What causes Teratozoospermia (Part 2)

The more I read up about Teratozoospermia (and not just Teratozoospermia, but male infertility in general), the more i am convinced that Oxidative Stress plays a huge role.

The building blocks behind healthy sperm are quite simple; maintain a healthy weight, exercise regularly (but not to excess), avoid stress and eat a healthy diet of protein, fruit and vegetables. This alone should give a man everything they need to create healthy sperm well into their 40's and 50's. Simple.

But for whatever reason, in some males, there appears to be something happening which impedes the healthy formation of sperm. For a healthy man to have 0% morphology at 33 years old is quite unusual, there must be something else at play, something which is constantly nuking the production process.... And almost every study out there seems to think its Oxidative stress.

There are a few things that (i think) I've come to understand over the last few months which could be impacting me;

1) Oxidative Stress on the testicles is something that can build up over time; The major culprits appear to be

• Alcohol 
• Poor diet
• Excessive heat (in fact i read in some cultures people use excessive heat to sterilise themselves!)

These things cause oxidative stress, which leads to poor sperm morphology.

But there's another source of Oxidative stress, and that's;

• Defective Sperm themselves - They essentially fall to pieces and in doing so, actually cause Oxidative Stress to the other healthy sperm.

So......

More Oxidative Stress means more Defective Sperm
More Defective Sperm leads to more Oxidative Stress

Its a vicious cycle which if left unchecked could totally trash the quality of your sperm.

This article provides a good overview of all things that can impact on sperm quality, it summarises;

"Spermatozoa are vulnerable to ROS (oxidative stress) because their plasma membrane and cytoplasm contain large amounts of polyunsaturated fatty acids.5 Excessive generation of ROS in semen by leukocytes as well as by abnormal spermatozoa could be a cause of infertility."

I think its possible my intake of antioxidants has been so low over the last few years that the build up of Oxidative Stress has pushed my sperm into this vicious cycle from which it cannot escape on its own..

2) Each cell in the body is under constant attack from Free radicals;

"Bruce Ames, a well-known scientist in the field of antioxidants, estimates that just one cell in the human body is hit about 10,000 times a day by a free radical. If that’s multiplied by the trillions of cells in the body the magnitude of this activity is tremendous."

10,000 times per day for each cell! That truly is huge, the one glass of orange juice a week i had on my old diet really wasn't enough to fight this barrage, so its no wonder my sperm production process has fallen into this vicious cycle. 

The 'cure' to all of this definitely appears to be a huge and ongoing dose of a variety of antioxidants, this should be enough to pull the sperm production process out of this funk and get things back on track. Time will tell, the next sperm test is only a few months away!

Selenium (AKA Brazil Nuts)

I'm now taking so many supplements that I'm starting to rattle, however the research continues and the latest discovery relates to Selenium. And it appears as though the jury is out.

When i received by sperm analysis results, the doctor suggested i should eat some brazil nuts and drink green tea, at the time i thanked him for his advice but in my head i was thinking 'no way that's going to make any difference'. Regardless, i started eating the brazil nuts, about a handful a day.

Brazil nuts are apparently extremely high in Selenium, which appears to be very important to the formation of sperm;

"..Selenium protects lipid shell encasing each sperm (prevents lipid peroxidation), which is especially important since sperm have a very delicate fatty acid composition."

Essentially it helps protect the sperm from free radicals.

According to the below supplement sheet, 6 large brazil nuts can contain a whole load of useful nutrients including Vitamin E, Zinc & Magnesium, but most importantly, they contain about 800% of the RDA for Selenium;

That's an extremely high dose of selenium for just 6 brazil nuts, so how many should i be eating exactly?

Well, it seems that nobody really knows for sure. Too little and there's no impact, too much and it can have a negative impact;

A study into a dose of just 0.2mg of Selenium combined with n-acetyl-cysteine (another antioxidant i haven't yet looked into) had a good result;

"after 26 weeks of Se supplementation the mean total sperm count, concentration, normal morphology percentage and motility increased from baseline relative to placebo treatment"

Good stuff, so how about a higher dose?

A study into a dose of 0.3mg Selenium alone had this to say;

"higher Se supplementation (300μg/ day orally) increased serum and seminal plasma Se concentrations but did not affect sperm Se, serum androgen concentrations or sperm parameters [22]. The lack of an increase in sperm Se suggests that testicular Se stores are unresponsive to dietary Se concentrations"

...No major impact. Ok so how about even higher?

This study tried a volume greater than 0.4mg and had this result;

"The fraction of motile sperm in the high-selenium group decreased by 32% by week 13 and ended 18% lower than baseline. Selenium concentrations changed in seminal plasma but not in sperm"

So it appears as though a high dose is a no-go. The studies show an increase in Selenium within the seminal plasma, but not the sperm itself... This suggests to me that the spermies just don't require that much selenium.

