Scientists have experimented with growing sperm cells in a lab before, in petri dishes. But they didn’t succeed, because the sperm wouldn’t go through all the necessary developmental stages. Turek says sperm go through about 12 different steps before they are fully formed.  Unfortunately, previous attempts only led to stages 9 or 10. So, rather than trying to form sperm cells from scratch, he and his team will try to ”recreate the testicle in an artificial environment, with all of its components”.

Turek explained how his team plans to develop this sperm-creating machine, saying that they will first focus on so-called Sertoli cells — which play a large role in sperm development. They will them add stem cells, which can be turned into any other kind of cells. The researchers planned to add genes to make sure the cells will develop on the right track.

The process is certainly very complex, and others inside the medical community have called Turek’s project “ambitious”. Cord blood banking has made the availability of embryonic stem cells more widespread, but infertile men who need treatment now won’t have that luxury. Instead, scientists will have to take stem cells from their skin and “turn back the clock” on these cells. It sure doesn’t sound like all of this will come to pass very soon, but it sounds fascinating and like a potential hope for infertile couples in the future.

If you like the idea of “artificial testicles”, you will also be fascinated by artificial ovaries to help cancer patients get pregnant.

Photo credit: Wellcome images via Flickr Creative Commons.

The study team took a detailed look at 500 couples in China who were trying to conceive without any success. The couples where the male partner possessed two copies of the defective gene were found to have a 30 percent increased chance of fertility problems, and were much less likely to get their partner pregnant within two years of trying. Those who did get pregnant, even with two copies of the said gene, took an average of two months longer to conceive.

While the study team made it clear that the exact connection between this gene and male fertility is not yet certain, the missing protein certainly seems to make achieving pregnancy more difficult and in some cases perhaps not possible. Lead author on this study, Gerry Cherr, said: “Our data suggests a likelihood or probability that couples are unable to conceive in the twelve-months window will increase significantly if men lack the normal gene.”

Cherr is a professor of environmental toxicology and nutrition at the University of California, and he added that a lack of the protein alone is probably no reason to believe a man is infertile. Other factors, like sperm count, motility and morphology are also important – and they all contribute to the whole picture of a man’s fertility.

This is certainly fascinating news and something that couples who have been struggling to get pregnant may like to keep in mind.

A low sperm count can be caused by many things, but there are few symptoms. In some cases, the solution is as simple as quitting smoking and living a more healthy life. Other men who have oligospermia suffer from underlying medical conditions that are not as easy to treat. Men who have had previous testicle or scrotum surgery and have been trying to conceive with no success should seek medical help earlier, for instance. Those with painful and swollen testicles, or those who are suffering from erectile dysfunction, also need medical care. But for many, a low sperm count has no symptoms, and the only indication is infertility – the inability to conceive a child after trying for more than a year.

Hormonal imbalances, tumors, antibodies that attack the man’s own sperm, an infection, or a varicocele are among medical causes of oligospermia. Environmental causes include smoking, exposure to pesticides, overheated testicles (due to clothing that fits too tightly, or hot baths), and heavy metal exposure. But even a vitamin deficiency, stress, or age can contribute to a low sperm count.

The treatment of oligospermia is of course dependent on the underlying cause. In many cases, it is possible to solve the problem and boost sperm count. When this is not possible, Intrauterine insemination, or in more severe cases IVF in combination with Intracystoplasmic Sperm Injection, may enable a man with a low sperm count to have a child.

Every 70 to 90 minutes of every day the hypothalamus, a gland in the brain, sends a pulse of gonadotrophin releasing hormone (GnRH) to another gland in the brain known as the pituitary. The pituitary in turn sends follicle stimulating hormone (FSH) to the testes, where the hormone stimulates the maturation of long stalks known as follicles which eventually release hormone.

Because the trigger to produce sperm originates in the brain, simple practices that enhance brain health also enhance male fertility. When men get more sleep, for instance, the hypothalamus releases more of the GnRH that triggers the release of FSH. Getting more sleep can actually be more useful than getting testosterone injections, because high testosterone levels actually shut down the production of GnRH.

It also helps to sleep in the dark, without a light or night light on. What could sleeping in the dark have to do with male fertility?

It’s not about the relationship of darkness (or light) to the frequency of sexual intercourse. Sexual intercourse, after all, has to be timed to the woman’s optimum fertility for pregnancy to be achieved. The important of sleeping in a totally dark room to a man’s fertility is that the brain can only make melatonin, the sleep hormone, when the eyes do not receive even the slightest amount of blue light.

Even the amount of light a man can see with his eyes shut is enough to interrupt the production of melatonin. A study reported in the journal Andrology, however, found that men who take supplemental melatonin before going to bed enjoy increased sperm count and sperm quality. As little as 1 mg is enough, and melatonin should only be taken before going to bed.

