On January 21, 2011 Reuters news agency reported another definitive evaluation reinforcing the role of antioxidants in sperm function. Couples who are struggling to conceive could find baby-making help from antioxidants such as vitamin E and zinc, According to a meta-analysis which reviewed more than 30 research studies.

Those who took antioxidants were more than four times as likely to get their partners pregnant than other subfertile men who did not take the supplements. The study did not look at men with azoospermia or absent sperm.Subfertility affects one in 20 men and is responsible for half of delayed conceptions. Up to 80 percent of cases are thought to be due to the effects of oxidative stress on sperm cells, lowering both their numbers and their quality.

Oxidative stress happens when molecules known as free radicals, byproducts of cell metabolism, damage DNA and cells’ ability to function. Antioxidants, including certain vitamins and nutrients, help to protect cells by stabilizing free radicals. This is the rationale behind the use of antioxidants to help sperm  swim robustly.

The study was conducted at the University of Auckland, in New Zealand. The information was derived from 34 studies that involved nearly 3,000 couples undergoing fertility treatments, including in vitro fertilization and intrauterine insemination — two of the most commonly used methods of boosting conception odds when sperm-related issues are involved. Each study investigated the potential role of one or more antioxidants.

Antioxidant use by the male partner increased the odds of conception four-fold, based on 96 pregnancies among 964 couples in 15 of the studies. Antioxidants improved the likelihood of their partners giving birth to a live baby by a factor of five, the researchers report in The Cochrane Library. Only three of the studies contained data on live births, however.

Oral antioxidant supplements are generally safe and there is no evidence that they can cause any harm. In addition to oral supplements, antioxidants can be found in a range of foods, from cranberries to collard greens, tomatoes and mozzarella cheese.

The findings in this study support the use of antioxidant formulations such as Proceptin XL when enhancement of male reproductive function as desired.

Steven a Brody, M.D., PhD

The causes can be genetic, anatomical like dilated veins, inflammatory or hormonal. New research out of New York shows men that put their laptop on their lap, even with a protective pad underneath, can lower their sperm production.

After 30 minutes with this scenario there will be an increase in heat – enough that can effect sperm production.

Doctors  encourage couples that have been trying to conceive for a year without success, that  it’s time to see a doctor. For many couples the use of an over-the-counter antioxidant formulation, such as Proceptin XL can be useful for supporting male reproductive function.

By Denise Mann
WebMD Health News

Reviewed by Laura J. Martin, MD

Nov. 24, 2010 — The popular over-the-counter and prescription acid-blocking drugs proton-pump inhibitors (PPIs) do not appear to increase risk of birth defects when taken during the first trimester of pregnancy, a study shows.In the study, 2.6% of more than 840,000 live births occurring in Denmark from January 1996 through September 2008 involved major birth defects. The study showed that 3.4% of 5,082 infants whose mothers took PPIs during the four weeks before conception through first trimester were diagnosed with a major birth defect. By contrast, 2.6% of 835,886 infants whose moms did not take these acid-reducing drugs during the same time period were diagnosed with a major birth defect.

The study is published in the New England Journal of Medicine.

The researchers did an analysis of the study data on PPI use limited to the time period during the first trimester of pregnancy. Statistically speaking, there was no significant increased risk of birth defects seen among children of women who took PPIs — including Aciphex, Nexium, Prevacid, Prilosec, and Protonix — during their first trimester of pregnancy compared with women who did not take these drugs during the first trimester of pregnancy.

“We found no significant association between the use of PPIs during the first trimester of pregnancy and the risk of major birth defects,” conclude study researchers Björn Pasternak, MD, PhD and Anders Hviid of Statens Serum Institut in Copenhagen, Denmark.

“This is the biggest and best study to date, and it is generally reassuring about use of PPIs in pregnancy,” says Allen A. Mitchell, MD, director of the Slone Epidemiology Center at the Boston University Medical Center in Boston. Mitchell wrote an editorial accompanying the new report.

That said, more studies are needed to support the safe use of PPIs during pregnancy, he says.

An Obstetrician’s Perspective

The new study “confirms the results of previous studies that did not show an increase risk in major congenital anomalies, [but] the study is limited because they used filled prescriptions as a definition of drug exposure and the information about birth defects is acquired from a registry, which may be subject to misclassification,” says Shari Gelber, MD, PhD, an ob-gyn at Weill Medical College of Cornell University in New York City, in an email.

“Furthermore, the specific reasons for the patients to be taking the medication are not available, and certain medical conditions can independently increase the risk of birth defects,” she says. “Although this study is not definitive, it should provide reassurance to women with pregnancy exposure to this class of medications [and] given the large number of patients in the study, it is unlikely that the investigators would have missed a large increase in a major anomaly.”

Her bottom line? “Pregnant women should always discuss with their doctor any medications they are taking, including herbs and over-the-counter medications,” Gelber says. “Women should not start or stop any medications during pregnancy without a discussion with their physician [and] with any pregnancy exposure, patients and their physicians should weigh the potential benefits of a medication with the theoretical risk to the fetus.”

