FOCUS online: There are several studies that indicate that male fertility in Germany is declining. Is that correct?
Dr. Andrea Salzbrunn: In fact, that cannot be said with certainty. The problem is that we don’t have any reliable data, especially in Germany. The only truly representative study is from the early 2000s, which was done at muster. It is not easy to recreate this cross-section of the population. In the current studies, apples are often compared with oranges, often it is also patient data and thus data from sick people. This is not representative.
Conclusion: A slump in fertility cannot be clearly proven. There are also no limit values for “normal fertility”.
What can men do specifically to increase their fertility?
Salzbrunn: There is no magic pill for better fertility – even if many men want it! I always say I can’t make up for the sins of 40 years of life. Smoking, drinking, smoking weed, eating from plastic bowls and little exercise – all of these are very harmful. The body works as a whole, so focusing on just one organ – like the testicles – is often not enough.
I always have my patients first fill out a questionnaire about their lifestyle – how do they eat, how much exercise do they do. We can often start here as well. My recommendation is always to “live like your great-grandmother” with a balanced diet, lots of exercise and little alcohol.
But low fertility is not always the cause of an unhealthy lifestyle, is it?
Salzbrunn: That’s correct. The males also carry an innate backpack. These include possible epigenetic changes by the parents. An example: If parents smoke during pregnancy, the sperm count of the son is halved!
But in general, most people have a “vulnerable organ”, for example a tendency to headaches or stomach ache. The same is true for testicles (with sperm quality) – they too can be inherently “more susceptible to disease or degenerative changes”.
Are there any warning signs that can indicate fertility problems?
Salzbrunn: Undescended testicles or malformations in the groin or kidney area that occur in boys in childhood can be clues. My recommendation is to go to an andrologist as early as puberty and have a spermiogram done. This shows possible discrepancies. Because restrictions in fertility do not cause any symptoms. As a result, special attention can be paid to a healthy lifestyle or sperm can actually be frozen.
How about cell phone radiation, sauna or cycling. Do they also contribute to infertility?
Salzbrunn: So far we have not had any studies that would clearly prove this. There are now some studies on mobile phone or laptop radiation that speak for and some that speak against it. As always, the truth will lie somewhere in between. But even without a secure study situation, I would not necessarily put the laptop on my lap or carry the cell phone around in my pocket with all the apps open.
For the sauna, short, heavy sweating followed by cooling off is perfectly fine. The Finns, for example, have the best fertility in Europe and they spend the whole winter in the sauna! What is harmful – and unfortunately often done in this country – is to sweat for a long time on the bottom bench in the sauna, then munch on your bathrobe and take a nap. I would rather not.
And for cycling, if you get off the saddle and can’t move, the saddle is wrong, but the cycling isn’t.
But I also think that a healthy testicle must be able to withstand normal life!
What do you recommend to a couple who involuntarily remain childless?
Salzbrunn: I recommend one to one and a half years as a time limit for pain. Then man and woman should go to the examination at the same time. Because the rule of thumb is: It is one third up to the man, one third up to the woman and one third down to both at the same time.
What examinations are carried out by an andrologist?
Salzbrunn: We do a basic spermiogram, which examines the quantity, movement and external shape of the sperm and, if necessary, a DNA fragmentation analysis, which examines whether the genetic strand is well packed in the DNA and whether there are any possible breaks in the DNA. They are linked to an increased rate of miscarriages.
If problems arise, reproductive medicine techniques can then be considered. Fertility medicine has come a long way since then!