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Authors: Winifred Conkling

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Give Yourself Time to Recover from Illness

Your body produces about 50 million sperm each day, but it takes about three months for those sperm to be ready for action. It takes about seventy-eight days for sperm to be produced and twelve days more for them to mature. Any kind of viral illness with a fever—even a bad cold—can lower sperm counts for the full three months. The medications you take to treat an illness can also interfere with sperm production. If you have a normal
or high sperm count, illness may not lower your sperm count enough to interfere with conception. But if your sperm count is more modest, it may be enough to cause temporary infertility. So be patient; give your sperm time to bounce back after an illness.

Take Steps to Manage Diabetes

Diabetes can wreak havoc on your body—and your sex life. The disease can damage sperm production, and it can cause progressive damage to the blood vessels and nerves in the penis, sometimes resulting in impotence. An estimated 22 to 55 percent of all diabetic men are impotent. Some—but not all men—regain their potency when they bring the illness under control, either by exercising and losing weight or by taking supplemental insulin. To protect your fertility, consult your doctor and take steps to control the illness if you are diabetic.

Find Out if You’ve Had Mumps—and Get the Vaccine if You Haven’t

Mumps is a virus that can cause infertility if it reaches the testicles of a male who has passed puberty; severe cases can damage tissue before puberty as well. (Most childhood cases of mumps do not impair fertility.) Not every case leads to sterility; in roughly half the cases,
the virus does not damage the testicles. Other times only one testicle is damaged and the other can compensate.

Fortunately, only about 18 percent of mumps cases occur in men during or past puberty, and in 70 percent of those cases, the virus infects only one testicle. Even if both testicles are affected, when properly treated the disease can usually be stopped before it damages both testicles. In fact, only 5 percent of men who contract mumps become permanently sterile.

If you have not had mumps, talk to your doctor about having a vaccine against the disease.

Treat Varicocele

A varicocele is a varicose vein in the spermatic cord inside the scrotum. These enlarged veins (like those that can form on the backs of the legs) may cause infertility in some men by increasing the temperature inside the testicles. Most varicoceles form above the left testicle in one of the vessels that transport blood from the groin back to the heart.

Varicoceles form deep inside the testicles. While the affected vein cannot be seen, in many cases it can be felt. The condition is said to feel like “a bag of worms” over the top of the testicles. The condition is not painful; in fact, about 8 percent of all men have them, often without experiencing infertility or other problems. However,
researchers have found that the condition in roughly 30 to 40 percent of infertile men, and fully 80 percent of those with varicocele have abnormal sperm profiles.

A varicocele can be tied off surgically. In most cases sperm production improves three to six months after the procedure, and in some men up to a year later. About half of all men who undergo treatment regain their fertility following the surgery.

W
HAT
I
S
“N
ORMAL
” A
NYWAY?

It only takes a single sperm to fertilize an egg, but millions of the little swimmers are present in the ejaculate of fertile men. A normal sperm count includes at least 20 million sperm cells per milliliter of ejaculate, or approximately 150 million to 200 million per ejaculation.

Typically, at least half those sperm are “motile,” or moving forward, rather than swimming in circles. And at least 40 to 50 percent should be normally shaped. Ideally you want to have both quality and quantity when it comes to sperm, but to protect your fertility, it is better to have fewer high-quality sperm than an abundant supply of sub-par sperm.

COUPLES
Try to Reach—and Maintain—a Reasonable Weight

You may not need another reason to worry about your weight, but evidence suggests that being too fat—or too thin—can affect your fertility. In men, being overweight can cause fertility problems because the testicles become surrounded by fatty tissue, making testicular temperatures rise and sperm counts drop. In women, too much or too little body fat can affect hormone levels and interfere with ovulation.

Women’s bodies are particularly susceptible to weight-related fertility problems because women’s fat cells are like tiny estrogen manufacturing plants. While some estrogen is produced in the ovaries, 30 percent of the body’s supply—and 80 percent during certain points of your menstrual cycle—comes from the fat cells. The typical body fat for a fertile woman is 29 percent; a woman’s hormonal system can shut down and she can become infertile if her body fat is more than 10 to 15 percent above or below normal. One study of 276 infertile women with ovulatory dysfunction found that 6 percent of the women had problems because they were overweight, and 6 percent because they were underweight.

Underweight women are often undernourished and
have borderline vitamin and mineral deficiencies. Ultra-thin women often stop having their periods. Also, women who lose 10 to 15 percent of their total body weight (or one-third of their body fat) may stop having periods temporarily. Fortunately, weight gain often helps these women regain their fertility: One study of twenty-nine infertile women (each no more than 91 percent of her ideal body weight) found that those who were able to reach 95 to 100 percent of their ideal weight regained normal ovulation. Within one to three years, twenty-four of twenty-six of these now normal-weight women had become pregnant. Ideally, underweight women who have suffered from amenorrhea (absence of periods) should follow a balanced diet for three or four months after they resume menstruating before they try to conceive.

On the opposite end of the scale, obese women (those more than 20 percent above their ideal weight) produce too much estrogen, which then strains the liver as it tries to break down the excess levels of hormone. The high levels of estrogen also disrupt the hormone system that tells the egg follicle to mature. In fact, oral contraceptive pills take advantage of this hormone response by creating an artificial hormone imbalance. Obese women require higher doses of hormones to induce ovulation than their lean counterparts.

So, how much should you weigh? Your bathroom scale can tell you how much or how little you weigh, but not how fat you are. To assess your body fat, you can calculate your body mass index, or BMI. While bone structure and muscle development can influence accuracy, this method tends to be more reliable than a weight table, and it is accurate enough to give you an idea of whether you have a weight problem that may interfere with conception. Use the following formula:

For example, for a five-foot, seven-inch woman (sixty-seven inches) weighing 135 pounds, the formula would be:

  • If your BMI is 19 or less, you are underweight and may need to gain weight to enhance your fertility.

  • If your BMI is 20 to 25, you are within your healthy weight range and your weight should not cause a fertility problem.

  • If your BMI is 26 to 27, you are somewhat overweight,
    but your weight should not inhibit your fertility;

  • If your BMI is 27.5 to 30, you should lose weight before getting pregnant.

  • If your BMI is above 30, your weight may be affecting your fertility—as well as your overall health. You need to take steps to gradually lose weight, following a low-fat, high-fiber diet rich in fresh vegetables and fruits.

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