Fertility Struggles? Dr. Mistry on Semen Analysis and Boosting Sperm Health

Thanks for tuning in to the Armor Men’s Health Hour Podcast today, where we bring you the latest and greatest in urology care and the best urology humor out there.

In this segment, Dr. Mistry and Donna Lee discuss some of the factors that can contribute to infertility in both men and women. Of the roughly 12% of couples who have difficulty conceiving, about 30% of the cause can be attributed to the man's sperm quality. This can mean either he isn't producing enough sperm, the sperm aren't moving as they should, or that the quality of the sperm produced is compromised. Another 40-50% of infertility can be attributed the woman's reproductive capacity. If you're doing the math, that leaves approximately 20-30% of the cause of a couple's infertility to be of mixed or combined causes. Luckily, at NAU Urology Specialists, we offer thorough and convenient sperm analysis as well as counseling on the lifestyle changes both men and women can and should make to increase their chances of getting pregnant. We offer an in-house functional medicine provider, Shefaly Ravula, who can help patients prioritize wellness and holistic health through nutrition services and functional medicine. We also provide in-house sex therapy for patients who struggle with the psychological aspects of sex, whether due to past trauma, the mental toll of fertility struggles, or any other reason--sex therapy can be an invaluable tool when a couple is trying to conceive. Finally, we love to refer patients who need additional help getting pregnant to our partners at Texas Fertility Center. If you or a loved one are struggling to conceive and either you or your partner are 35 or over, we'd strongly recommend a fertility evaluation with us today! You can also contact TFC at txfertility.com. 

Dr. Mistry is a board-certified urologist and has been treating patients in the Austin and Greater Williamson County area since he started his private practice in 2007.

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Transcript

Welcome to the Armor Men's Health Hour with Dr. Mistry and Donna Lee.

Dr. Mistry: Hello and welcome to the Armor Men's Health Hour. I'm Dr. Mistry, your host, here as always with my co- host, Donna Lee.

Donna Lee: Hmm. No adjective?

Dr. Mistry: She's very funny in her own mind.

Donna Lee: And cute sometimes.

Dr. Mistry: You know , I think that recently we started putting the podcast in the on-hold music because I hated the on-hold music.

Donna Lee: It was very boring.

Dr. Mistry: And we've gotten mixed reviews.

Donna Lee: I'd say so. Some people love it and can't wait to hear the rest of it and told our staff, they were upset when we answered the phone because they wanted to hear the rest of the podcast.

Dr. Mistry: We sure didn't want to make it so being on hold felt longer.

Donna Lee: Right? But...

Dr. Mistry: You're not marrying the podcast.

Donna Lee: But for those of you who are not a fan of it, we're just trying to give you some more information.

Dr. Mistry: Yes. And hopefully we can get you off the phone and in a person's queue as quickly as well.

Donna Lee: We're working on that. If you're looking for a job, reach out to armormenshealth@gmail.com.

Dr. Mistry: Just like everyone from Raging Canes to...

Donna Lee: Raging Canes?

Dr. Mistry: Raging Canes.

Donna Lee: It's not raging.

Dr. Mistry: This is a men's health show. I'm Dr. Mistry. That is my real name and I'm a board certified urologist. And this show is brought to you...

Donna Lee: Raising Canes.

Dr. Mistry: ...by the urology specialty clinic that I started in 2007, NAU Urology Specialists with offices all around town.

Donna Lee: That's right. We're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas.

Dr. Mistry: We are open for business. We are seeing patients quite actively. We have a , a real zest to see patients and a desire to see patients quickly.

Donna Lee: Yes we do, but y'all are so busy.

Dr. Mistry: But we're trying.

Donna Lee: Can you be a little less busy sometimes so we can give you more patients ?

Dr. Mistry: Well, we're trying. And so if you want to see a particular provider or see me after hearing us on the radio or on the podcast, and if you want to get some advice quicker, just send us an email. We love answering these email questions on the show. It's really what drives the show, but seeing you in the clinic drives us even more.

Donna Lee: That's right. We also have lots and lots of people that you can see aside from our amazing providers. We have sleep coordinator, sex therapist on site . And I love that we have that because people are like, "Why do you have a sex therapist on site?" We're like, "Well, we treat sexual dysfunction."

