assessed for toxic impacts on human health and the environment. Under the current law, it is almost impossible to take regulatory action against dangerous chemicals, even those that are known to cause cancer or other serious health effects”.

We absorb almost 60% of what we put on our skin and if we take just a quick snapshot of the chemical bath we are exposed to just in body care, it is quite easy to rack up an impressive chemical count within hours of waking. By the time we eventually go to bed, we will be exposed to many hundreds of chemicals just in one area such as body care.

Many couples have unexplained infertility and cleaning up their exposure to chemicals is one component of an overall plan and used in conjunction with others will help them become more fertile. Everyone has a different physiology so as a rule I always recommend an overhaul of body, home and lifestyle.

Exposure to chemicals used to preserve lotions and potions heavy metals, radiation, and toxic chemicals in some foods, drugs and other products can damage DNA and can influence our gene structure and expression.

Here are a few things to help you clean up your act in regards to chemicals prior to conception:

1. Minimize your exposure to toxic chemicals

Once pregnant exposure to environmental toxins (in the form of industrial chemicals) both in utero and neonatally may dramatically affect the growing child. There appears to be less stringent controls on them as there are for medicines. Consequently, poisonous chemicals end up circulating in our environment, food supply, air and water.
Heavy metals and environmental pollution can alter hormone function and result in adverse reproductive health effects. These include:
Ovotoxicants: which can disrupt or even stop ovulation.
Endocrine disruptors: Which can interfere with hormone function and cause endometriosis and PCOS.
Phthalates: in plastic food containers, cling film, bags, medical supplies, vinyl flooring and packaging at high levels have been associated with miscarriage and testicular toxicity. At low levels they disrupt hormonal balance.
VCH chemicals: used in rubber tires, plastics and pesticides.
PAH: released from cigarettes, car fumes and road tar

Men are also affected

Studies confirm male sperm counts are declining, and environmental factors, such as pesticides, exogenous oestrogens (Xenoestrogens), and heavy metals may negatively impact spermatogenesis (formation of sperm).
Sperm seems to be more sensitive to heavy metals and industrial pollutants than Ova. Many sperm abnormalities have been linked to these toxins. The majority of these chemicals can be found in the atmosphere, on the ground in cities and in the waterways.

They have also been termed “reprotoxicants” for their negative effects on sperm development and maturation. Shanna Swan who was involved in the sperm study published in 2017 has written a great book looking at chemicals as the main reason for declining sperm health.  

What can we do about this – The top 7 environmental toxins to avoid

Pesticides: found on non-organic fruit and vegetables, meat, dairy and unfiltered tap water
Formaldehyde: found in air fresheners, deodorants, floor polish, upholstery cleaners
Bisphenols: found in plastic containers and can leach into food and water.
Organic solvents: petroleum based liquids found in household products, electronics, car repair, health care, photography, agriculture, printing, construction and cosmetics and many more
Parabens used in common shampoos, conditioners and body care items.
Dry-cleaning chemicals
Paint fumes
Occasional exposure to one or the other toxic chemical is not of concern. What is of concern is accumulation of these chemicals over a long period.

2. Water

Our waterways are constantly being polluted by industrial waste and by-products, pharmaceutical drugs, pesticides and herbicides and commercial cleaning products.
How to minimise this = use a filtration system
Buy a filtration water system that filters particles smaller than 1 micron (this will filter out the drugs as well as heavy metals). Use the filter in your shower and your kitchen. Shower steam contains the same chemicals, which you can end up inhaling and can be absorbed through your skin.

Conclusions

It can be difficult to totally banish chemicals from our life, as after all we do live in a modern society; however we can make a big dent on our chemical exposure by:

1. Minimising and switching to natural products for body hair and teeth
2. Making sure the majority of your food is chemical free
3. Not obsessing about using plug in air filters and using harmful chemicals to clean your house

4. Filtering your water with a really good filtration system

Abnormalities in shape make it more difficult for sperm to penetrate and fertilize an egg. However this is not impossible and in my clinic I have seen many people go on to have a healthy pregnancy with 4% or lower morphology.

If there has been a morphology issue at an early stage before working together from last years test –  one of the next things I suggest is a DNA fragmentation test https://examenlab.com/for-men/your-results-explained/ 

In my experience this seems to be the largest anomaly in most the sperm tests I see. And in my opinion relates to physical and environmental reasons.

The sperm shape it vital to a successful pregnancy. Often if there are zero morphologies this can be down to an illness, virus and heating the testicles too much, or chemical exposure Please read the ground breaking book by Dr Shanna Swan ‘ Count down’ about chemicals that can affect sperm if this is the case as there are some changes that need to happen on an environmental level taking out everyday chemicals. When you take these things out of the equation things may improve.  Also there is a blog I have written about this for more information here. ( link to blog on chemicals) 

Taking out the things suggested below will help this immensely

Heating the testicles is a sure way to mutate sperm so no lycra pants, saunas or steam rooms and cycling and sitting for long periods of time can boil thing a bit!

