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Q & A With Male Reproductive Urologist, Dr. Ariel Moradzadeh

Q & A With Male Reproductive Urologist, Dr. Ariel Moradzadeh
Dr. Ariel Moradzadeh is a distinguished Reproductive Urologist at Cedars-Sinai UCLA. He is at the forefront of male reproductive health and a beacon of hope for couples facing the challenge of infertility. Armed with a wealth of knowledge, innovative techniques, and a compassionate approach, he has dedicated his career to understanding and addressing the complex issues surrounding male fertility. We sat down with Dr. Moradzadeh for an insightful Q&A session…

Q: What is male infertility?

 

Male infertility refers to the inability of a man to impregnate a fertile female due to factors such as low sperm count, abnormal sperm shape or motility, blockages, hormonal imbalances (such as low testosterone or pituitary gland abnormalities), genetic conditions, testicular issues, ejaculation problems, environmental factors, and lifestyle choices.

 

In the realm of reproductive health and family planning, discussions around fertility have traditionally centered on women. However,  men make up 50% of the problem – and the solution. 

 

It’s important to note that male factor infertility is a common cause of infertility, but it doesn’t necessarily mean that a man is completely sterile. With the help of lifestyle interventions, and focusing on optimizing sperm health, many couples can overcome infertility and achieve successful pregnancies.

 

 

Q: How common is male infertility?

 

Research conducted over the past few decades consistently indicates a concerning trend of declining fertility and poor sperm health. A man today has 50% less sperm than what their grandfather had. Roughly 1 in 6 couples in the United States have trouble conceiving, and more than 50% of the time, there is a male factor leading to infertility or subfertility. And yet in 25% of infertility explorations, men were never even examined.

 

In a new analysis, researchers at Mount Sinai Medical Center, the University of Copenhagen, and the Hebrew University of Jerusalem, among others, found that sperm count globally dropped by more than half between 1973 and 2018, and that the decline is accelerating: Since 1972, sperm count has dropped by about 1% each year. Since 2000, the annual decrease has been, on average, more than 2.6%.

 

In my practice, I’ve seen infertility struggles and hormonal dysregulation for decades. I’ve come to realize that a hugely neglected part of the conversation is the role of the male partner. There has been an increasing decline in male fertility that has been unspoken and it has to do with the role of environmental toxins, nutritional deficiencies, stress, and diet.  It’s crucial to bring men into the mainstream fertility conversation since they account for 50% of fertility issues and pregnancy challenges. 

Q: What are the causes and/or risk factors for male infertility?

 

I don’t believe it’s a coincidence that infertility has increased just like diabetes and obesity have. That’s because excess sugar and subsequent belly fat drive hormonal imbalances and exacerbates problems related to  infertility. ⁣In men, infertility can manifest as lower testosterone, which indicates other hormones like insulin are also imbalanced. Among the consequences are visceral fat, enlarged breasts, low sperm count, and decreased sex drive.⠀⁣

 

While genetics and age can play a role, the most significant factors contributing to the decline in fertility and poor sperm health are poor nutrient status and exposure to endocrine disruptors.

 

Endocrine disruptors are chemicals that interfere with the normal functioning of the endocrine system, which is responsible for regulating hormone production and signaling in the body. These chemicals can mimic, block, or alter the effects of hormones, leading to various adverse health effects like low testosterone, sperm DNA damage and infertility. Exposure to these endocrine disruptors, such as pesticides, plastics, and certain chemicals, has been linked to reduced sperm quality and infertility.

 

Another significant contributor to the decline in male fertility is poor nutrient status. The sad reality is that most people are deficient in several key nutrients. Even with a perfect diet, the combination of many things—including our depleted soils, the storage and transportation of our food, and the increased stress and nutritional demands resulting from a toxic environment—make it impossible for us to get all the vitamins and minerals we need solely from the foods we eat.

 

Optimizing your nutrient status can profoundly impact conception rates, pregnancy outcomes, and even the health of your future baby for decades to come. 

 

Additionally, other factors that contribute are:

  • Excessive drug and alcohol use
  • Being overweight
  • Having certain past or present infections
  • Sedentary lifestyle
  • Overheating the testicles
  • Having experienced trauma to the testicles
  • Poor stress and sleep management 

Q: How is male infertility diagnosed?

 

One of the easiest and best indicators of fertility health is to do a semen analysis which now can be done at home through direct-to-consumer companies.   Doctors examine the semen volume, as well as the number of sperm (concentration), their shape (morphology), and their motility  (forward movement). All of these have a direct impact on fertility health and chances of conceiving. 