Dr. Mistry: That's right. Both men and women we have a lot of sexual dysfunction that we treat, whether it be due to prior trauma, due to prior hangups about sex, whether it be something related to do with fertility or other, or some other medical condition that could be impacting your sexual satisfaction.

Donna Lee: Whether it's physical or cultural. Correct?

Dr. Mistry: Sure. And with women, especially not knowing, trying to take what they feel should be societal normative behavior, or maybe what their husband or partner expects and resolving it with with how they feel inside.

Donna Lee: So if their husband's a little dirty, they got to come to grips with that. Is that what you're saying?

Dr. Mistry: Well, if he's really dirty or they're just too clean.

Donna Lee: Oh, that's true. There's two sides of this story.

Dr. Mistry: We do a lot of fertility and I thought today, what we could do is talk a little about fertility.

Donna Lee: Yeah . That's weird, we just talked to a couple of patients earlier about that.

Dr. Mistry: So in this town, there's a lot of interest , a lot of patients, and a lot of providers that do fertility work. And I think oftentimes we focus on the women when it comes to fertility.

Donna Lee: Right? You're always trying to make us the bad guys that we're infertile, but hey, some of you guys.

Dr. Mistry: I think it's because the woman's pushing to have the baby all the time. So it's so much easier to...and increasingly now we have more and more coverage of advanced fertility services by insurance companies. There's a ton of infertility reproductive endocrinologists that are called doctors who do in-vitro fertilization. We work very closely with Texas Fertility Center. They're, they're our favorite in town. They're exceptional in terms of the work they do and have a wonderful lab and very helpful. And they do a great, great job. Dr. Vaughn, Dr. Silverberg, Dr. Burger, Dr. Hansard, Dr . Propst--excellent, excellent partners of ours. Now they send us often and patients come to us often for a male fertility evaluation.

Donna Lee: Yeah, that's what? 30% of couples can't conceive because it's the guy, right? Is that, did I make that up in my head? I did. I made it up in my head.

Dr. Mistry: So it's about 12% of couples have trouble conceiving. And of that, about 30% of it is because the mens' semen parameters are too poor.

Donna Lee: I knew I heard you say that.

Dr. Mistry: In about 40% or half, it is a female component or factor. And then the rest, it's mixed. So , so what we say is about half the time, there's at least some component of male factor infertility present there. And so if you're out there and you're contemplating having a child, or you've been trying to get pregnant for over 12 months, if you're under, if she is under the age of 35 and certainly over six months, if, if your partner is over the age of 35, I think it's worthwhile to go get a fertility evaluation. And the men's evaluation is inexpensive. It's highly informative and something that we perform in our office and see hundreds of patients a month for.

Donna Lee: What does that entail, the male?

Dr. Mistry: So it entails, it entails what you think would be the most obvious thing .

Donna Lee: The semen drop-off?

Dr. Mistry: The semen drop-off and we make our semen drop -offs so easy. There's a, there's a place in town where you have to drop it off downtown before like nine o'clock in the morning. And it's so inconvenient, if you , you know , to like...

Donna Lee: You're feeling it at lunch?

Dr. Mistry: ...yeah, to like, to give you that, give you the sample at like seven o'clock and then get in the car, and like drive down town. And so we, we read semen at virtually all of our offices except for the Dripping Springs office. But at North Austin, both locations, the Round Rock location, as well as the South Austin location, we do read your semens. But our evaluation is more than just the sperm count. Because sometimes people with good sperm counts, can't still can't get pregnant and it's because of how the sperm are moving or how they're looking or how they're functioning. And so we also do a full what we call metabolic and hormonal lab evaluation. So we look at your thyroid, your testosterone. We do tests on looking at how well your testicles are functioning. We want to make sure that you're healthy because the sperm count is really a barometer of your overall health.

Donna Lee: Interesting. That makes sense.

Dr. Mistry: And, I think it does. I mean, you know , if you were designing, designing a body or a human system or an animal system, if that animal is unhealthy , it probably shouldn't be reproducing.

