Boxers or briefs: Myths and facts about men's infertility

When a couple is diagnosed as infertile, first thoughts often run to the woman, with unhelpful thoughts like: she's not a "complete" woman because she can't get pregnant. However, as nature would have it, problems with infertility are equally due to male and female conditions.

Infertility is the inability to get pregnant after one year of unprotected sexual intercourse. Around a third of the problems are caused by male conditions and another third by female conditions. The rest are either problems with both partners, or causes which cannot be identified.

Men's part in fertilisation is quite amazing. About 200 million sperm are mixed with semen to form ejaculate. In most men, 15 to 45 million of these sperm are healthy enough to fertilise an egg, although only 400 survive after a man ejaculates. Only 40 of those 400 reach the vicinity of the egg, surviving the toxic environment of the semen and the hostile environment of the vagina. After another process called capacitation (an explosion that allows the remaining sperm to drill a hole through the tough outer layer of the egg), only one lone sperm reaches the egg for fertilisation and conception.

Top causes of male infertility

• low sperm count
• slow sperm motility (movement)
• abnormal morphology (shape and size of sperm)
• problems with semen

Even though specialists know the causes of male infertility, what's not always known is the cause behind the cause. There are many factors - lifestyle, genetics, physiology - that might explain low sperm count, slow sperm mobility, abnormal sperm shape and so on.

Recent developments in treatment have made fertility possible for many men. Before undergoing any complicated procedures, there are some simple lifestyle changes that can increase the odds of a successful conception. (These tips are helpful for any couple trying to conceive, whether or not infertility has been diagnosed.)

• Stop smoking. Smoking has been linked to low sperm counts and sluggish motility. Long-term use of cannabis (marijuana) can result in low sperm count and abnormally developed sperm.
• Decrease your drinking. Alcohol can reduce the production of normally formed sperm needed for a successful pregnancy.
• Watch your weight. Both overweight and underweight men can have fertility problems. With too much weight, there can be hormonal disturbances, and when a man's too lean, he can have decreased sperm count and functionality.
• Exercise in moderation. Excessive exercise could lower your sperm count indirectly by lowering the amount of testosterone in your body. Use of anabolic steroids can cause testicular shrinkage, resulting in infertility.
• Value the vitamins in your diet. Low levels of vitamin C and zinc can cause sperm to clump together. Vitamin E can counteract excess free-oxygen radicals, which can also affect sperm quality.
• Turn your back on toxins. Landscapers, builders, manufacturing workers and men who have regular contact with environmental toxins or poisons (pesticides, insecticides, lead, radiation or heavy metals) are all at risk of infertility.

Have you ever heard the debate about whether men should wear boxers or briefs? The theory is that briefs are tighter, so it's possible that your body temperature can rise above the level the testicles require for good sperm production. So if a man wants to be really fertile, boxers are the better choice. The truth is, this has yet to be scientifically proven. However, if you're trying to get pregnant, there's no harm in wearing loose clothing and staying out of hot baths and saunas.

Maintaining a healthy lifestyle and a positive attitude will give you the best chances if you're considering becoming a father.