Sometimes male infertility can be corrected by taking label-directed doses of the B vitamin folic acid (folate) and L-carnitine, plus about 60 mg of a zinc supplement every day. Danish studies have found that infertile men who don’t suffer deficiencies of these nutrients sometimes gain enough added sperm count to become fathers when they supplement.

Any man who does not have azoospermia, that is, who has a low but non-zero sperm count, of course, can increase the number of sperm per ejaculation by refraining from ejaculation for 1 to 4 days before having intercourse with the intent of conceiving a child.  At least 1 day is necessary to make a difference, but abstaining from intercourse or ejaculation for more than 4 days will not further increase sperm count for timed  intercourse done while trying to conceive.

Morphology? What is that? If you are asking yourself this question, you are not alone. While most people have heard of sperm count, the other factors that contribute to male fertility, including motility (which will be another topic!) and morphology, are not something the majority of us have ever needed to learn about.

Morphology looks at the size, shape and structure of sperm. Normal, healthy sperm have a long tail, and an oval head. I am sure that you have seen this image before! When sperm is abnormal, they can either have a head that is not shaped correctly, or they have a tail that is too short, or even a double tail. Every man has some sperm that are shaped abnormally. This is completely normal.

Only when a large percentage of a man’s sperm are abnormally shaped is fertility affected.  If a semen analysis showed morphology problems, your doctor may suggest some lifestyle changes, and order another sperm test at a later date, usually around six weeks after the first one. Temporary causes of an abnormal morphology include, but are not limited to, an infected anywhere in the body, a fever, the use of prescription drugs, and enlarged veins in the scrotum.

Even men with large numbers of abnormally-shaped sperm do not have to be completely infertile. They will still usually have a certain amount of healthy sperm, that can fertilize an egg. However, conceiving is statistically likely to take a lot longer in such cases, and sometimes, medical assistance is necessary.

As the term suggests, male secondary infertility refers to cases where male half of a couple is struggling with infertility. How is this determined? Fertility testing procedures are no different for couples who face secondary infertility. Both partners will go a through physical screening, and for the male partner semen analysis will normally be carried out. These tests will often reveal the cause behind a couple’s infertility, so that a course of action can be discussed.

Male infertility can be caused by a number of factors including a low sperm count, morphology and motility. A low sperm count means that there are too few sperm in one ejaculation to provide reasonable odds of pregnancy, and motility and morphology refer to the speed and shape of sperm. All of these factors play key roles in male fertility.

The goods news is that health has a huge impact on male fertility, and that lifestyle changes can often go a long way when a man wants to boost his fertility. A healthy and balanced diet, including foods that specifically increase fertility, can greatly improve sperm quality. Quitting smoking, cutting down on alcohol and caffeine, and being physically active  all contribute to healthy semen. Reducing stress levels and ensuring the best possible sperm count by having neither too much nor too little intercourse can also be beneficial.

Of course, the mere fact that some men succeed in “curing” their own infertility through lifestyle changes does not mean that all male infertility is the result of less-than-healthy habits, or can be resolved by the patient himself. Sometimes, medical intervention is necessary, even for men experiencing secondary male infertility.

Clomid, the trade name for clomiphene, is commonly prescribed to women who have trouble ovulating. The clomiphene molecule is very similar to estrogen. When clomiphene enters the bloodstream and circulates to the brain, it occupies the same receptors that ordinarily respond to estrogen, but it does not stimulate brain activity the same way as estrogen. This makes Clomid an estrogen blocker.

Blocking estrogen is helpful to women with PCOS who have too much estrogen during the second half of the periods, after ovulation. Sometimes the excess estrogen effectively makes the lining of the uterus too “rough” to receive the fertilized egg. If the egg cannot be implanted, there can be a spontaneous abortion long before the embryo is long enough to be seen with the naked eye. Clomid helps make the uterus more receptive to the fertilized egg, the first step in a successful pregnancy.

Sometimes male infertility benefits from Clomid. The best candidates for Clomid therapy are men who have become temporarily infertile after use of steroid medications, whether they were prescribed for an inflammatory condition of they were used in bodybuilding.

In these men, Clomid is a recovery drug. The doctor may prescribe Clomid as the man is tapering down his steroid dosage so future fatherhood will be possible. In these men, Clomid can increase the volume of semen so that those sperm that are produced can more easily survive the cervical mucus and swim to the opening of the fallopian tube.

Clomid also blocks the effects of injected testosterone that breaks down into estrogen, especially gynecomastia, unusual growth of the breasts in a man.

The other group of men who may benefit from Clomid are those who suffer unusually low testosterone levels due to some systemic illness such as hemochromatosis (iron overload syndrome). In these men who have some condition causing their bodies to produce so much estrogen that the gonads literally shrink, Clomid can block the effects of abnormally high levels of estrogen and allow testosterone to express itself.

