When things finally start happening, you realise that the whole process is a true miracle.

Once your wife receives her hormonal stimulation, ideally more than 8 follicles begin to develop in her ovaries instead of just one. The hormone therapy is meant to increase the production of oocytes, however, your wife still needs her regular checkups during this process. The doctor will see what is happening inside of her ovaries using a simple ultrasound scan after five days of beginning hormonal stimulation. The most important question is how many healthy follicles will develop with the help of the stimulation.

One aspect I was curious about were the parameters of that particular sample compared to the previous one. Was this one better, worse or the same?

The number of follicles is important, but their size matters as well. The approximate diameter of a mature follicle is 18 millimetres, which actually surprised me at first - it is almost 2 centimetres! The oocyte that develops inside of the follicle is 0.1 to 0.2 mm, much smaller than the actual follicle. However, it is still large compared to a single sperm, which is approximately 45 micrometres from head to tail.

After the ovarian stimulation, my wife received another hormone therapy (called the “trigger shot”), which contains a human chorionic gonadotropin (hCG) to help the oocytes mature. Approximately 36 hours later our big day arrived: it was time for the oocyte retrieval and semen collection.

Oocyte retrieval is considered a minor surgery, but I was still a little bit concerned about it. I tried not to show it, of course, but I was worried about my wife. The procedure should take about 20 minutes, but it is still a surgery. Most of the time it is performed under general anaesthesia, especially if the woman has a greater number of available follicles. We only had five follicles after the ovarian stimulation, which is not ideal, but we were grateful to have at least some that were ready for the next step.

My wife was not under anaesthesia during the procedure, but the nurse gave her painkillers beforehand. According to her, she only felt some level of discomfort when the oocytes were suctioned out of her ovaries with a needle that went through her vaginal wall.

To clarify, during the oocyte retrieval process the doctor inserts a needle into each follicle and draws out all the fluid, including the matured oocytes. After just 10 minutes, she was done with this part.

During that same time, I came into the picture as well, or more precisely, my semen. The semen collection happens simultaneously with oocyte retrieval. By now I am used to not being the one at the centre of attention; most of the time I play the role of a supporting husband, but now it was my time to participate. Since I know my way around the clinic, I grabbed my cup and went to the collection room.

When the door closed behind me, I was left alone with thoughts and some porn magazines. Anyone who has ever been through this knows how awkward and uncomfortable this experience can be, but the staff at the clinic see many patients every day, so there is no need to feel embarrassed. Semen collection is an essential part of the IVF process, and it is just something that has to be done.

It’s time to take our part of the fertility journey: let’s boost the little guys.

There are very few men left on the planet who don't need any help to boost their fertility. I am not one of them, so I decided to do as much as possible to improve my sperms’ health. I am going to have very little to do during our IVF program compared to my wife, so this is the least I can do to increase our chance of success.

"With any positive changes, we can do a lot to consciously improve our fertility."

Let’s continue to learn more factors which can affect the health of our sperms and male fertility.

1. Ideal weight: Both too much and too little fat have a negative effect on hormone production, and sperm health and count. Moreover, in overweight men, fat pads warm the testicles, and as we learned, sperms don’t like heat. Weight is something that we cannot change overnight. Making a significant and healthy change on it, can take months (sometimes even years). Losing or gaining weight should be part of a well-planned preparation. I have 4-5kg extra weight on me, and it is impossible to lose (in a healthy way) in 4 weeks (at least for me).

1. Caffeine: The most popular stimulant. That's how I start the day every morning. But keep in mind that energy drinks and cola also contain caffeine. Funnily caffeine can be a double-sharp weapon. In a small amount it stimulates sperm production in small amounts. Great news! However, in larger quantities, it can be one of the causes of sperm deterioration, and also can reduce its quantity. Another important fact that is important to remember, that beverages that contain caffeine, have diuretic effects and may cause dehydration, which is not good at all when we try to conceive. I am a coffee lover but fortunately I am not a big fan of energy and soft drinks. So, it will be easy for me to be a good boy on this.

1. Exercise: Sport is one of the best things in the world if you do it within normal limits. It relieves tension (so you can reduce stress), creates good conditions, and makes you balanced. It can help you reach your ideal weight as well. But you don't want to be Schwarzenegger for now. Do not touch anabolic steroids, muscle and weight gainers. Firstly, your testicle can get smaller (you will look stupid), secondly, you can even reset your sperm count with them.

