Preparing for a baby — for men

Having a baby is not the woman's job alone. This page gathers all six of my articles on getting the man ready — read them straight through, or jump to whichever one you need.

• Śiva supplement
• Lubricants
• How semen is made
• Semen analysis
• Before you give a sample
• Lifestyle and sperm quality

Śiva — a supplement for men who are trying to conceive

I put together a sperm-support formula of my own called Śiva. It came out of sitting down with a great deal of research and settling on this one combination — then filing with the Thai FDA, finding a factory that meets standard, choosing the packaging myself and designing the label myself. (If I could sit and press the capsules myself, I probably would have.) Every one of those steps is so that a patient taking it can be confident he is getting the full benefit.

In the article I lay the research out nutrient by nutrient, so you can see exactly what each ingredient is there for. You will see that improving sperm quality really is not that hard — read it here: Śiva, a supplement for men trying to conceive

Lubricants and fertility

A lot of people do not realise that the ordinary lubricants sold in shops — even the ones with no spermicide in them at all — may be harming sperm without anyone noticing.

Every cell in the body only works properly when the conditions around it are right: the acidity (pH), the concentration of electrolytes, the electrical charge, the temperature, and so on.

• Sperm need a pH of 7.0 — neutral — to work well the whole way along. That matches the fertile mucus the body produces around ovulation, which is also pH 7.0.
• Outside that window the vagina has its own pH keeper, the lactobacillus bacteria, which hold it slightly acidic at pH 3.0-5.0 — not a comfortable place for sperm to do their job.
• The lubricants on the shelf — the K and D brands, say — are formulated to match most women's vaginas so they do not sting from being too acidic or too alkaline. That puts them at about pH 3.0-5.0, which is not especially safe for sperm.

Full article: Personal lubricant and fertility

How semen is made

Semen is made of two things: sperm and seminal fluid — and they come from completely different organs. The cell side makes nothing but sperm cells; the glands that make the fluid and its nutrients make nothing but fluid. The two only come together moments before ejaculation.

The sperm

• They are made from spermatogonial stem cells (SSCs) in the testis — which is why a man can keep making sperm his whole life.
• Once cell division is finished, the sperm are stored in the epididymis, where they mature and learn to move.
• At ejaculation the sperm travel along the vas deferens to the urethra, where they join the seminal fluid on the way out.

The seminal fluid

It comes from a set of glands — the prostate, the seminal vesicle, and the bulbourethral gland, which supplies the lubricating fluid. Seminal fluid is rich in the nutrients sperm need for the swim through the female reproductive tract.

Full article: The genesis of semen

Semen analysis

Semen analysis has been the basic test for men with fertility problems for a very long time. The reference values come from the World Health Organization, which keeps adding data and revising them — most recently in 2021.

A full analysis is not one measurement but many, and it takes two to three hours to work through all of them.

• Volume
• Sperm concentration
• Percentage of motile sperm (%motility)
• Percentage with normal shape (%morphology)
• Plus others that matter rather less, such as the percentage alive (%vitality)

There are also finer tests available now — the chromosome count, for instance (a sperm normally carries 23 chromosomes, half of what a body cell carries), and %DNA fragmentation.

Once the results are in, we look at how normal — or how abnormal — the sample is, and whether a first-line approach like IUI or conventional IVF will do, or whether we need ICSI, or in some cases donor sperm.

So a standards-compliant semen analysis takes real manpower and real time before every result is out. But smartphone cameras now magnify sharply enough to be useful, and artificial intelligence (AI) is learning to see more like a human brain every day — so AI has been brought in to help. At Life by Dr. Pat we use Lenshooke® to analyse our patients' samples, which brings the whole semen analysis back in under 10 minutes, with a video clip as well, so the patient can see what his own sperm actually look like.

Full article: Semen analysis

Preparing before you give a semen sample

This applies whether you are giving a sample for testing or for treatment — IUI, IVF or ICSI alike.

From the article on how semen is made, you can see the whole thing runs like a factory. The cell department makes the sperm and stocks them in the transport tubing. The fluid department does its own job, making the fluid with the nutrients that let sperm swim. The two departments combine into semen just before it leaves the body.

Finished sperm are held in a long tube and released into the world in the order they went in — they queue politely. So the sperm that come out on the day are the oldest ones in the warehouse. Which means: the longer you abstain, the more dead sperm and the more non-swimmers you get.

From what I have seen in patients who have tried it, this clearly raises both %motility and %morphology — I can just about promise motility close to 80%. If you try it, tell me how it went.

Full article: Prepare yourself for semen collection

Lifestyle and sperm quality

Men — and in most cases their partners too — are always asking me what eating, drinking, smoking, staying up late and the rest of it actually do to sperm. So I pulled the research together into an infographic, which you will find in that article.

Full article: Lifestyle and sperm quality

With my best wishes — Dr. Patsama