Things we can do to improve the shape of sperm:

• Reduce caffeine
• Reducing Alcohol
• Taking out Tobacco and marijuana 
• Maintaining some form of exercise three times weekly as obesity reduces chances of well functioning sperm

Diet wise these things can help

Vitamin C – studies looking at increasing fruit and veg containing vitamin C as well as vitamin E two key antioxidants helps to boost morphology

CoQ10 – works at an energy and mitochondrial levels so will also improve motility and energy of sperm https://pubmed.ncbi.nlm.nih.gov/26500895/ 

Lycopene- used alongside zinc and folate helped improve semen parameters and pregnancy as well as reduce oxidative stress https://pubmed.ncbi.nlm.nih.gov/32111479/ 

Pycnogynol 

A marine pine bark and full of antioxidant possibility has helped not only with morphology but all parameters and also erectile issues https://pubmed.ncbi.nlm.nih.gov/25531191/ 

As in previous blog posts the sperm test is made up of a variety of parameters. These are useful to gage a general view on the health of the male. The WHO set the parameters that all GPS or urologists use regarding a healthy level. Sperm Count is regarded by this to be 15 million per milliliter (ml), or at least 39 million per ejaculate. If this is under 15 milliom this is considered low. As you may expect as testosterone is the driver of this a routine hormone test will show if there are issues with testosterone and other factors like FSH, LH and prolactin. 

 
There may also be a hindering physiological issue that impede sperm getting to larger numbers, which has to be ruled out. But in terms of lifestyle, a good healthy diet is the key starting point. 

Why is this so important surely it only takes 1 sperm to get there? Sadly of the many  millions that are released the more you have the more chances that the calculation of around 50-100 sperm getting to the egg make it as the ‘ best possible winners’ 

Vitamin C

Including vitamin C in your diet through fruit and veggies such as mango, papaya, broccoli, cabbage, kiwi fruit, chilis, potatoes, camu camu, spinach and ontop of this adding in 1,000-mg vitamin C supplements twice a day for up to 2 months increased sperm count by more than 100% https://pubmed.ncbi.nlm.nih.gov/17004914/ 

Also, taking zinc supplements increases testosterone levels and sperm count in those who are low in zinc https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6010824/ 

Folate 

The key to DNA replication is just as important in Men as it is in Women for creating good quality reproductive ‘money makers’ you can get folate in leafy green such as  Kale, cabbage, Watercress,  Brocholi, Beans and legumes like chickpeas/garbanzas spinach, Brussel sprouts and spouted broccoli seeds, Beetroots or beet greens. Also organ meat like liver is a great source  https://pubmed.ncbi.nlm.nih.gov/11172823/ 

Selenium is needed to make healthy sperm and boost count. Foods such as Brazil nuts, fish, meat and eggs provide selenium.

Vitamin D

In a 2018 review low levels of vitamin D can have an effect on fertility. The best way to increase this in diet is oily boney fish. But in terms of sunlight this is the gold standard to improve levels. However in most cases like thos who live in colder climates that rarely tips the mercery higher than a fewq weeks a year a vitamin D supplement to therapeutic levels is needed. 

https://pubmed.ncbi.nlm.nih.gov/31561004/

Semen parameters

Although some cases of male fertility are due to physical reasons such as varicoceles or block ducts etc it is estimated that 40-90% are due to poor semen quality.

How do we know this. – we test always!

There are many parts to a Semen or Sperm test. 

The WHO hasn’t changed it’s criteria on since 2010, but I have seen varying parameters even in NHS test. I rarely see a good one these days so anecdotally can corroborate that levels are going down. 

A semen analysis tests for the following:

• number of sperm (volume)
• shape of sperm
• movement of sperm, or  sperm motility 

Amount.

A normal amount is between 1.5 – 5 mL, or between ¼ – 1 teaspoon. 

Viscosity

Looking for a good liquid balance not too clumpy which can hinder sperm on the journey. Usual response – normal or abnormal. 

Liquefaction 

Needs to happen by 20 mins- if taking longer there maybe and issue that needs looking into. 

Total sperm

WHO numbers – 39 million plus for a good example. 

Concentration .

WHO state that the concentration per sample needs to be jam packed to the tune of 15-20 million. If lower in IVF they recommend ICSI instead. 

Motility

How many sperm are motile. This needs to be 50+% I always laugh when clients talk about this as they call this ‘mobility’ I imagine sperm on scooters! ????

Total motile count

This should be 20-40 million moving. If it’s less and there are morphology ( shape and mutations) they may suggest ICSI if going for IVF. 

Morphology 

Shape of sperm. Should be over 4% good morphology ideally 9+.  If lots of tail, double heads and neck issues this can mean something needs to be addressed lifestyle wise.

PH

The vagina, is very acidic to ward off infection so sperm pH needs to range between 7.2 and 8 according to WHO. Ideally less than 8, but this is still acceptable.

Testing is always a must in my clinic and it’s not just about the ladies! If there have been miscarriages one of the first things I ask the couple to do is to test the sperm.

morphology which was found to be higher in the winter and spring compared to the summer. 

For the latest WHO document detailing this to a greater degree  click here