Fertility

Does Masturbation Cause Infertility?

Eloise Edington  |   28 Jan 2022


Plenty of misconceptions fly around the fertility space and at Fertility Help Hub, we always insist that no question is a silly question.

Whilst we can say this, sometimes a question feels silly but we’re still curious whether there’s some truth in it.  So, we’ve asked Gynaecologist and Fertility Specialist, Dr Sergio Caballero at IVF-Life for expert fertility advice on demystifying common misconceptions about fertility.

IVF-Life are specialists in complex cases and the fertility clinics are located in multiple locations across Spain: Alicante, Madrid and San Sebastián (view their profile here).  Using the latest advances in reproductive medicine, their outstanding fertility professionals ensure patients’ wellbeing is at the forefront of fertility treatment.  Visit the IVF-Life website here.

Lifestyle Questions

Does obesity cause infertility?

Obesity is associated with a higher prevalence of subfertility and this correlation is stronger the higher the body mass index (BMI). In women, the main mechanism is the dysregulation in the ovulatory process, but even in women that ovulate regularly, subfertility is more common among obese women. In men, sperm quality decreases with obesity and there is a synergic negative effect if both members of the couple are obese.

As for assisted reproductive techniques, results are worse in obese patients. Gonadotropins are needed at a higher dose and stimulation is needed for a longer period. The number of oocytes retrieved is lower, the quality of the embryos is worse and endometrial receptivity is negatively affected. Ultimately, whilst obesity doesn’t cause infertility, the rates of pregnancy and live births decrease while the rate of miscarriage increases in individuals who are obese.

Obese women have also more comorbidities during pregnancy and there is an epigenetic impact on the children that develop into adulthood. The silver lining is that as little as a 5-10% loss of body weight preconception is enough to observe a positive impact on natural fertility and the outcomes of an assisted reproductive treatment, although the goal should be reaching a BMI <25-30 kg/m2.

Does masturbation cause infertility in men or women?

The answer for this one is a resounding: “No, it does not”. In either case, there is just no plausible explanation to support this stance.

In men, ejaculation as a result of masturbation (instead of as a result of sexual intercourse) changes nothing in how the man’s reproductive system works, yet it is obvious that to achieve a natural pregnancy, sexual intercourse is needed. It would be similar to saying that sexual intercourse can cause infertility. However, there is something to note: if a man masturbates multiple times a day, the concentration of spermatozoids and the total number of spermatozoids available could diminish in each ejaculation. As little as 1-2 days of abstinence allows time to replenish the epididymis – this should solve complications resulting from regularly masturbating multiple times a day.

In women the reason is more or less the same, there is no correlation whatsoever between female masturbation and infertility.

Can beauty products affect fertility?

Parabens, phthalates, benzophenones and bisphenols are endocrine disruptors that can be found in beauty products. Endocrine disruptors are substances with hormonal effects that create an imbalance in normal homeostasis. Regarding fertility, the mechanism underlying this negative effect is that they bind themselves to sexual hormones’ receptors and either activate or block them; altering their normal physiology.

The problem is that these toxins surround us in our daily lives (we find them in plastics, cosmetics, food, air pollutants, etc.) and the doses that pose a threat, as well as the synergic effect between them, are not neatly defined.

Does alcohol affect fertility?

Yes: that alcohol affects fertility has been widely demonstrated.

In women, alcohol consumption correlates with menstrual irregularities, lower fertility rates and a possible negative impact on oocyte maturity. In IVF cycles, alcohol is associated with a lower number of oocytes retrieved, lower quality embryos, lower implantation rates and a higher frequency of miscarriage. These effects are dose-dependent although there is no clear threshold established.

In men, alcohol also negatively impacts sperm quality in both conventional and functional parameters and is also involved in the imbalance of the hypothalamus-hypophysis-gonadal axis.

Should I TTC for at least a year before seeking medical advice?

Even in couples without fertility problems, the normal rate of fecundity (fertility) is low (about 20% each month) and the cumulative rate gets to 85% throughout the span of a year. However, only half of the remaining 15% will achieve pregnancy during the second year of trying. That is why after one year of trying to conceive you should always seek medical advice.

There are some cases, though, in which diagnoses and subsequent treatment should be started as soon as after six months of trying to get pregnant. These involve cases in which waiting could decrease the chances of success once we initiate assisted reproductive techniques, such as known or expected low ovarian reserve (age >35, endometriosis, surgical removal of an ovary, etc.), low sperm quality or other known health conditions that may interfere with fertility.

Does diet affect fertility?

Yes, diet influences many aspects of our lives, and fertility is one of them – in both men and women.

For example, there are studies that suggest the Mediterranean diet improves sperm quality and success rates in women attempting IVF. In addition, pesticides may act as endocrine disruptors. Some fruits and vegetables are vehicles of larger amounts of these pesticides (learn more here) and we should be especially careful when rinsing them (maybe even letting them soak for 10 minutes in 1 litre of water with 10g of sodium bicarbonate to be completely sure we remove the pesticides).

