If there are certain taboo topics for men, male infertility most surely makes the list. After all, being infertile comes with the stigma of being less of a man. After years of trying for a family, no guy wants his friends to jokingly ask, “What’s wrong, are you firing blanks?”

Infertility is defined as the inability to get pregnant after one year of unprotected sexual intercourse. Although it is often assumed that the problem is due to the woman, in actual fact, men are just as likely to suffer from infertility.

When it comes to male infertility, advice of all sorts can be found online, but how to tell what’s myth and what’s fact? For instance, is it true that a man had better wear boxers instead of briefs? What about taking supplements for fertility? Shedding light on the topic is Dr Rajesh Hemashree, Senior Consultant at the Department of Obstetrics & Gynaecology, Singapore General Hospital (SGH), a member of the SingHealth group.

What really causes male infertility?

As it turns out, most cases of male infertility are idiopathic, a medical term used for conditions that arise spontaneously and for which the cause is actually unknown.

“Male infertility can be attributed to low sperm count, slow sperm motility, abnormal morphology or problems with the semen, but we don’t always know what’s behind these different factors,” says Dr Hemashree.

Here are some of the more common myths concerning male infertility, and what you should know:

Myth 1: Boxers are better for your "boys" than briefs

The battle between boxers and briefs has been raging for the longest time… with no conclusion in sight. It is based on the belief that tighter underwear such as briefs keeps testicles at a temperature too high for healthy sperm production.

However, a study comparing the scrotal temperature of men wearing boxers to that of men wearing briefs found no significant difference between the two. Hence, there is no factual evidence suggesting that wearing boxers improves sperm counts, says Dr Hemashree.

“Increased scrotal temperature may affect sperm quality, but it is unclear whether this is related to the tightness of the underwear.”

Myth 2: A man's age has no effect on his fertility

While everybody has heard of men fathering children in their 50s, 60s and even 70s, male fertility isn’t age-proof. According to Dr Hemashree, sperm count and sperm quality begin to dip when a man turns 40 years of age.

Fortunately the decline is slow and gradual. However, it can speed up dramatically if the man develops a condition that hampers sperm production (such as an infection in the genital tract or varicocele).

Myth 3: Diet and weight can have an impact on male fertility

This is true. Obesity can lower male hormone levels and is also associated with chronic conditions such as diabetes and hypothyroidism, which can impair sperm production and even lead to azoospermia, the complete absence of sperm in the ejaculate.

“A healthy diet rich in fish, chicken, fruit, vegetables, legumes and whole grains has been associated with increased sperm motility,” advises Dr Hemashree.

Myth 4: Frequent masturbation lowers your sperm count

Yes, frequent masturbation may lead to a lower sperm count but it also improves sperm quality. This is because infrequent ejaculation increases the quantity of dead sperm.

According to Dr Hemashree, alternate day intimacy is best for couples trying to conceive as the sperm is fresh and young.

Myth 5: Taking supplements may help to boost a man's fertility

Many micronutrient deficiencies are seen in infertility, but there is no definitive evidence that any of them causes infertility. However, Dr Hemashree does suggest trying supplements like L-carnitine, L-arginine, zinc, vitamin D, vitamin E, selenium, coenzyme Q10 and folic acid to improve sperm quality.

Ref: R14