1. Toxins: Unfortunately, improper nutrition already delivers a lot of toxins into our bodies. We can come into contact with many toxins at work and home (solvents, cleaners, pesticides) as well. Try to avoid them if it is not possible, or at least use appropriate protective equipment.

Obviously, there are many things listed above that are difficult to change. These are just some important factors – at least - to be aware of. With any positive changes we can do a lot to consciously improve our fertility. And if we were “accidentally” keeping these lifestyle changes for the long term and living healthier by the way, we could hold not only our own child, but hopefully even our grandchildren in our hands. Is it enough motivation? Is there more motivation than that?

How you can improve sperm quality and quantity with some changes in your daily life and habits. Beware, you might notice positive changes in other areas of your life as well.

If you are like me, you never really paid attention to your sperms (I mean in a scientific way). It completely changed when I received my sperm analysis result, and it’s not too great a number. I felt like it’s time to learn more about them (especially when it comes to their parameters).

"Studies show that a smoker has 15% less sperms compared to a non-smoker, and more lazy sperms with abnormal shape."

I read about many factors which can cause sperms with abnormal shape, not enough quantity or pure concentration. BUT I also learned that actually there are many things that I can do, and make improvements on these parameters. These are mainly lifestyle changes, and most of them don't cost too much, I just need to pay a bit more attention and be willing to change.

1. Smoking: I was a heavy smoker for 15 years, but I quit 15 years ago though. I know exactly how hard quitting is. (This is not the easiest lifestyle change, I know, but I wanted to start with the most difficult one.) BUT you have to know smoking has a huge negative impact on the quality and quantity of your sperms. The problem is mainly caused by the nicotine (so electric cigarettes are not really an option either). Studies show that a smoker has 15% less sperms compared to a non-smoker, and more lazy sperms with abnormal shape. SMOKING + ABNORMAL SHAPE + LAZY SPERM = NOT IDEAL!
2. Alcohol: At this point I started to be worried a bit (I love red wine). Actually, I don’t have to be abstinent (a big release!), I just have to be careful with the quantity. 2-3 glasses of wine or beer weekly won’t do a huge harm on my sperms. A bigger dosage of alcohol would lower the chances of my boys, because they can have an abnormal shape and a smaller army in numbers. It sounds doable to me.
3. Drugs: I cannot share any personal experience about this point, but what I learn for sure: they don’t do any good for our hormones. They can reduce our testosterone level, have a negative effect on the shape of sperm, and the sperms go nuts (as you do) if you are on drugs (I don’t know what does it mean exactly, they might move too fast?).
4. Heat: It never even would cross my mind. Using my laptop on my laps, or enjoying the comfort of the seat heating in the car actually can overheat my sperms. They don’t need too much heat as they are super sensitive. If they get some extra, unwanted heat on their outer layer, it’s enough for them to die. Riding a bicycle, spending time in a sauna can also cause extra heat. It is also better to switch from hot baths to showers for the health of our sperms. I think here I am going to face some difficulties (laptop usage, love of hot baths and bicycling).
5. Stress: I know, it’s easy to say, do not stress these days. At least be aware that too much stress has a huge negative impact on every area of your life. Speaking about sperms: it decreases the concentration, makes them lazy, and will affect the shape as well. So, just take it easy!

There are still a few possible lifestyle changes I would like to share with you in my next articles, but I find it easier to take these changes step by step.

More and more men are affected by fertility problems. Why is this topic not spoken more about?

To make it short, on the second consultation, we got the green light from the doctor to go for IVF, as our only one chance of having a baby. Actually, the plan was that in a week or so, we will start our fertility treatment.

"It never crossed my mind before how much I can do to improve my reproductive health. To be honest, it did not cross my mind either that I have to do anything for it."

As you could read in my previous article, I am going to face our first IVF cycle with my ‘not too tragic’ but ‘not great at all’ semen analysis result. After the stage of ‘Unbelievable’, I entered the phase of ‘Acceptance’, then I started to think about how I can improve my result.

I dived into the world of ART (Artificial Reproductive Treatments), and came across my new favorite word: fertility awareness. We hear about many different awareness and consciousness, but the term ‘fertility awareness’ was completely new for me. It never crossed my mind before how much I can do to improve my reproductive health. To be honest, it did not cross my mind either that I have to do anything for it.

