Women are not the only ones who need to get their bodies ready for conception. Men face their own challenges in both becoming fathers and in maintaining their health throughout the early years of parenthood, especially if they are older at the time of conception. It is often not until a couple is expecting their first child that men may schedule a long overdue preventive health care visit.
For a couple in which the prospective mother is over age 35, time is of the essence. If a couple has been trying to conceive for six months or longer without achieving pregnancy, an infertility work up should be initiated. One of the first and least invasive steps includes a semen analysis to detect male factor infertility. Low sperm counts, dysmorphic sperm and poor sperm motility may all lead to low fertility in men. If the semen analysis reveals a low sperm count or poor sperm quality or motility, a urological consultation may be required.
For some couples erectile dysfunction and low libido may further impact fertility. Blood tests for testosterone and free testosterone levels should also be done to investigate and abnormal sperm count or low sex drive. Testosterone levels fluctuate throughout the day and day to day. As a result, levels should be checked in the early morning. Finally, anabolic steroids including testosterone, androgens and supplements claiming to boost muscle mass, such as those used in professional body building, should be avoided. These all inhibit normal testicular function and can affect male hormone levels.
There are natural methods for boosting testosterone levels and sperm production in men. Adequate exercise and getting enough sleep may help to boost testosterone levels. In addition, weight loss and avoidance of endocrine disrupting environmental contaminants may also naturally boost androgens. High temperature, on the other hand, has a negative effect on sperm production. An example of an exercise that may temporarily lower sperm counts is long-distance cycling. Known endocrine disruptors include certain plastics and pesticides as well as alcohol, marijuana, and opiates can also impact fertility in men.
Diet and medications can also affect male fertility. When considering a man’s diet, I generally counsel patients to eat as clean a diet as possible with focus on organic plant-based foods. Nonessential medications should be avoided, and alcohol should be used only in moderation. Commonly prescribed drugs for depression, like SSRIs, can have an adverse effect on male sex drive and sperm production as can various drugs used to treat an enlarged prostate. Men taking these prescription medications should consult their physicians before discontinuing use in order to assess the risks and benefits of stopping drug therapy. Drugs used to treat erectile dysfunction are generally thought to be free of adverse effects on fertility.
A physical exam looking for common chronic health problems is essential for the father-to-be. It is especially important for any man experiencing erectile dysfunction, which can be a sign of cardiovascular disease, or who has hypertension, hypercholesterolemia and diabetes. A blood pressure check, complete blood work and review of any pertinent symptoms should be included as part of the exam. An EKG should be added for men with hypertension, diabetes, or symptoms of heart disease. Smokers are counseled to quit if attempting to conceive and especially before the birth of their child. Smoking increases the risk of respiratory infections in infants and children, and may increase the risk for SIDS, or sudden infant death syndrome.
Newborn infants are especially vulnerable to certain infectious diseases. A preventive visit for a father-to-be should include appropriate immunizations. I advise all parents of young children and expectant moms and dads to be immunized every fall for influenza. All adults who will be in close contact with infants should also have a pertussis, or whooping cough, booster. Infants under 6 months are at risk of dying from this common respiratory infection. The pertussis vaccine is combined with the tetanus and diphtheria vaccines in the TdaP shot. Current recommendations are for this vaccine to be given to expectant mothers during pregnancy. Fathers and grandparents are also targets of immunization efforts. Finally, all men should ideally be offered HIV and syphilis testing as well as other sexually transmitted infection testing prior to conceiving a child. These infections can be spread to the fetus or newborn and can cause severe disease or even death.
Although dads may not go through all the physical changes of pregnancy, they are challenged with sleepless nights, frequent colds, increased stress, crashing libido and even baby blues after the baby arrives. Self-care is as important for new fathers as it is for a new mother and baby. All too often I see busy parents drop their work out routines, sleep 6 hours or less per night, consume caffeine, sugar and fast food in order to keep going throughout their busy days, and use cigarettes and alcohol to unwind. They are too tired to enjoy their babies and each other. Having a new helpless family member can take its toll on their relationship. Health and lifestyle problems can pile up very quickly, especially for busy working parents. Maintaining healthy routines and sharing of new responsibilities is essential to healthy parenthood at any age.