Medically, the male role in the I.V.F. cycle involves the sperm retrieval process, which coincides with the woman’s “follicle aspiration” procedure—the procedure used to retrieve the eggs. Men may not realize it, but just as women have a monthly cycle, male sperm production is also cyclical. Basically, what this all means is that it takes time for sperm to mature in the testicles. In fact, there’s even been a recent study to determine exactly how long it takes sperm to be ready for ejaculation. Research performed at the University of California San Francisco found that the time from sperm production in the testicles to ejaculation is anywhere from 42 to 76 days.
What does this mean for men? It means that, just like women, there are things men can do behaviorally and nutritionally in the 42 to 76-day time span before their sperm retrieval for I.V.F. to make sure their sperm are the healthiest they can be. The nutrition and life choices men make in the two to three months prior to I.V.F. treatment could have an impact on sperm counts, sperm motility (ability of the sperm to move to the egg), and sperm health. With this long view in mind, this “Men’s Guide to I.V.F.” is designed to help you make healthy choices before, during, and after your I.V.F. treatment.
Just as women are advised to take steps to prepare for I.V.F., and to prepare their bodies for pregnancy, men can also take steps before sperm retrieval, to ensure that their sperm counts are high and healthy, and to increase emotional well-being during what is, for many couples, an incredibly stressful process. The activities you choose in the weeks prior to your I.V.F. procedure and the decisions you make could impact your sperm count and sperm health. Let’s explore how you can prepare for I.V.F., but first, here’s a quick overview of what the I.V.F. procedure involves.
The I.V.F. procedure involves five medical stages:
- Administration of Fertility Drugs. According to Penn Medicine, during this period, women are given fertility drugs, which includes the Follicle Stimulating Hormone to get the body to produce more than one egg. Normally, the body only produces one egg, but the goal of I.V.F. is to retrieve more eggs to increase a couple’s chances of successful pregnancy.
- Follicular Aspiration. Follicular aspiration is the surgical procedure used to remove the eggs. A day before this procedure, the woman is given a hormone that will result in faster maturation of the eggs. A needle is guided in through the vagina to the ovaries to retrieve the eggs. Penn Medicine notes that women are given medication to prevent discomfort during this procedure.
- Sperm Retrieval. The type of sperm retrieval procedure you will use will depend on your needs. John’s Hopkins Medicine lists the various sperm retrieval types available. While the most common form of sperm retrieval is through masturbation, if men have low sperm count, no sperm count, blockages, or other issues, surgical retrieval may be necessary. Sperm retrieval is typically performed when the egg is harvested, or the day before. Options include masturbation, aspiration, testicular sperm extraction, and other specialized procedures. Aspiration is used when there might be a blockage. A needle is inserted into the testicle to retrieve sperm (with medication provided to reduce discomfort). Testicular sperm extraction involves an incision in the testis to find viable sperm in tubules. This procedure may be performed under general or local anesthesia. Other specialized procedures are available, may require general anesthesia, and depend on patient needs. They include MESA and microTESE.
- Sperm is united with the egg in a culture.
- Embryo Transfer. About three to five days after the sperm is united with the egg (fertilization), the embryos are transferred to the uterus using a catheter (specialized tube). Multiple embryos are transferred in this procedure, which means that if more than one embryo implants, you could potentially have a multiple pregnancy.
While there are five main stages of I.V.F., for the purposes of this guide, we want to take into consideration the preparation process before I.V.F. even begins, and also take into account the period after it ends. For the purposes of helping men prepare for I.V.F., we want to discuss:
- Navigating Infertility: Deciding whether I.V.F. is right for you.
- Preparing for I.V.F.: 2-3 Months before your first I.V.F. cycle begins.
- During your I.V.F. cycle (the period of time described in the five stages above)
- After your I.V.F. cycle, when you learn whether your procedure was successful or not.
Let’s explore what men can do in each of these stages to prepare for I.V.F.
Navigating Infertility: Deciding Whether I.V.F. is Right for You
Many couples seek I.V.F. when they have had trouble having a baby. A couple is considered infertile if they have tried for 12 months to have a baby without success. At this time, many couples seek fertility treatment. The decision to pursue I.V.F. will depend on your medical needs after a medical assessment. In this time of pandemic, whether you’ll have access to treatment will depend on the prevalence of COVID-19 in your area. Other considerations include the affordability of treatment and whether a couple decides they are emotionally ready to embark on a course of I.V.F. treatment. Let’s look at each factor:
- Go See Your Doctor. Both men and women should see a doctor to determine whether there may be physical causes for their infertility. With men, low sperm count, no sperm count, blockages, prior injury, or illness can lead to infertility. A medical assessment will help you decide whether I.V.F. is right for you, and what kind of sperm retrieval method will be necessary.