“My general recommendations for heartburn are lifestyle modifications first,” Gelber says. “Before I recommend PPIs for patients, I do an individualized assessment about how much discomfort they have from their heartburn, I review their history and physical to make sure there are no underlying medical illnesses other than pregnancy causing their symptoms, and discuss the fact that there is no known risk to PPIs, but that the data is limited,” she says. “This study supports that view, but again the study is not definitive.”

Neonatologist’s Perspective

Robert Kimura, MD, director of neonatology at Rush Medical Center in Chicago, is cautiously optimistic about the use of PPIs during pregnancy. He sees newborns and is not in the habit of asking new moms if they took these drugs during pregnancy, but may start doing so.

“There are certain drugs we know are associated with anomalies, but PPIs have not been that high on the radar screen,” he says.

“Some obstetricians may cite this study and tell their pregnant patients that these drugs are safe,” he says. “If a woman is really symptomatic, you can use these drugs to treat heartburn, but we shouldn’t use them like water,” he says.

Often, risks do not become apparent until millions of people take the drugs, he says.

SOURCES: Pasternak B. New England Journal of Medicine, 2010; vol 363: pp 2114-2123.Mitchell, A.A. New England Journal of Medicine, 2010; vol 363: pp 2161-2163.Allen A. Mitchell, MD, director, Slone Epidemiology Center, Boston University Medical Center.Robert Kimura, MD, director, neonatology, Rush Medical Center, Chicago.Shari Gelber, MD, PhD, ob-gyn, Weill Medical College of Cornell University, New York City.

By Daniel J. DeNoon
WebMD Health News

Reviewed by Laura J. Martin, MD

Nov. 12, 2010 — Common over-the-counter painkillers taken during pregnancy may be to blame for a global rise in male infertility.

Even acetaminophen (Tylenol) may put a developing boy’s future reproductive health at risk, suggest findings from a study of some 2,300 Danish and Finnish women by Henrik Leffers, MD, PhD, of Rigshospitalet, Copenhagen, Denmark, and colleagues.The researchers suggest that acetaminophen, ibuprofen, aspirin, and other NSAID painkillers act as hormonal “endocrine disruptors” and interfere with normal male sexual development. Chemicals in the environment, such as phthalates, act as endocrine disruptors and have in the past been blamed for harmful effects on human sexual development.

“A single [acetaminophen] tablet (500 milligrams) contains more endocrine disruptor potency than the combined exposure to the ten most prevalent of the currently known environmental endocrine disruptors during the whole pregnancy,” Leffers says in a news release.

Despite the strong language, the researchers note that their findings are based on a small number of boys whose testicles were late to descend — a risk factor for poor future semen quality. While they note that more study is needed, they stress the urgency of such studies.

“Although we should be cautious about any over-extrapolation or overstatement … the use of these compounds is, at present, the best suggestion for an exposure that can affect a large proportion of the human population,” Leffers says.

The Leffers study is based on questionnaires from the mothers of 834 Danish boys and 1,463 Finnish boys, and on interviews with the mothers of 491Danish boys (285 of whom also were among those who filled out the questionnaires). All of the boys were examined for signs of undescended testicles (congenital cryptorchidism).

In the end, the researchers identified only 42 boys with signs of undescended testicles. Over 64% of these boys were born to mothers who took painkillers during pregnancy.

Women who took more than one kind of mild painkiller were more than seven times more likely to have a boy with signs of undescended testicles.

It appeared that painkillers taken during the second trimester of pregnancy were particularly risky — increasing risk of congenital cryptorchidism by 2.3-fold.

Nevertheless, these risks are based on very small numbers of affected boys. The vast majority of boys born to women who reported painkiller use did not have any sign of undescended testicles.

Leffers and colleagues will continue to follow up on the boys through sexual maturity.

Leffers’ team also performed rat studies showing that acetaminophen and NSAID painkillers can affect sexual maturation.

The Leffers study appears in the advance online edition of the journal Human Reproduction.

SOURCES: Kristensen, D.M. Human Reproduction, published online, Nov. 8, 2010.News release, European Society of Human Reproduction and Embryology.

There are important biological reasons why the testes are stored in the scrotum–outside of the body. Sperm production requires a lower temperature than the standard internal body temp. The system of pipes and tubes, called the seminiferous tubules, is the site where sperm cells are produced. High temperatures can impair the maturation process in these tubules. As a result, the sperm cells are either reduced in number or in efficacy. In some cases, the increased heat impairs the motility of sperm cells or results in the production of sperm cells with abnormal shapes.

Tech gadgets generate a significant amount of heat–a remarkable amount of heat in some cases. There are even Android and iPhone apps specifically designed to max the processor and heat the smartphone up to use as a hand warmer in colder climates. A recent study found that the temperature generated by placing a laptop on your lap–even when using a laptop cooling pad–results in temps that can impact male fertility.

Men looking forward to fathering children may want to think twice about using a laptop on their lap. Men should avoid exposing their genitals to high temperature elevations and should be extra cautious if fertility is already a problem.

