Posts Tagged ‘sperm production’

Public Enemy #1 for Male Fertility: Anabolic Steroids

Anabolic steroids, such as testosterone and its derivatives, are often taken by athletes to get “pumped.”

But these drugs have a unique side effect — they can shrink a man’s testicles and drastically reduce his fertility.

One of the more serious side effects of these poisonous chemicals is on male reproductive organs, says Marc Goldstein, MD, director of the Center for Male Reproductive Medicine and Microsurgery and surgeon-in-chief of male reproductive medicine and surgery at Weill Cornell Medical Center.

“Because of the high level of circulating testosterone caused by the steroids, the testicles no longer need to manufacture this hormone, so they being to shrink.

This reduces sperm production and may lead to both impotence and sterility,” says Dr. Goldstein.

In a new article posted on the American Fertility Association website, Stanton C. Honig, MD, Associate Clinical Professor of Surgery/Urology and Obstetrics and Gynecology at the University of Connecticut School of Medicine, examines how anabolic steroids affect male fertility.

“The use of anabolic steroids historically has been used by athletes in major sports, such as weight lifting, baseball and football,” writes Dr. Honig, who is also a Staff Urologist at Yale New Haven Hospital and the Hospital of St. Raphael in New Haven, CT.

“Because these so-called ‘role models’ use these drugs, anabolic steroid use or abuse has filtered down and is being used by recreational weight lifters, college, and high school athletes.”

The good news is that in many cases this problem is reversible, Dr. Honig says.

Once performance enhancing drugs (PEDs) such as steroids are stopped, sperm production may start again and sperm will return in the ejaculate, usually in about 3 months.

However, for those who have used steroids for years, this may take up to 2 years.

Once steroids are stopped, medical therapy may help enhance the ability of a man’s body to restart sperm production.

What’s more, PEDs can also cause sexual dysfunction, Dr. Honig notes.

When testosterone levels crash, this may lead to tiredness, loss of energy, and loss of sex drive.

“The most important point here is if you want to have children at some point in your life, DON’T USE ANABOLIC STEROIDS!!!” Dr. Honig admonishes.

And Dr. Goldstein agrees: “If you want to preserve your fertility, do not use anabolic steroids.”

In fact, testosterone has been successfully used as a contraceptive for men, he notes.

Upgrading Fertility Status with Varicocele Repair

The most common identifiable cause of infertility in men is a varicocele.

Approximately one third of infertile men who have never fathered a child have a varicocele, and up to 80% of men who were once fertile, but are now infertile, also have a varicocele.

Varicoceles are abnormally enlarged veins draining the testicles.

They cause pooling of blood in the scrotum and a rise in testicular temperature.

Even one degree rise in temperature in the scrotum can have an adverse effect on sperm production and testosterone function.

The good news is that varicoceles are treatable, writes Marc Goldstein, MD, who is the Matthew P. Hardy Distinguished Professor of Reproductive Medicine and Urology at the Weill Cornell Medical College of Cornell University, and Surgeon-in-Chief, Male Reproductive Medicine and Surgery at the New York Presbyterian Hospital, Weill Cornell Medical Center in New York, in a blog for the American Fertility Association.

“Dozens of reports have been published demonstrating the benefit of varicocele surgery to improve sperm counts,” writes Dr. Goldstein, who is also co-author of the book A Baby at Last!.

“Yet, varicocele repair remains controversial, particularly for small varicoceles that can’t be seen or felt on a physical exam.

Studies have shown greater improvements in semen quality for repair of large varicoceles compared with smaller ones.”

Dr. Goldstein details how he developed a microsurgical technique of varicocele repair using an operating microscope.

This technique can help couples achieve a 43% pregnancy rate after 1 year.

Microsurgical varicocele repair also:

— decreases sperm fragmentation, or the breaking up of DNA strands into pieces

— may cost less than in vitro fertilization with a single sperm injection (intracytoplasmic sperm injection, or ICSI)

— can induce sperm formation and help achieve pregnancy for couples in which the man has a zero sperm count (azoospermia) or a severely low sperm count and low sperm motility

— improve testosterone levels in two-thirds of men

“In conclusion, varicocele repair is a cost-effective treatment of infertility,” writes Dr. Goldstein.

“Men can upgrade to normal semen, which can allow for a natural pregnancy, or upgrade to semen of adequate quality for intrauterine insemination.

Men with azoospermia may produce ejaculated sperm adequate for ICSI.

Even if a man remains azoospermic, varicocele repair may enhance spermatogenesis allowing enough sperm production for ICSI.

Finally, microsurgical varicocelectomy will improve testosterone levels in a majority of men, which is a men’s health issue aside from fertility.”

No Need to Stress Out Over Fertility

Does stress affect fertility?

A body of evidence continues to build about the effects of chronic stress on a woman’s ovulation and a man’s sperm production. Stress may lead to a cascade of hormonal events that led to inhibition of the body’s central reproductive hormone signal, and subsequently disturb ovulation or sperm production and sexual activity, write Weill Cornell fertility doctors Drs. Zev Rosenwaks and Marc Goldstein in A Baby at Last!

Humans are designed to endure acute stress. That’s a part of life. But the significant amount of stress couples endure, cycle after cycle, as they attempt to conceive may disrupt reproductive function. Normal fitness and diet routines may fall by the wayside, leading to a more frazzled, stressed lifestyle. Putting this into Eastern philosophic terms, if you are not in harmony with yourself and your culture, you are stressed.

However in studies attempting to make a direct connection between stress and lower in vitro fertilization success rates, the results are mixed.

A new meta-analysis of 14 studies and more than 3,500 infertile women undergoing assisted reproductive treatment found emotional distress did not affect their chances of becoming pregnant. In the Feb. 24, 2011 online edition of the British Medical Journal, Cardiff University psychologists conclude: “The findings of this meta-analysis should reassure women and doctors that emotional distress caused by fertility problems or other life events co-occurring with treatment will not compromise the chance of becoming pregnant.”

We still need more information to determine the exact relationship between stress and its effects. It may be helpful for couples to know that anxiety and depression won’t necessarily ruin their chances of having a baby.