I refuse to age gracefully. That is to say, I refuse to age at all, other than for accounting purposes and to get discounts, which seem to kick in at movie theaters and hotels at 62—six years away. This applies to my sperm as well. I fully intend to maintain excellent spermatic health into my nineties, at least. It’s not just that my hard-wired imperative to perpetuate my genes is driving me to keep my options open; I’m not claiming my genes are anything special. It’s more the principle of the thing. Allowing any part of my body to fade just because I don’t strictly need it anymore is a slippery slope.
Admittedly, my motivation may smack of vanity, but in the case of sperm we all have good reason for concern. While the evidence is a bit inconsistent, some medical researchers insist that human sperm are going downhill and have been doing so for at least a century. Men appear to be making less sperm on average, several studies report, and what is made tends to be subfertile, which the World Health Organization describes as sperm that swim poorly, take on a funny shape, fail to reach concentrations higher than 15 million per milliliter, or otherwise struggle to impregnate an egg.
“We’re producing pretty poor sperm compared with those of primates and other mammals,” says Gary Cherr, a reproductive toxicologist at the University of California, Davis. “Even in the most fertile men, there are quality issues.” A recent European report found that one in five young men has underachieving sperm. That is probably one reason why in vitro fertilization (IVF) is becoming increasingly common, with 4 million humans worldwide already owing their existence to the procedure.
Good thing technology is watching our backs, right? Well, maybe. While certainly a blessing to the estimated 219,000 American couples with intractable infertility problems, IVF is both a measure and an enabler of men’s failure to be competent caretakers of their sperm. Or so charges Harry Fisch, a urologist and researcher at Weill Cornell Medical College in New York City, who has pretty much dedicated his career to keeping sperm robust, plentiful, and effective. He believes that reproductive technology all too often becomes a convenient fail-safe for couples seeking to postpone parenthood as long as possible. “It’s best to make babies in the bedroom,” Fisch insists, “and if fathers expect their sperm to be up to the job, they need to be in the best shape of their lives.”
Epidemiology studies have linked low sperm counts not only to aging but also to being too fat, being too thin, lack of exercise, excessive exercise, junk food, soda, exposure to toxins in food and air, and use of both prescription and nonprescription drugs, including tobacco and alcohol. “I can tell much more about a man’s health by his sperm count and belly size than I can from all the blood tests men usually get at the doctor’s,” Fisch says.
In keeping with his professional conviction that “the testicle is the future,” Fisch’s frontline treatment pushes his patients to embrace a healthier lifestyle. Fix a seemingly infertile guy’s bad habits and get him off medications he doesn’t really need—including increasingly popular testosterone supplements, which shrink the testicles and impede sperm production—and in about one-third of all cases, that guy will end up being able to do his share of the procreative job, Fisch claims.
In addition, some 40 percent of the men who show up in his office have varicoceles, or varicose veins of the testicles, and these, too, impede sperm production and quality. This wormy problem can be corrected surgically. An infection of the prostate or urinary tract—another common sperm blocker that typically goes undetected—can be cleared up with antibiotics or, in more severe cases, surgery.