Infertility: A Physical and Emotional Health Matter

Written by Melissa Gorley. Adapted from Family Foundations article from Adam Storey.

When Alex and Carmen Santamaria of Miami, Fla., were married in 2001, they discerned to postpone starting their family. After all, shortly after walking down the aisle Carmen enrolled in law school and the newlyweds knew Carmen would need to put her time and energy into focusing on her studies. However, during her last year of school, the couple decided they were ready to welcome a child.  

To their great joy, they conceived their daughter without any struggles. Two years later they had their oldest son, again without difficulty. Alex and Carmen were excited for their family to continue to grow. But when it came time to conceive a third child, things were surprisingly different. In fact, it took about a year and a half of trying for baby number three before they sus­pected something was wrong. And then when they did realize that something wasn’t right, it was difficult to find treatment that respected them and was attentive to their unique health situation. At first, Carmen’s OBGYN was dismissive, offering “cookie cutter treatments,” as she remembers them. Another doctor told them to “just parent the children you have.”  


Eventually Carmen was connected with a Napro­Technology doctor in New York state, who “tailored the treatment to me.” After undergoing various tests, Carmen was diagnosed with PCOS.  

This was also the first time it was recommended that Alex, now 46, have a semen analysis. Thankfully, the doctor was able to offer the couple a way to do the semen analysis that didn’t violate the couples’ Catholic faith via the use of a perforated condom during intercourse. The results of his semen analysis were not optimal, and so he went through further testing. Alex, who owns an archi­tectural firm, was eventually diagnosed with a varicocele (a varicose vein in the scrotum that reduces sperm count and sperm motility). About a year after discovering the varicocele, Alex underwent surgery to attempt to correct the issue. While the Santamarias are still open to biologi­cal children today, the surgery did not improve Alex’s sperm numbers and they have not conceived since.  

Often Overlooked Male Fertility and Health Considerations  

Traditionally fertility treatment has largely focused on female factors, yet according to a 2015 study published in Nutrition Reviews, it is estimated that approximately 40 percent of infertility is due to male factors. In recent years, more and more studies have focused on male factor infertility. Nutritionist Marilyn Shannon, author of Fer­tility, Cycles & Nutrition, believed that a driving force in the new interest in male fertility is a worldwide decline in male fertility health.  

The keys to male fertility health are quantity and quality of sperm, she said. Quantity refers to the number of sperm in any ejaculation, which is typically 60-120 million sperm. When the count falls below 15-20 million sperm per milliliter, a man is diagnosed as infertile. Qual­ity refers to the sperm’s shape (morphology) and ability to move forward (motility). 

The discovery is that basic diet makes a difference in practically all parameters of sperm health,” she explained. “To me that is just breakthrough information.

While Shannon points out that it’s difficult to isolate specific factors that affect male fertil­ity, the most important factor is diet. She relies on several newer studies that divide men into those who follow a “western diet,” which is largely made up of fatty, processed food, and those who follow a “prudent diet,” which is based more on fruits, vegetables and fish. “The discovery is that basic diet makes a difference in practically all parameters of sperm health,” she explained. “To me that is just breakthrough information.”

Additionally, at the root of many, if not most, of the factors that reduce male fertility is oxida­tive stress, she writes. The new 5th edition of her book has a completely updated chapter on male fertility, and explains that oxidative stress is damage done to a cell by “reactive by-products of their normal oxygen usage.” Sperm are particu­larly vulnerable to oxidative stress, in part be­cause they use a lot of oxygen and have very little cellular material to protect themselves. A man’s diet and lifestyle can help combat oxidative stress and improve both his sperm quantity and quality. Antioxidants, such as vitamins A, C and E can also help protect a cell from the damaging by-products of oxygen use. 

Whatever the infertility or subfertility diag­nosis is, Shannon’s work encourages couples to address fertility issues as a couple. The goal is to opti­mize the fertility systems of both the man and woman, knowing that one spouse’s fertility health can help overcome issues in the other spouse’s fertility health. For example, if a woman has scant mucus, a higher sperm count can make conception more likely, and alternatively, healthy mucus can assist with lower sperm counts. That’s why Shannon’s work advocates for fertility treatment that is “is always a team effort, no matter what the on-paper diagnosis is.” 

This is Part 1 in a series of articles about infertility. Part 2 of this series will be published in a few weeks. 

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