The effects of Clomid for raising sperm count may take several months, but some couples report Clomid success in conceiving after raising sperm counts. It is important to remember that in addition to raising sperm count, conception will only be possible if intercourse is carefully timed.

What conclusions to you arrive at from those simple facts? What do you do when you have been trying to get pregnant, and are wondering why it is not happening? Many couples don’t feel comfortable with going to the doctor as soon as the 12 month mark has hit, and would like to know if there is anything else they can do to find out what causes their infertility, and perhaps even cure it.

When it comes to male infertility, lifestyle factors are often at play. Quitting the use of substances that harm fertility and sperm (alcohol, cigarettes, coffee, fast food) and eating the right foods, that improve the quality of sperm, sperm count, and morphology and motility, certainly hold potential for many men. Simply changing your eating habits may just do the trick for you.

But of course, when a couple has trouble conceiving, they want to know what is causing the infertility. More and more men are asking themselves if there is anything they can do in terms of infertility testing, without a doctor involved. Just recently, that would have sounded like utopia. How could you possible determine what the cause of your infertility is, or even which partner has a problem, without medical help?

That is going to change soon. This month, a new male fertility testing kit was approved, and it should already be available to buy online. If you wait a little longer, you will be able to buy “SpermCheck Fertility” in pharmacies across the United States. The new at-home male fertility tests check a man’s sperm count. I’m sure that I have no need to mention here that a low sperm count is not the only thing that can cause male infertility, but checking this figure is a start in the right direction.

If you find out through this DIY sperm count test that your sperm count (or that of your partner) is low, you can seek help for that. If sperm count is not the problem, you might want to go to the doctor for additional testing.

The idea used to be that if men had high levels of FSH, then they did not have obstructive azoospermia. That is, if a man’s body was trying really hard to make sperm, sending out more and more FSH, then there was no possibility of finding “pockets” of sperm production that in turn could be used in in vitro fertilization.

Nowadays many doctors will save the expense of FSH testing and go straight to biopsy. However, before you authorize this procedure, make doubly sure your doctor has eliminated the possibility that you have obstructive azoospermia. Surgical treatment of a problem with a vein can be far more successful and far less expensive than IVF.

Generally speaking, “alternative” methods of azoospermia as a cause of male infertility are not a wise investment of money. Many clinics in India advertise “discount” male infertility treatment, which turns out to be yoga instruction.

Herbal remedies occasionally help obstructive azoospermia, but they need to be prescribed by an herbalist with specific knowledge of and experience with male infertility. The herbal formulas that treat obstructive azoospermia caused by inflammation after sexual transmitted disease are not the herbal formulas that might restore the testicular “plumbing” after chemotherapy or radiation treatment.

Nutritional supplements are often helpful when the problem is a low sperm count, but they are almost never helpful when the problem is no sperm count. L-carnitine, folic acid, and zinc will not cause problems and they are inexpensive, but no man seeking to become a father who has been diagnosed with azoospermia should rely on nutritional supplements just to save money, when other treatments are available.

Treatment cost is not the only consideration. Make sure you fully understand the possible causes of azoospermia and do not automatically say “yes” when your doctor leads you in the direction of an expensive treatment.

All men should avoid excessive sugar consumption, but men who have low or no sperm counts due to obstructive azoospermia may find sugar restriction especially useful.

Sugar in the diet, along with the arachidonic acid that is highly concentrated in beef, cured meats, luncheon meats, most margarines, and eggs, affect the chemical processes that make pro-inflammatory and anti-inflammatory hormones.

Sugar and arachidonic acid encourage the production of pro-inflammatory hormones. When the problem in male fertility is an obstruction to the “plumbing” that carries the mature sperm to the prostate gland to be incorporated into semen, then inflammation is bad and relieving inflammation is good. Eating less sugar and fewer high-fat protein foods encourages the production of anti-inflammatory hormones that may permit more sperm to reach the prostate gland.

Avoiding sugar is also keenly important when female infertility is due to PCOS, also known as polycystic ovarian syndrome. Although the symptoms of PCOS are tied to the overproduction of testosterone, the overproduction of testosterone is connected to insulin resistance, a condition that can be relieved by consuming less sugar.

The way this works is that some kind of stress – an injury, a long illness, or just years of unrelieved stress – raises blood sugars long enough that cells start to shut out sugar to prevent free radical damage. When cells burn a lot of sugar, they produce a lot toxic byproducts, so they resist the efforts of insulin to carry sugar out of the bloodstream into the cell.

The ovaries, however, are never insulin resistant. Sugar flows into the unimpeded. All the extra energy makes the ovaries work overtime, and one of the results of additional ovarian activity is an excess of testosterone.

Insulin resistance is such a major factor in this form of female infertility that reducing sugar consumption just enough for 2 to 5 pounds of weight loss often is enough to enable conception. Although avoiding sugar is never a guarantee for couples trying to conceive, couples that eat healthy are far more likely to have children sooner than those who do not.