These studies highlight the fact that there are many environmental insults, which can impact on reproductive function in men. Long distance bicycle riders would narrow saddle seats have been found to have similar problems. For couples contemplating fertility treatments, male partner should be especially tuned in to environmental factors which can impair sperm function. In many cases use of antioxidant formulation can be helpful in supporting the body’s defense against these environmental insults.

Many environmental health experts, as well as public health specialists, have expressed concern over the level of air pollution in many urban cities and called the attention of government and  members of the public to its attendant effects on human health.Various studies have also shown that the polluted air in towns and cities is one of the contributory factors to the escalating incidence of health problems. Researchers have also revealed that the risk in people who regularly breathe air containing a high concentration of fine particles, emitted by vehicles and factories.

There is also a mounting evidence which suggests that air pollution should be taken serious because of its attendant effects on other vital organs of the body. Fumes from generators and exhaust from cars could affect not only the heart, but also cause infertility. Exposure to airborne “particulate”, which is less than three per cent of the width of a human hair and invisible, could cause damage to human health, especially the reproductive system.

These fine particulates seen as dense clouds as they emerge from exhaust pipes trigger a cellular and biochemical process that often start in the lungs and then proceed from there into the cardiovascular system where they cause maximum damage. If car exhaust or fumes from a generator is inhaled over time, it does not only affect the heart, it could also have a devastating effect on the production of spermatozoa.

Scientists want people to be aware that infertility in men had been on the increase over the past 40 years. Many men are now becoming sterile. There is evidence pointing to environmental causes of infertility and one such cause is the exposure to car exhaust and fumes. Vehicle exhaust, when inhaled over a period of time could cause infertility. Vehicle emissions contain both high levels of lead (Pb) and toxic hydrocarbons or solvent combustion products. That is why it can affect the production of sperm cells.

in a medical journal article entitled: “Environmental Health Perspectives,” researchers observed that a compound, benzo(a) pyrene, a  common constituent of car exhaust can cause a significant reduction in fertility in test animals and fertility was further lower when the animals were exposed to BaP and lead (Pb) simultaneously.

Fumes that contain carbon monoxide, oxides of nitrogen and even nicotine are very dangerous to health. If such gases are inhaled over a period of  time, they could affect spermatogensis. Therefore, commercial drivers, especially long distance drivers and automobile mechanics are vulnerable because they regularly inhale large quantities of carbon monoxide,  benzo chemicals  and other harmful gases.Car exhaust could damage the sperm-producing part of the male testicles called the seminiferous  tubules and also reduce ovarian weight by 33 per cent, as well as cause remarkable reduction in ovarian follicles.

Most commercial drivers, especially long distance drivers, can also experience low libido because the ambient temperature of their testes increases when they sit for long hours and in the process of traveling long distance inhale large quantities of these hazardous compounds daily.

These dangerous gases interfere with the process of spermatogenesis and thus make it difficult to produce sperm cell. It should be noted that the testes function  well at a low temperature, therefore, anything that would increase the ambient temperature around the testes should be avoided.

Given the fact that we are exposed to toxic fumes in our polluted environment is reasonable and practical to utilize preparations of biologically potent antioxidants as a potential first line of defense to support the body’s ability to produce normal sperm cells in men.

Why we so concerned about Bisphenol-A? because it has the chemical characteristic of the female sex hormone estrogen. It can interfere in many ways, the hormones of being processed in the human body. It has been of some concern as a feminizing chemical on unsuspecting consumers.Now U.S researchers have linked the BPA chemical to poor semen quality in men for the first time. The prestigious journal fertility and sterility has published a scientific research paper on this very subject. The researchers found that Chinese factory workers exposed to high levels of the plastic chemical and low sperm counts.

In many ways this is not surprising, since animal studies have long shown that the chemical was linked with reproductive problems. Basically, it has an estrogen effect so it would be particularly dangerous with respect to male reproductive function. Along these lines, previous research in the same men linked BPA exposure with sexual problems. This latest study was funded by The National Institute of Occupational Safety and Health.

The findings clearly suggest that BPA may be one of the main offending compounds in plastic can interfere with sperm function. The study involved 130 Chinese factory employees who worked directly with materials containing BPA and 88 workers who didn’t handle it and whose exposure was similar to that of typical western men.

Low sperm counts were found in workers who had detectable levels of bisphenol-A in their urine. Poor sperm quality was two to four times more prevalent among these men than among workers whose urine showed no sign of BPA.

Remarkably, the lowest sperm counts were in men with the highest levels of BPA.Levels of BPA in urine were linked with lower-quality semen even in men who didn’t work with the chemical, although their average BPA levels were much lower than in the other group.

Many authorities have called for an urgent review into the safety of bisphenol A (BPA ).The leading academics have also urged manufacturers to cut down on BPA in food packaging and containers. Millions of pounds of this compound are being produced every day, uut remarkably, we still don’t have a clear handle of the many ways that this compound is getting into humans.

Small effects for large numbers of people matter because it means that the prevalence of the problem may increase. Human drug trial-type assessments are needed to settle once and for all whether this compound is bio-active in humans. The bottom line cut exposure to BPA containing plastics, especially if fertility considerations are an issue.