This summary sheet provides a good overview of the various Selenium studies out there, it essentially concludes that selenium is most effective at a low dose and combined with antioxidants, particularly vitamin E (which is also present in Brazil nuts).

So exactly how many brazil nuts should i be eating? This website suggests 6-8 brazil nuts can contain about 0.5mg of selenium. I need about half of that apparently, so from now on I'm going to eat just 3 brazil nuts a day for my selenium fix.

Vitamin C

Vitamin C (aka Ascorbic acid), i had no idea how important it was.

In my quest to understand the importance of Antioxidants in improving sperm morphology, I've stumbled across a few useful promising studies.

This study is particularly fascinating, 13 patients with low sperm counts (but normal morphology) were given a whopping 2000mg of vitamin C a day for 2 months, and this was the result;

A huge uptick across the board! Importantly for me though Morphology saw a huge increase, and it appears that the lower the starting morphology, the greater the improvement.

This study also suggested lower levels of vitamin C leads to higher rates of DNA damage within the sperm itself;

"When dietary AA was decreased from 250 to 5 mg/day, the seminal fluid AA decreased by half and the level of oxo8dG in sperm DNA increased 91%."

And this study further confirms that low levels of vitamin C appears to correlate with poor sperm morphology;

"Seminal AA in fertile and infertile (smokers or nonsmokers) males correlated significantly with the percentage of spermatozoa with normal morphology (p<0.01). Seminal AA decreased significantly in infertile men. Decrease of seminal plasma AA is a risk factor for low normal morphology of spermatozoa and idiopathic male infertility"

So I've immediately purchased some chewable vitamin C (500mg) tabs for my ever growing collection of supplements, I'm also going to add more citrus fruits to the diet... Aside from the odd glass of orange juice, this is something that admittedly has been almost totally absent for many, many years now.

CoQ10

I'm buying tome CoQ10.

While trawling the internet for more information on antioxidants, I found a useful summary which provided collection of studies on the effects of anti oxidants on sperm. Most interesting of this was this table, which provides an overview of all the studies, the anti-oxidants, and the results.

This study immediately caught my eye;

"RESULTS:

Mean sperm concentration, sperm progressive motility, and sperm with normal morphology improved significantly after 12-month CoQ(10) therapy by 113.7, 104.8, and 78.9%, respectively (all Ps < 0.05). The overall pregnancy rate was 34.1% within a mean of 8.4 ± 4.7 months.

CONCLUSIONS:

CoQ(10) supplementation improves semen quality with beneficial effect on pregnancy rate."

WOW! CoQ10 can improve sperm morphology by nearly 80%? 34% of participants had a spontaneous pregnancy during the study?! These are incredible figures!

This study was apparently a year long and involved 287 people taking 300mg of CoQ10 twice a day, so this isn't an overnight cure, but its a solid study and a promising start.

I've no idea if my poor sperm morphology is caused by oxidative stress or not, but even if its not, some CoQ10 apparently wont hurt my overall health, all of the CoQ10 studies appeared to have some sort of positive impact on sperm, with the higher doses having the greatest impact, so I'm heading over to Amazon now to do some shopping.

Day 0 - The test results

So today, after 18 months of trying to conceive, I picked up the results of my sperm test.

They're not great;

0% Normal morphology. Zero. The doctor said he's only ever seen one other case like it.

Diagnosis; Severe Teratozoospermia, technically I'm totally infertile.

The doctor informs me Teratozoospermia (aka Teratospermia) is a condition whereby the sperm are simply unable to penetrate the egg due to their shape. In my case the heads are either too big, too small, too long or too short, and the egg just wont allow it. Theres a video on this website which better explains things, anything below 4% morphology and you are classed as having Teratozoospermia.

As things currently stand, 0% morphology suggests i have literally zero chance of getting my wife pregnant, and this thought genuinely saddens me to my very core.

But I've decided I'm not going to sit here and cry about it, I'm going to research the hell out of this condition and I'm going to try and fix it.

I've searched around the internet and cant find much about Teratozoospermia, there're a few websites that provide more information on the condition, but not much support out there from the male perspective (as far as i can see so far anyway). So i figure I'd start a blog to detail my journey. If i happen to stumble across a regime or 'cure' which significantly improves my morphology i figure its best to share it with the world.

The doctor has given me some advice on improving my sperm morphology, and wants to see me again in 3 months for a retest. He said there are a few ray's of hope on my results; The motility (51%) and the volume (437 million) is quite good. Theres a chance a few of my guys are making it to the egg on a regular basis, they just cant crack it.

But If i can get the morphology up to just 1%, that equates to a whopping 4.37 million normal sperm, and our chances of successfully conceiving go up dramatically.

So that's my target, 1%.