- COVID-19 and I.V.F. The American Society for Reproductive Medicine has issued cautious guidelines calling for fertility clinics and doctors to follow the guidance of local health officials regarding resuming I.V.F. treatments at this time. Some regions of the country have the medical facilities and resources, while other regions may not. Individual I.V.F. doctors may or may not have the resources to mitigate the spread of the disease within their offices. Ultimately, your ability to access I.V.F. will depend on where you live, the medical resources available in your community, whether your community has been able to flatten the curve, your doctor’s access to personal protective equipment, your doctor’s ability to mitigate contagion, and your own needs as a patient. Couples choosing to get pregnant at this time should also consider that much remains unknown about the impact of the coronavirus on early trimesters of pregnancy.
- Affordability. According to the New York Times, the average cost of a single I.V.F. cycle is anywhere from $12,000 to $17,000. Insurance may cover some of your treatment costs. Couples should plan ahead, and decide how many treatments they can afford. If you are having difficulty affording I.V.F., the Daily Wellness blog has an article about treatment options for those with lower incomes.
- Emotional Preparation. I.V.F. can be stressful and stress can impact the success of your I.V.F. treatment. Research published in the journal Human Reproduction found that women with lower concentrations of adrenaline and noradrenaline saw higher embryo transfer success. If both men and women can keep stress levels low before, during, and after I.V.F., they can potentially increase their chances of success. Couples might choose to seek counseling to explore their emotions, address issues of depression or anxiety, and gain emotional tools they can use during the process.
2-3 Months Before Your First I.V.F. Cycle Begins
Because sperm take anywhere from 2-3 months to mature, the choices you make in the months before your sperm retrieval procedure can impact your sperm counts and sperm quality. Let’s explore how your choices can impact your sperm health and sperm counts.
Counseling & Emotional Preparation. Research published in Human Reproduction noted that couples who underwent counseling before undergoing I.V.F. were better able to process the experience and talk about their concerns, leading to better psychological outcomes and better ability to discuss their relationships. Counseling can help you and your partner manage the stressful aspects of I.V.F. treatment.
Diet. According to the journal Fertility and Sterility, men undergoing fertility treatments should consume seafood, poultry, nuts, whole grains, fruits, and vegetables. Several studies, including a study in Human Reproduction found that men who adhered to the Mediterranean diet saw better sperm counts than men who adhered to a more western-style diet.
Avoid Hormone-Disrupting Chemicals. Lead, mercury, parabens, and other chemicals found in everyday products, chemicals found in non-organic fruits and vegetables, and chemicals found in industrial byproducts can impact your sperm health. Daily Wellness has a good list of chemicals to avoid here.
Heat Exposure to the Testicles. Heat exposure like the kind you can get in a hot tub, Jacuzzi, sauna, hot bath, and even hot shower can lower sperm count. When preparing for I.V.F. wear loose breathable clothing, avoid hot tubs, and whatever you do, don’t use a hot laptop directly on your lap. Read more at Daily Wellness. [JG1]
Avoid Too Much Alcohol Consumption. If you drink heavily, you could be impacting your sperm count and sperm quality. The good news is that the effects of heavy drinking can be reversed according to the Asian Journal of Andrology. If you’re preparing for I.V.F., cut down on the heavy drinking.
Quit Smoking. The International Journey of Hygiene and Environmental Health found that smoking could have a limited effect on sperm parameters. Smoking puts toxins into your body that can impact sperm health.
Sleep. Too little or too much sleep can impact sperm health. Research in the journal Sleep found that sleeping too much or too little could affect semen quality. Basically, sleeping more than 9 hours and night or less than 6.5 hours a night could impact your sperm. So, getting just the right amount of sleep is key.
Supplements. While a good diet is important in the production of healthy sperm, men are also encouraged to take daily wellness supplements to help them get the full complement of vitamins and minerals necessary to produce healthy and active sperm. Many studies that draw connections between vitamins and minerals and sperm count often look at how blends of vitamins and minerals contribute to healthy sperm count. When preparing for I.V.F. consider taking zinc, vitamin C, vitamin D, and FertilityBlend for Men (a blend that contains many of the minerals and herbs listed below) to prepare for I.V.F.
What are some vitamins, herbs, and supplements known to contribute to healthy sperm? Here are some natural ways men can boost testosterone (needed for a healthy libido and sperm production), and ways men can naturally increase sperm count:
- D-Aspartic Acid. A formulation of D-aspartic acid, coenzyme-Q10, and zinc was studied to evaluate whether it would improve sperm production and sperm motility. Research published in Endocrine found that the formulation, which contained D-aspartic acid, improved sperm counts and sperm motility in men with diagnosed issues with sperm motility. It is important to note that it is not just one vitamin that improves sperm count and motility (ability of the sperm to move toward the egg), but that improvement in sperm count and health is a complex process that involves a balance of essential vitamins and nutrients. Because the study looked at D-aspartic acid in conjunction with zinc, and coenzyme-Q10, men might want to consider looking for a daily wellness supplement that provides a balanced formula designed just for men.
