Male Infertility: Therapy

The following recommendations – in the spirit of holistic reproductive medicine – should be implemented before starting reproductive medical therapy.

General measures

  • Regular sex (every 2 days) during a woman’s fertile days increases the likelihood of pregnancy. After ovulation, an egg is fertile for about 12-18 hours. Sperm can survive up to 5 days in the uterus.
  • Notes on the optimal time of conception (conception):
    • Sexual intercourse on the day of ovulation (ovulation): pregnancy rate 33%.
    • Sexual intercourse six days before ovulation: pregnancy rate 5-10%.
    • Fertilization ability of sperm (sperm cells) in the woman’s body: – 2 days.
  • Note: With a waiting period of:
    • < 2-3 days: sperm concentration and sperm motility (mobility) decrease and sperm have less DNA damage (DNA fragmentation).
    • > 5-6 days: decrease in sperm motility and increased DNA damage.

    According to the results of one study, daily sex did not negatively affect sperm quality, whereas long intervals affected important quality parameters (esp. DNA fragmentation).

  • Nicotine restriction (abstaining from tobacco use).
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea).
  • Preferred wearing of boxer shorts: men who wore boxer shorts more frequently, compared with men who preferred other underpants, had 25% higher spermatozoa concentration (95% CI = 7, 31%), 17% higher total spermatozoa count (95% CI = 0, 28%), and 14% lower serum FSH levels (95% CI = -27, -1%).
  • Aim for normal weight!Determination of BMI (body mass index, body mass index) or body composition by electrical impedance analysis.
    • BMI ≥ 25 → participation in a medically supervised weight loss program.
    • Falling below the BMI lower limit (from the age of 19: 19; from the age of 25: 20; from the age of 35: 21; from the age of 45: 22; from the age of 55: 23; from the age of 65: 24) → Participation in a medically supervised program for the underweight.
  • Review of permanent medication due topossible effect on the existing disease.
  • Adequate and restful sleep increases sperm count and concentration. The ideal length of sleep depends on age. Adults should sleep between 7 and 9 hours.
  • Avoidance of psychosocial stress:
    • Stress can reduce sperm concentration and motile sperm count.
  • Avoidance of excessive exercise
  • Avoidance of environmental pollution:
    • Hyperthermia of the testicles – work at the blast furnace, bakery, frequent sauna sessions; heated seats in the car: long and frequent driving with heated car seats can reduce male fertility. This can lead to oligozoospermia (< 15 million spermatozoa per milliliter), asthenozoospermia (reduced motility/mobility (< 32% motile spermatozoa)) and teratozoospermia (reduced proportion of morphologically normal spermatozoa: < 4% normal forms). If all three disorders are present together is called OAT syndrome.Also laptop on the lap or cell phone in the pants can overheat the testicles, which has a negative impact on spermatogenesis.
    • Environmental toxins (occupational substances, environmental chemicals) such as polychlorinated biphenyls (PCBs; halogenated hydrocarbons / toxic chlorine compounds) also affect male fertility – PCBs humans ingest mainly through animal foods.

Conventional non-surgical therapy methods

  • Drug therapy:
    • Hyperprolactinemia
    • Prostatitis (inflammation of the prostate)

Nutritional medicine

  • Nutritional counseling based on nutritional analysis
  • Nutritional recommendations according to a mixed diet taking into account the disease at hand. This means, among other things:
    • A total of 5 servings of fresh vegetables and fruit daily (≥ 400 g; 3 servings of vegetables and 2 servings of fruit).
    • High-fiber diet (whole grains, vegetables).
  • Observance of the following special dietary recommendations:
  • Selection of appropriate food based on the nutritional analysis
  • See also under “Therapy with micronutrients (vital substances)” – if necessary, taking a suitable dietary supplement.
  • Detailed information on nutritional medicine you will receive from us.

Sports Medicine

  • Endurance training (cardio); moderate continuous training (MICT) most significantly improved sperm quality compared with the control group:
    • 8.3% higher ejaculate volume (volume of sperm fluid).
    • 12.4% higher sperm motility (sperm motility).
    • 17.1% better morphology
    • 14.1% higher sperm concentration per milliliter

    Note: One week after regular exercise was discontinued, sperm concentration returned to baseline. The higher motility was maintained for 30 days.

  • Sports such as cycling, swimming, jogging are suitable.
  • Preparation of a fitness or training plan with suitable sports disciplines based on a medical check (health check or athlete check).
  • Detailed information on sports medicine you will receive from us.

Psychotherapy