 

One of the main factors affecting male infertility is DNA fragmentation in the sperm. Sperm DNA is a vital component of human conception as sperm DNA damage may affect various markers of conception including embryo quality, implantation, pregnancy, and miscarriage. Sperm DNA fragmentation tests evaluate the quality of the DNA which carries the important genetic information of the offspring. The tests are distinct and more significant than the conventional semen parameters.

 

Blood tests are another great way to get more information about male fertility health. They can help identify a man’s level of testosterone and other related reproductive hormones. Hormone imbalances can lead to low sperm counts, cause erectile dysfunction, and lower sex drive.

 

 

Q: How is male infertility treated?

 

Typically the conventional focus has been invasive and expensive methods like in vitro fertilization and hormonal interventions, and while those tools are great, they are not always needed.

 

Lifestyle factors such as diet, and more specifically nutritional status, play a vital role in overall health, and it is no different when it comes to male fertility. 

 

Modern lifestyles and dietary patterns often fall short of providing the necessary nutrients, this is why supplementation is key for those trying to conceive. By addressing nutritional deficiencies and supporting the biological processes involved in the world wide sperm decline, prenatal supplements have the potential to improve sperm health and contribute to the restoration of male fertility. 

 

This is why I believe it’s a non-negotiable to supplement with a high-quality prenatal to make up for the nutrients we can no longer get through food alone, especially during the months leading up to conception. Prenatal supplements for men, like WeNatal, have emerged as a promising intervention in combating the sperm crisis.

 

WeNatal is the first prenatal on the market intentionally designed for her AND him. Their formulas contain functional doses of bioavailable ingredients, with no fillers and only 3 capsules per day. 

 

These supplements, specifically formulated to support male reproductive health, are designed to bridge nutritional gaps and provide the essential nutrients needed for optimal sperm production and quality. I highly recommend checking out WeNatal if you’re thinking about starting or adding to your family.

While I ultimately encourage you to work with a Functional Medicine doctor to address and correct these problems, I have found these seven strategies can help anyone (female and male) balance hormones, improve on infertility, and create abundant health.⠀⁣

 

 

  • Incorporate Antioxidants:  Studies after study show that nutrients like L-carnitine, vitamins C and E, N-acetylcysteine, zinc, and have more than a 4 times chance of their partner conceiving and a 5 times higher chance of a live birth compared to men not taking antioxidants . 

 

  • Support Your Gut Health: Include gut-supporting foods like fermented foods, fiber-rich options, and probiotics in your diet to improve gut health, which can have a positive impact on hormonal balance and fertility.

 

  • Exercise Regularly (in moderation): Engage in regular physical activity to support overall health and hormonal balance. However, it’s important not to overdo it, as excessive exercise can have adverse effects on fertility. And remember, keep the testicles cool!

 

  • Manage Stress: Find effective ways to manage and reduce stress levels, as chronic stress can disrupt hormonal balance. Explore stress-reducing techniques such as meditation, yoga, or engaging in hobbies you enjoy.

 

  • Prioritize Quality Sleep: Getting adequate and high-quality sleep is crucial for hormonal balance and overall well-being. Establish a consistent sleep routine and create a sleep-friendly environment to optimize your rest.

 

  • Minimize Exposure to Environmental Toxins: Reduce your exposure to environmental toxins, which can disrupt hormone function. Take steps such as using natural cleaning products, filtering your water, and being mindful of potential sources of toxins in your environment.

 

 

Q: Do you have any tips for coping with male infertility? Not just physically, but mentally as well.

 

Focus on the relationship between you and your partner, and know that the mind + body connection is just as important as the physical one. 

 

Companies like WeNatal recognize the importance in creating a healthy partnership. Their Guided Journal guides partners to a loving connection. Through daily gratitude affirmations and questions to prepare for parenthood, couples will manifest their dream life alongside their partner. 

Dr. Ariel Moradzadeh

Dr. Ariel Moradzadeh earned his medical degree at The David Geffen School of Medicine at UCLA. After medical school, Dr. Moradzadeh completed his Urology residency at Cedars-Sinai Medical Center, where he developed his passion for men's health and male infertility. He then went on to complete a fellowship at UCLA in the field of Andrology, Men's Health, and Male Infertility, prior to joining the faculty at Cedars-Sinai as a reproductive Urologist.

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