Fortunately, the sperm production is continuous in our body, and takes approximately 3 months to create a completely new army. It means that with some changes in our diet, lifestyle, and habits, we can do a lot for sperm who will be formed in the future. Of course, this cannot happen overnight. It takes about 3 months to notice significant improvement on the result.

Unfortunately, in my case, I had too little information about this topic, and too little time left for big improvement or to correct my bad result. But, of course, it didn’t discourage me to start some changes, because – I believe - every journey starts with one step.

It would be great if this information wouldn’t reach only those couples who are already participating in IVF programs. It’s scary to read that there’s a tendency for men’s fertility to deteriorate from decade to decade, and moreover, typically, men don’t like to test and face it. How much easier it would be to avoid a lot of setbacks, stress and sometimes relationship problems that come with fertility failures. Fertility awareness is all about avoiding these above.

Edit: Our IVF cycle is postponed, because a little miracle happened. Who knows how, but we were able to conceive naturally. We had a chemical pregnancy, meaning that one of my sperm was able to fertilize an egg naturally, but unfortunately the implantation was not successful. This is proof: we can do it! ☺ We have to wait a month to start our fertility treatment, which also means that I gained an extra month to improve (even a bit) my sperm condition.

How I learned that sperm analysis isn’t about getting a certificate about my fertility superbness, but showing me there’s room for improvement.

On the next consultation with our doctor, unfortunately it became official, which was only my guess until then: the result of my semen analysis is – let’s say - not ’the best’. The doctor pronounced it clearly: I am involved in our fertility journey as much as my wife is. I am the other 50% in the formula, and the reason why IVF is our only way of having a child together. It didn’t break me, but it was not a comfortable feeling either. I needed some time to digest the situation. I read a few studies about the fact that male fertility has become a bigger problem these days than female fertility. Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side. Studies also show that men’s sperm count dropped, and the capability of fertilization decreased drastically (to its half) over the last few decades in Europe. It surprises me, because if it’s really such a big, common problem, why don't we speak / know more about this?! Knowing that I am definitely not alone with this problem helps me put my mind to ease but it still bugs my ego.

Anyway, let's see what a sperm analysis is about, and my result?

"Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side."

1. During the test, they measure the volume of the semen. The normal parameter is 1.5-6 ml (I had 5 ml, so I was OK with this part). This factor is important to show us how big our army will be to start with.
2. They also check on its pH. The ideal value is 7.2 (slightly alkaline), but it is considered normal between 7.2-7.8. (Mine was 8.)
3. They also check on the motility of the sperms, which is significant because they have to take a long way to reach their goal. If we calculate from the total sperm count, at least half of the little fighters should have good movement. In my case, the progressive motility (when the sperms move in a straight line along a large-arc circle) was 50% (this is ideal). My non-progressive motility value (when sperm moves along a small-arc circle) was 5%. 50% + 5% = 55% in total (which is ok!). I’ve never been a great dancer, but at least my spears are moving well.
4. Sperm concentration and sperm count are also determined. Sperm concentration shows how many sperm are present in 1 ml of semen, and sperm count shows the total number in the whole ejaculation. These indicators are changing so mournfully, that an acceptable normal minimum value is no longer even set. The WHO (World Health Organization) has recently given the normal values at 15 million / ml and 39 million / sample. I had 10 million / ml and 50 million / ejaculation, which are not particularly good values.
5. They also examine the morphology of the sperms (if the sperm head is in the right shape or size). The sperm head, for example, plays an important role in breaking through the egg wall to be able to fertilize it. According to the WHO numbers, at least 4% of the sperms should be in formal order (unfortunately, this was only 2% for me). Interestingly, I also came across a study that showed that 29% of men with 0% normal-shaped sperm were able to fertilize an egg in the natural way (not with IVF). So, sperms with abnormal head shape doesn’t mean that there’s any genetic problem with them.

The official diagnosis of seeing all my numbers together was: oligo-teratozoospermia. Meaning I have reduced sperm count and low sperm motility.

However, there is a significant advantage for men over women. While the number of eggs is given at birth, and from then this number decreases and then runs out, in men the sperms are renewed cyclically. The process of sperm formation (spermatogenesis) takes 74 days. (Because we cannot know which part of this cycle we are in, it is better to calculate with 3 months). Meaning: in most cases, men have a chance to improve their ‘sperm situation’ in three months.