Donna Lee: Good point. I never thought of it that way. So what if you meet a guy and you're like, "This guy would be a terrible dad." Do you just like fake it and say, "Sorry, you're fine. Go on your way."

Dr. Mistry: I don't judge.

Donna Lee: I'm kidding. That was a joke.

Dr. Mistry: I don't judge.

Donna Lee: No, we try to get them all pregnant. I liked the example...

Dr. Mistry: All the men pregnant?

Donna Lee: All the men pregnant.

Dr. Mistry: We've been very unsuccessful.

Donna Lee: One day. The example you gave, if a guy was smoking pot and his little spermies are just really slow. I don't know why there's always a visual that stuck in my head and is so cute.

Dr. Mistry: It's because we think of the Simpsons a lot, and the Simpsons are always these, like, these little Homer Simpson sperm that are kind of knocking into each other. But yes, I mean , regular marijuana use will certainly slow down sperm rates of progression. And then over time it can lead to decreased sperm counts and other problems. I think some of that may be doing due to the smoke, you know, like the actual, like inhalation and things that are in the substance that you ingest. So...

Donna Lee: What about regular cigarette smoke? Same thing?

Dr. Mistry: Cigarette smoke is the same thing. It leads to the sperm don't look so good. They , they don't move so good. And those are things that we try to alter. Now, the good news is that in men, sperm are re-made every 90 days. So if you commit to like a three or six month, you know, cleaner lifestyle, better eating, losing weight, we will see an improvement in sperm counts in over 80% of patients.

Donna Lee: Wow, that's a big number.

Dr. Mistry: So for that reason, that's why lifestyle management and diet nutrition is such a big part of what we do when it comes to men's fertility. A lot of people don't do it because it's such a hard thing to kind of convince people to do, lifestyle changes and eating better, but it's certainly worth it. I mean, if you're motivated to get pregnant enough to spend $20,000 on IVF, you know, maybe you'll, you know, cut it down to just three drinks a night, and maybe get out and take a walk every once in a while to try to get your sperm counts up. We're also much more aggressive about being very tightly controlled on some , what we call metabolic illnesses. So if you have a high cholesterol or high blood pressure and your primary care doctor's like, "Well, you know, we'll just see how it looks in six months," knowing that it's going to look exactly the same in six months, because you don't plan on changing anything in six months, then we are more apt to put you on medicine and, and more aggressively recommend intervention because those little bitty perturbations in your blood pressure and cholesterol really also can have an impact on your, on your sperm count.

Donna Lee: Hmm . Okay. That makes sense. Perturbations, is that the word you said?

Dr. Mistry: I'm just up words now.

Donna Lee: Sounded good.

Dr. Mistry: And I think this is true, this is true for women, too. I mean , women who are overweight, who are smoking and drinking excessive alcohol are also less likely to get pregnant.

Donna Lee: They just want a miracle sometimes.

Dr. Mistry: They want a miracle. Especially as you get older, and as couples are starting to begin the family planning process much later than previous generations--almost, you know, probably a bigger difference from this generation to the last than almost any other two generations before that. And it's only going to get increasingly a bigger issue as couples start thinking about having kids when they're, you know , 38, or 36, or 39.

Donna Lee: All these new 40 year old moms.

Dr. Mistry: Which is which I'm a big fan of, but the biology of the human body isn't going to change overnight. You know , even if you're a very, very fit 40 year old woman, your chances of getting pregnant are going to be less than they were when you were 25. So the male fertility evaluation is something that we specialize in and take take real seriously. So if you've had a semen analysis in the past, or a fertility evaluation or were told you've been having a low sperm count in the past, but no interventions were given, then please come and see us. We we'd love to help treat you.

Donna Lee: That's right. You can see us during the week, call us during the week at (512) 238-0762. Again, we're in Round Rock, North Austin, South Austin, and Dripping Springs, Texas. If you're listening on the other side of the world and our email address is armormenshealth@gmail.com and check out our podcasts wherever you listen to podcasts.

Dr. Mistry wants to hear from you! Email questions to armormenshealth@gmail.com. We'll be right back with the Armor Men's Health Hour .