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Male Infertility 61

limited to one to two units once or twice per week Table 3.1.1 Nutritional influences that decrease
(NHS Choices 2011). fertility

Male Infertility Nutritional influences that can In In
decrease fertility females males
The causes of male infertility remain largely
unknown as it is difficult to identify the role of Weight loss >15% of normal YY
single factors, and various studies have shown weight
conflicting data. Lifestyle factors such as smoking,
alcohol and diet, environment and socio-economic Negative energy balance YY
factors may affect sperm motility, fertility or
pregnancy outcomes. Inadequate body fat YY

Gastrointestinal complaints and low intake of Obesity YY
fruit and vegetables have been associated with low
sperm counts (Wong et al. 2003). Zinc, selenium Excessive body fat especially YY
and vitamin C may be particularly important in central adiposity
sperm production (Tas et al. 1996).
Extreme levels of exercise YY
Exposure to heavy metals, halogens (pesticides),
glycol (antifreeze) and oestrogen-like chemicals High alcohol intake YY
(DDT and PCB) in the environment have also been
shown to reduce male fertility. The oestrogen-like Eating disorders Y
chemicals reduce the activity of the androgen
hormones (e.g. testosterone). High caffeine intake Y

The most prudent advice for men is to: High-fibre/low-fat diets Y

●● consume a balanced and varied diet based on Poor iron stores Y
the five food groups, ensuring adequate fruit
and vegetable intake Coeliac disease Y

●● limit themselves to a moderate alcohol intake of Diabetes mellitus Y
less than 3–4 units per day
Inadequate zinc status Y
●● aim for a healthy body weight – very
underweight men should gain weight and obese Inadequate antioxidant status Y
men should lose weight.
Heavy metal exposure Y
Nutritional influences that decrease fertility are
summarized in Table 3.1.1. Exposure to halogens (pesticides), Y
glycol (antifreeze) and
Activity 1 environmental oestrogen-like
chemicals (DDT and PCB)
List the nutritional topics you would discuss
with the following in a clinic for couples who Activity 2
are failing to conceive: What advice would you give to a diabetic
woman planning a pregnancy?
a) an underweight woman
b) an overweight couple References and further reading
c) a couple both of normal weight.
Chavarro JE, Rich-Edwards JW, Rosner BA and
Willett WC (2006) Iron consumption and the risk
of infertility. Obstetrics and Gynecology 108:
1145–1152.

Clark AM, Thornley B, Tomlinson L, Galletley C and
Norman RJ (1998) Weight loss in infertile women
results in improvement in reproductive outcome
for all forms of infertility treatment. Human
Reproduction 13: 1502–1505.