Practically Fertile

Episode 5 - What the New Research Says About Exercise and Sperm Quality

• Dr. Adrienne Wei, DACM, FABORM, CFN, L.Ac.

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We’re switching gears to talk about male fertility—the other part of the equation to get pregnant. It's a well-known fact that over 40% of infertility cases are caused by issues with sperm.  We'll explore in this episode:

  • The state of sperm quality decline
  • Possible causes of this steady decline 
  • The Frog Study
  • Which level of exercise is best for sperm quality

Follow me on instagram @dradriennewei

Website: www.adriennewei.com

Speaker 1:

Welcome to the Practically Fertile Podcast. I'm Adrienne Wee, doctor of acupuncture and Chinese medicine, functional medicine practitioner and functional nutritionist. I specialize in using an evidence-based method, blending principles of East Asian medicine and modern functional medicine to help women optimize fertility and get pregnant. I believe in a world where every woman who wants to be a mother becomes one. If you're tired of being told that you're infertile and you want to take the right steps to get pregnant naturally and quickly, this podcast is for you. Hey, fertile friend, we're going to switch gears a little bit today and talk about male infertility. After all, the sperm is just as important as the egg, and male infertility is on the rise. More than 40% of infertility cases are now caused by issues with a sperm. So for this reason, before I get into the nitty-gritty, I think that you should be proactive and test the sperm before you get to that one-year mark. Should be proactive and test the sperm before you get to that one-year mark. I can't tell you how many times I've worked with patients who go through a lot of emotional distress, feeling like a failure and at the end, the problem is with the sperm. And a lot of doctors do not proactively test sperm until you get to that one year of trying to conceive, mark, because that's the technical definition of infertility if you've been trying for longer than one year. But I want to share with you a super easy way to do this test without going to the doctor. There's actually an at-home sperm testing kit from a company called FELLOW F-E-L-L-O-W. I'm not a partner and they're not paying me anything, so this is not an advertisement for them. I just recommend it to my patients and many of them are very happy that they tested the sperm early, and giving a sample at home is probably a lot less awkward than having to go to a doctor's office. So the website is called meetfellowcom M-E-E-T-F-E-L-L-O-Wcom. Again, fellow is not paying me to say anything and they don't even know who I am, and I just think that this is one thing that you can check off the box and make sure that there aren't any issues.

Speaker 1:

Now there are many factors that affect sperm quality, but I specifically want to talk about exercise and sperm quality today. Because I specifically want to talk about exercise and sperm quality today? Because I hear this a lot. My husband is super conscious about what he eats and he works out every single day, so I think he is really healthy. The reality is healthy doesn't always mean fertile. A healthy diet isn't always a fertile diet. A healthy lifestyle isn't always a fertile diet. A healthy lifestyle isn't always a fertile lifestyle. There's such a thing as too much of a good thing and turns out there is a sweet spot for exercising that's optimal for sperm quality.

Speaker 1:

Now, before I get into the details, I do want to talk about the rise of male factor-related infertility. How do we get here? I don't know if you know, but the World Healthulate motility morphology, which is the normal number of sperm. So back in 1980, when these parameters were first introduced, what was considered normal was the following A volume per ejaculate greater than 2 milliliters, count greater than 40 million, motility greater than 50% and morphology greater than 50%. This was the first edition and then there have been five more iterations since then. Right now we're using the sixth edition and the current standards are this Volume greater than 1.4 milliliters, so a little bit of a decrease from 1980. Count greater than 39 million, so not too big of a change. Motility greater than 42%, versus 50% back in 1980. And sperm morphology greater than 4% is now considered normal. So the number of normal sperm went from 50% to 4% from 1980 to 2021. What was considered normal in 1980 has dropped off significantly. How did that happen? Of course, many reasons the environment, poor diet, toxin exposure, stress. There's this very well-known study called the frog study. It's not really called that, but it's known as the frog study because the frogs were the study subjects. In 1997, the EPA wanted to find out the environmental impact of atrazine.

Speaker 1:

Atrazine is a popular herbicide. It's used to control weed for corn and sugarcane crops. Corn is a huge industry because of high fructose corn syrup, so there's a large demand for corn. This researcher by the name of Dr Hayes, tyrone Hayes. He did a study and the results showed reproductive damage to frogs. Just a little bit of atrazine 0.1 parts per billion was enough to cause male frogs to produce eggs in the testes and start to become more feminine. And that's because atrazine disrupts an enzyme called aromatase. Aromatase is what converts testosterone to estrogen and the research showed that, if this disruption is severe enough, there were cases of feminization and sex reversal in frogs. Pretty scary. The concern is if the atrazine in water source is affecting wildlife, it could affect humans too. But this chemical, atrazine, is still used today. The EPA didn't ban the chemical because, you guessed it, the companies that make atrazine through a huge fit did their own study that's most likely biased and said Dr Hayes' research is not correct. Of course they have an interest to keep making atrazine. They don't want to go out of business. And this is just one example of hormone disrupting chemicals, how they can affect our health by getting into the water supply.

