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A Man's Swimmer Problems

May 8, 2022   Return


Man’s Health and Fertility with

Dr Agilan Arjunan

Consultant Gynaecologist & Fertility Specialist KL Fertility Centre


According to the Guinness Book of World Records, Moulay Ismail ibn Sharif who ruled Morocco during the 17th century likely fathered 1,042 children during his lifetime. Some historians believed that the number might be as high as 1,171!

These days, it may not be possible to have this many children, even if the man is crazy enough to want to, as there are reports that, overall, the sperm count for men in America, Europe, Australia and New Zealand has dropped by more than 50% in less than 40 years. However, we have yet to find out the exact reason(s) for this fall. It is speculated that perhaps it is due to exposure to chemicals or pollutants, smoking, stress, obesity or maybe even all of them.

This month, we join fertility specialist Dr Agilan Arjunan in looking at what men can do to ensure that their fertility is still up there to create that little bundle of joy with their beloved partner.

Reference: Kelland, K. (2017). Sperm count dropping in Western world. Scientific American. Retrieved from article/sperm-count-dropping-in-western-world/


Too much! “The heavier you are, the more fat you will have stored in your body,” says Dr Agilan. As a result, there is more testosterone, the male sex hormone, converted to oestrogen, the female sex hormone in the fat. This will significantly affect sperm production, which is driven by a cascade of hormones that include testosterone.

Too hot! Another issue that comes with having excess weight is that it causes the temperature in the testicles to increase. Optimal sperm production requires a temperature that is slightly lower than that of the rest of the body, which is why nature has designed a man’s testicles to dangle between the legs instead of being an internal organ. The hotter it gets inside the testicles, the lower is the rate of sperm production.


“So … eat less?”

Not just that. To maintain a healthy weight, total energy obtained through food should be equal to total energy used by the body. So, there are two components to consider here: eating healthy, balanced meals and being physically active on a regular basis.


“How can I eat less? I’ll starve!”

We don’t have space in this article to fully dwell on the principles of healthy eating, but you can consult a dietitian for more advice. Basically, you should eat foods from all food groups, according to the recommended portion size based on your age, sex, current body weight, level of physical activity and any existing health condition you may have.

Some hunger is inevitable at the early stages of your new diet, but you will survive and adapt. Hang in there – over time, you will feel healthier, happier, and sexier!


“I’m already hungry and now you want me to exercise? Are you joking?!!”

Daily physical activity is important, as it strengthens the muscles and keeps the body working in good condition (all these are great for many things, including making babies). It also burns away any unused calories from your meals, ensuring that you do not gain weight. Furthermore, exercise is a great stress reliever. The gains far outweigh any momentary discomfort you may experience when you begin your new exercise routine.


If you like your alcohol, brace yourself as there is no way to break it gently: abstaining from alcohol is always better when it comes to trying for a baby. Even moderate consumption of alcohol can affect fertility in a significant manner.

Alcohol affects both sperm count and quality. This is because it can disrupt the ideal conditions in the testicles needed for optimal sperm production. Over time, it can even cause the cells in the testicles responsible for sperm production (Sertoli cells) to deteriorate. Alcohol may also affect the production and regulation of hormones that regulate sperm production.

All in all, drinking is not a good thing when it comes to ensuring that a man’s swimmers are in good condition and numbers!

“Sober up, huh? You think that’s simple? HAH!”

Don’t be so pessimistic! These days there are programmes to help people quit drinking successfully. A psychiatrist specializing in treating addictions will be the best person to turn to, but if one is not available near you, you can try asking a family medicine specialist for help. There are also many support groups available both in real life and online.


“It’s been known for many years that smoking can reduce both sperm count and the quality of the sperm produced by the man,” Dr Agilan points out, adding that the sperm count is especially affected by this habit.

It is found that the tobacco in cigarette contains substances that can negatively affect the ability of a man to produce normal amounts of sperm.

In the sperm cells that are produced, it is found that many have lower motility than sperm cells produced by non-smokers – which is to say, these sperm cells are less capable of traveling along the woman’s womb to successfully reach the egg cell.

“Hmm, so I should quit. That’s hard, right?

These days it’s easier to quit compared to the past, thanks to a combination of nicotine replacement therapy and counselling. You can consult your neighborhood pharmacist for more information.

“Wait … if the problem is nicotine, I can then vape instead, right?”

Dr Agilan points out that research on vaping is still at early stages, and it’s likely that other chemicals present in vape juices may also affect sperm count and quality. Why risk the chance? 


There is evidence that high levels of stress can affect sperm production, according to Dr Agilan. Furthermore, stress also makes it hard for couples to experience the mood to make babies!

When you are stressed, the body reacts as if you were in danger and releases stress hormones, which trigger the fight-or-flight response. You will feel your heart beating faster, your breathing will become shallower and you feel tensed up. The fight-or-flight response also closes off other functions that the body considers to be of lesser importance when dealing with the stress, and one of these functions is reproduction. Therefore, the more stress you experience, the more your sperm count may be affected.

Stress can come from a variety of external sources outside the bedroom – work, family finances, relationship woes, health issues. However, it can also come from the bedroom.

Dr Agilan cautions against what is called “medicalizing” the process of making babies. This occurs when couples are so determined to have a baby that each planned sexual encounter ends up becoming a stressful chore.


Calm down! Challenges and frustrations are inevitable parts and parcels of life. Often, stress relief can be obtained by stepping back for a while to focus on relaxation activities such as exercise, yoga, keeping a journal or anything else that can bring you a sense of peace.

But do reach out for help when you need to!

There are counsellors, hotlines and support groups out there that can help, and some of them offer free support. If trying to have a child is causing you and your partner undue stress, it may be time to seek a fertility specialist for advice.


It’s well known that boxers are supposed to be the underpants of choice as the tighter briefs- style underpants can elevate the temperature around the testicles and affect sperm production. Interestingly, there are studies which conclude there isn’t any significant difference in sperm production and quality among men who wear either type of underpants. However, Dr Agilan believes that there is no harm in choosing to wear boxers over briefs – anything that can increase the odds of success can be a good thing!

What happens if a man is born with low or zero sperm count? Dr Agilan will focus on such a situation in the next column, so don’t miss it! HT

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