- Vitamin C. The Urology Journal found that men who both lost weight and who took vitamin C saw increased sperm concentration and sperm motility. While the study looked at two factors: vitamin C and weight loss, it appears that taking vitamin C can improve sperm motility.
- Vitamin D. Researchers in the journal Urology found that sperm have a vitamin D receptor. Vitamin D is known to have an impact on male fertility, and men who are preparing for I.F.V. are wise to take supplements that contain vitamin D.
- Fenugreek. Fenugreek was found to increase sexual arousal and orgasm in men according to a study published in the journal of Phytotherapy Research.
- Zinc. Multiple studies have shown a link between low zinc levels and infertility in men. As you prepare for your I.V.F. procedure, make sure you’re taking a zinc supplement. The journal Nutrition Research found that low zinc levels are correlated with male infertility and low-quality sperm. So keeping zinc levels high can increase your chances of conception.
- Ashwagandha. The Evidence-Based Complementary and Alternative Medicine Journal identified ashwagandha as used in traditional Indian and Ayurvedic medicine to “treat male sexual dysfunction and infertility.” Men with low sperm count were administered a 675 mg/d dose of ashwagandha for 90 days. Men treated with ashwagandha saw 167% increase in sperm count, 53% increase in semen volume, and 57% increase in sperm motility. For men with low sperm count or for those looking to increase sperm count or sperm motility, ashwagandha appears to be a good supplement to take.
- Maca. Several studies show that Maca can increase sexual desire and libido. A study published in the journal Andrologia found that treatment with Maca could increase sexual desire, and a study in CNS Neuroscience & Therapeutics found that treatment with Maca could help depression patients suffering from SSRI-induced sexual dysfunction.
- L-Carnitine. A study published in the journal Fertility & Sterility found that patients treated with L-Carnitine saw increased sperm motility, particularly among patients who had lower sperm counts and sperm motility issues. Men with sperm motility issues could potentially improve sperm motility by taking L-Carnitine supplements.
- Dong Quai (Ferulic Acid). A study published in the Journal of Biotechnology Research Center found that dong quai (ferulic acid), when taken in FertilityBlend for Men, could improve sperm motility in vasectomized mice. The takeaway is that FertilityBlend for Men and dong quai may be able to help improve sperm motility in men with fertility issues due to blockages.
- Selenium. Taking a daily wellness supplement with selenium could improve sperm motility if your sperm counts are low or if you’ve been diagnosed with low sperm motility. A study published in the British Journal of Urology found that men who took selenium saw improved sperm motility.
- B Vitamins. Taking B12 and B9 could improve sperm counts and fertility in men with known fertility issues according to a study published in the journal Andrology. Taking a daily wellness supplement with B vitamins is a good idea when preparing for I.V.F. for men.
- Folic Acid. The journal Fertility & Sterility found that men who took folic acid and zinc saw increased sperm count. Another study published in the journal Fertility and Sterility found that low folate amounts was linked with low sperm counts. So, if you’re preparing for I.V.F. and want to keep sperm counts high, taking folic acid is a good idea.
- Lycopene. According to a study published in the Asian Journal of Andrology, taking lycopene can improve sperm count and sperm viability and decrease DNA damage.
During I.V.F. Treatment
Continue to make healthy choices, and continue taking supplements. Talk to your doctor about the sperm retrieval process you’ll use and review steps you can take to prepare for the big day. Some men may need to undergo surgery to extract sperm, so preparing for surgery may be part of the process. Ultimately, keeping stress down is paramount. As mentioned earlier, research indicates that stress can impact I.V.F. outcomes.
After I.V.F. Treatment
After your treatment cycle, you’ll learn about whether your I.V.F. treatment was successful. For many couples, this is just the beginning of their pregnancy journey. Having a plan in place for the next steps, whether or not treatment was successful, is important. For example, if you are successful, you may still want to continue to address stress and fears you might have as your pregnancy develops. If you are not successful with I.V.F., you’ll want to take some time to take stock of your emotions regarding the process.
Ultimately, whether you plan to go for another cycle, try natural conception methods, or consider alternatives like adoption, having a plan in place for how you’ll manage your emotions after each I.V.F. cycle is essential. Men and women cope with the stress of I.V.F. differently. According to research in the journal Human Reproduction, women tend to rely on confrontative coping, accepting responsibility, seeking social support, escape/avoidance, while men relied on distancing, self-control, and problem solving. The strategies identified by researchers as working best during the I.V.F. process include problem solving, distancing, and seeking social support. It looks like men and women can help support one another and borrow from each other’s best coping strategies. Take the time to problem-solve by addressing a plan for both a positive or negative I.F.V. outcome. Take time to distance yourself from your treatment by balancing fertility planning with healthy couple’s activities that you both enjoy. Finally, seek social support from other couples going through I.V.F. and consider the benefits of working with a counselor as you navigate treatment.
I.V.F. is a challenging process for both men and women. With this guide, we hope that men as well as women will be better equipped to begin their I.V.F. journey.