Speaker 1:

Let me give you another example. My husband and I the other day picked up a jar of this fancy pickled vegetables for a charcuterie board and I saw that it was imported from Greece. So I'm like, ooh, super fancy. I didn't read the ingredients because I thought what could possibly be in there? That's bad. It's just vinegar. It's just pickled vegetables. Of course, after I got home and I was preparing the charcuterie board, I read the ingredients and at first everything seemed normal just vegetables and vinegar. But at the very end it says yellow number five. Why on earth would a jar of vegetables need to have a yellow tint? Why is it even added? What value does it add? And I will bet money on it that this very same jar will not have yellow number five if it's sold in Greece, because yellow number five is not allowed in the EU.

Speaker 1:

The point of my rant is this we have to be more diligent in the US and other countries to make sure that we're reading labels and we're not consuming endocrine disrupting chemicals because our regulations are more relaxed here. I have my opinions on why that is, and we'll save it for another day, but we're exposed to more chemicals today than ever, and one of the areas of health that's affected is, unfortunately, our fertility. Let's go back to the sperm quality decline over the last 40 years. I want to share the results from this particular study on physical activity and sperm quality because up until now I haven't seen a lot of data on it. A few studies do exist, but they have a lot of variables. They weren't well controlled, so it was hard to trust the data, and I feel like so many men also feel like they need to worry less about hormones because sperm production is continuous and lifelong, so they feel like they have less to worry about. But that's not the case. As we just talked about it a few minutes ago, sperm quality is an all-time low.

Speaker 1:

So this study was done with 143 young and healthy men aged 18 to 25. So these are not men who are trying to conceive, who might be slightly older, and in this study they used the term physical activity instead of exercise, because exercise is a very specific way of moving the body and you're trying to make a change. You're hoping for a change in metabolism, body composition or you want to improve athletic performance. So the researchers didn't restrict the type of activities for the participants. They accounted for any physical activity and lumped them all together. So from running intensely for hours to something small like vacuuming around the house.

Speaker 1:

In this podcast I'm going to use PA for physical activity, because otherwise it becomes a mouthful. So the PAs were divided into three categories low, moderate and intense and each PA was matched to what's known as the MET, m-e-t, the metabolic equivalent of tasks, and the MET measures how much energy a person uses during a particular activity. This is something I teach inside my course because when I talk to patients about exercising, everyone's definition of low versus intense activity is so different. It is way easier to use the MET as a way to measure intensity. Basically, if an activity has a MET score of over six, that's considered intense. There is a difference between jogging at a pace of 2 miles per hour versus 8 miles per hour. A MET value of 1 to 2 will be considered low intensity, like vacuuming, because it doesn't use a lot of energy. Also, in this study, they took into consideration the frequency and duration of each type of activity. The participants can do whatever activity they wanted throughout the week. The MET value and how many minutes and how many times a week were all part of the equation.

Speaker 1:

These are the results from the study, and the researchers measured the quality of the sperm based on the WHO guidelines. The volume of the sample was about the same across the board between the three groups. The group that was sedentary had the highest sperm count, coming in at 80 million, but they also had the lowest motility, at 37%. The intense activity group had the next highest sperm count, at 66 million, and the moderate group had 53 million. The motility in the moderate and intense groups were not all that different 47% and 45% respectively.

Speaker 1:

What was most shocking was the morphology, since we typically associate exercise with being healthy and assume that the more exercise, the healthier the person. But what the study revealed was the intense activity group did not have the highest morphology, it was the moderate activity group. This group the moderate group, averaged about five hours a week, with activities like walking at a pace of three to four miles per hour, playing double tennis matches, yoga, dancing, recreational swimming, biking at 10 miles per hour or less and yard work. The morphology was 7% for this group, 6% for the intense PA group and 5% for the low PA group, and I know that this is only a 1 or 2% difference, but when you're talking about millions of sperm, that's a lot of sperm.

Speaker 1:

The theory about why high-intensity PA might be damaging for sperm is because intense activities do cause a lot of oxidative stress and inflammation. Also, depending on the athletic wear, some can be very restrictive and put a lot of pressure on the testes. The results from this study tell us that physical activity, the type, the duration and the frequency all matter. You can participate in a very intense activity like lifting heavy weights for an hour, but if you're doing that once a week, it's going to be better than training for a marathon that requires intense running 10 hours a week. Now, does this mean, if your husband is currently working out every single day and lifting weights for an hour each day, that he should all of a sudden stop? No, he doesn't have to stop. But here's something to think about. If the sperm quality is already an issue, then he might want to consider toning down the intensity and frequency and dial it down to a more moderate level. On the other hand, if he's sedentary and he's not really moving around, then he will need to dial up the activity a bit.

Speaker 1:

If sperm quality isn't the issue at the moment, it doesn't mean that you have a free pass. It can certainly mean that three months from now mean that you have a free pass. It can certainly mean that three months from now, the script could be flipped and it's a whole different story. All right, we're about to wrap up this episode Now. For some men, this might seem restrictive, especially if they're used to a certain lifestyle, and there could be some resistance to this. But I think that this does need to be a conversation to be had, as uncomfortable as it is.

Speaker 1:

What I consistently see is women are doing most of the work when it comes to trying to get pregnant, changing diet, researching supplements, going to appointments, joining support groups, but men have to pull their weight as well. You are a team. You can't accomplish any goals when it's just one person who is doing all the work. If you have any questions about this episode, please feel free to contact me. Send me a text, email me, send me a DM on Instagram. All right, fertile friend. If you found this episode helpful, please subscribe and share it with somebody who might benefit and, until next time, take care of yourself and your amazing body. You are one fertile cycle away from getting pregnant.