One in five couples in the UAE face infertility-related issues. In almost 50 percent of the cases, men are the causative factor, according to a study of UAE males, both expatriates and Emiratis.

The issue of male infertility is, in fact, a worldwide issue as reported by several studies and the causes are mainly related to modern-day lifestyle matters such as obesity, diabetes, smoking and stress.

When it comes to male infertility, many causal factors require medical management and consultation with a specialist but there are some modifiable lifestyle changes that have shown to influence sperm count, mobility and morphology. This article, we want to address those factors with health tips for optimizing your fertility.

Smoking – Cigarette smoking has been proven to cause reduced semen quality, as shown by data obtained from heavy smokers (>20 cigarettes a day) with low sperm counts and low sperm quality. Smoking has been shown to increase the levels of reactive oxygen species (ROS) that cause an increase in oxidative stress, DNA damage and cellular death. All these cause a decrease in sperm production, sperm concentration, and semen quality. Heavy smokers have been shown to have 13-17% lower sperm concentrations than non-smokers. TAKE HOME MESSAGE: Stop smoking. It takes some time for the detrimental effects of smoking to decrease. Just a few days or weeks of cessation will not be enough.

Alcohol – Alcohol seems to cause a disruption in all the vital hormones involved in male fertility (the Hypothalamus-Pituitary Gonadal (HPG) axis hence the levels of GnRH, FSH, LH, and testosterone) Leydig and Sertoli cells that are the main functioning cells in your testicles are impaired and cause a decrease in semen quality and levels of male reproductive hormones. Chronic alcohol use has shown to decrease testicular steroidogenic (endogenous steroid production) and antioxidant enzyme activities causing an increase in oxidative stress. TAKE HOME MESSAGE: Stop or at least minimize alcohol intake.

Substance abuse – Marijuana, Opioid, Anabolic steroid use, Cocaine, can all cause significant changes in testicular ultrastructure, impairing spermatogenesis and reducing sperm count and motility. TAKE HOME MESSAGE: Stay away from drugs

Obesity– Studies have shown that men who are obese (BMI >30) have a higher percentage of damaged sperm (with DNA fragmentation, abnormal morphology and increased levels of ROS). In individuals with higher amounts of white adipose tissue, testosterone is converted into estrogen which affects the hormonal axis and reduces substances that stimulate testicles for more sperm production (gonadotrophins). TAKE HOME MESSAGE: An ideal BMI is 18.5-24.9 kg/m2. Do not skip your exercise and cut on those fries…

Psychological stress – Stress has been shown to have detrimental effects on all bodily systems. Sperm production is actually one of the most affected. TAKE HOME MESSAGE: Life is full of stressful events find a way to deal with them. Do sports, do yoga, learn relaxation techniques or it can’t cope with them yourself please don’t hesitate to ask for professional assistance.

Diet – Dietary intake has been shown to be quite influential when it comes to male fertility. Many vitamins and minerals have been shown to enhance sperm production, motility, and quality. Diets rich in Omega 3 fatty acids, antioxidants, Vitamins, and low in saturated fats have proved beneficial in raising sperm count and quality. Foods such as fish, fruits, vegetables, cereals should all be included in the diet plan. Folate-rich foods have also been shown to be helpful. Examples of such foods that are rich in folate are; leafy vegetables, broccoli, beans, avocadoes, nuts, and seeds. TAKE HOME MESSAGE: Eat healthily, try to stay away from too commercial products and lean towards more organic food with fewer hormones’ used in their production.

Genital heat stress – Exposure to heat for prolonged periods can negatively affect sperm count. At higher temperatures, the testes cannot function properly causing spermatogenic arrest, oxidative stress, and sperm DNA damage. The male testes function optimally at a temperature slightly lower than the body’s own temperature, which is why they are so conveniently located in the scrotum and not intra abdominally.

Hot baths, saunas, and Jacuzzis should be avoided for those concerned with their sperm counts.

Laptops should also preferably be used on a table or on a stand which prohibits direct heat radiation to the scrotal area. Prolonged heat exposure from the laptop itself can cause testicular heat stress.

Cycling has also been shown to cause an increase in genital heat exposure and testicular heat stress.

It is advisable to wear loose fitting clothing to allow for better aeration of the scrotal region.

And the medically most important cause of heat effect is a condition that is called varicocele. This is a type of blood vessel enlargement, thus increasing the amount of blood associated heat to the testicles. If you find enlargement in the area where your testicular blood vessels enter the inguinal canal or if you have pain in your testicles please go to a urologist. TAKE HOME MESSAGE: It is not easy to avoid heat in UAE but take simple precautions mentioned above and if you have any doubts please go to a urology specialist.

Sleep – Sleep is vital for normal body functioning. During sleep, hormones are released and the body rejuvenates. Therefore, it is vital to get enough and good quality sleep at night. TAKE HOME MESSAGE: Please spare yourself good sleep time. You can watch the late night shows re-runs during the weekend daytime… If you are waking up tired and feel sleepy all day even though you have slept enough, you might have some sort of sleep disorder that diminishes your sleep quality. Consult a doctor for this condition.

Avoid contact with heavy metals – Some metals that have been shown to negatively influence male fertility are lead and mercuryMercury disrupts spermatogenesis in men and fetal development in females while lead causes HPG disruption and infertility. TAKE HOME MESSAGE: It is not easy every day to contact these metals. But beware of shellfish harvested from polluted waters, ask your landlord about lead-based paints. If you are working in a heavy metal industry please check your sperm counts regularly.

Radiation – X-rays, and gamma rays both cause male infertility. The dose of exposure usually correlating to the severity of spermatogenic arrest. Did you know that some appliances regularly placed in our everyday life produce radiation? Most important of them are TV’s, mobile phones, computer screens, and microwave ovens. TAKE HOME MESSAGES: Watch the TV from a distance of at least 2 meters, Do. not put your phones in your trousers front pockets. Do not stare and stand in front of the microwaves when they are on.

Regular exercise should be incorporated into daily activities. Benefits have been proven. But keep in mind that hormonal drugs to enhance bodybuilding has very bad effects that can sometimes be irreversible for testicular functions. TAKE HOME MESSAGE: Exercise should be an adjunct to your life, not an aim. Do not forget using medications to improve your muscles actually decreases your manhood.