Focusing on individual foods or ingredients, there are some that may have a negative impact, such as coffee, and we should reduce its intake.  Others, such as curcuma or black pepper, have been proven to have an antioxidant effect that may be beneficial when boosting fertility for TTC.

Does exercising impact fertility?

In women, moderate physical activity helps keep regular menstrual cycles and ovulation, which in term benefits fertility. It has also been proposed that it facilitates the implantation process by improving insulin sensitivity and by releasing factors that contribute to embryo adhesion. However, when the frequency or the intensity is very high, exercise has a negative impact on fertility, both in spontaneous pregnancies and IVF cycles.

In men, the same is true. Men who exercise moderately have better fertility indicators than sedentary men or those who exercise excessively. Specifically, cyclists tend to have lower-quality sperm due to the repetitive mechanical trauma and the increase in the scrotal temperature.

As long as I quit when I’m pregnant, is smoking okay?

Regarding fertility, smoking has a negative impact that lingers once you have already quit. This is because the toxins that enter your body through smoking can damage the oocytes’ DNA rendering them useless. As opposed to sperm, the number of oocytes is not constantly increasing, for the total amount of oocytes that a woman will have is generated before being born. This means that new healthy ones will not replace the damaged oocytes. Besides, smoking makes this ovarian reserve decline at a faster rate than usual, worsening the prospects of artificial reproductive techniques when needed.

Regarding the health of the foetus, once you are pregnant, smoking increases the probability of miscarriage and birth defects. Some of these birth defects occur so early in the pregnancy that they may appear before the woman realizes she is pregnant, so the recommendation is always to quit before actively TTC.

Other Factors

Are beauty and fertility linked?

There are some studies that link beauty and general health, and a few of them even correlate beauty with expected age at menopause, which would mean a longer reproductive potential. However, in both cases the evidence is far from strong, involving methodologically flawed studies (how do we assess beauty?), many of which have never been replicated.

Do worms cause infertility?

Recently, a study has shown that infection with intestinal helminths (worms) may affect fertility. The study was conducted on nearly 1,000 women of an indigenous population in Bolivia with a 70% helminth infection prevalence. The results varied depending on the kind of helminth involved, with those women infected by hookworm experiencing delayed first pregnancy and extended interbirth intervals while those infected by roundworm being having earlier first births and shorter interbirth intervals. The proposed physiological mechanism is the different immunological effect that follows infection by diverse species of worms.

Although there are no more studies that confirm these findings, the implications may be of relevance, especially in low- and middle-income countries, where helminth infection is more prevalent.

Do fertility problems run in families?

Some do, others don’t. It all depends on the aetiology of the subfertility problem. A few examples:

  • Subfertility as a result of a blockage in the fallopian tubes is often a consequence of genital infection by Chlamydia trachomatis, which is related to unprotected sex but does not follow a hereditary pattern.
  • Exposure to environmental factors (pollutants, endocrine disruptors, an unhealthy diet, etc.) has a negative impact on fertility that does not depend on genetics.
  • On the contrary, some health conditions may be a consequence of a genetic disorder that is transmitted to the offspring. This happens, for example, in some cases of premature ovarian failure when the underlying cause is an X-fragile syndrome, and also in cases of endometriosis – a disease that has a strong genetic influence although the specific genes involved are not well known.

Female factor

I have regular periods.  Does that mean I’m fertile and it will be easy to get pregnant?

Having regular periods indicates that the ovulation process is taking place each month. Demonstrating that ovulation occurs is part of the basic study of fertility and it is essential to be able to conceive. However, it is not the only factor involved and despite normal ovulation, pregnancy might not be achieved due to several reasons, such as, but not limited to:

  • Fallopian tubes blockage
  • Low sperm quality
  • Advanced maternal age, which translates into low oocyte quality
  • Endometriosis
  • Immunological imbalance
  • Sterility of unknown origin (unexplained infertility).

Male factor

Does sperm quality improve if I practise sexual abstinence?

We can analyze sperm samples from the point of view of conventional parameters (semen volume, concentration, the total count of spermatozoids, motility, morphology…) or focus on functional parameters (DNA fragmentation, mitochondrial function, chromatin packing…). The effect of sexual abstinence varies depending on the parameter analyzed: shorter abstinence periods improve motility, the percentage of DNA fragmentation and mitochondrial function, while longer abstinence periods improve semen volume, concentration and total count of spermatozoids.

The World Health Organization recommends an abstinence period of 2 to 7 days, although in the context of IVF, shorter periods (1 to 5 days) have been observed to yield better results.

Find out more about Dr Caballero

Dr Sergio Caballero graduated in Medicine from the Autonomous University of Madrid and specialised in Gynaecology and Obstetrics at the Hospital Gregorio Marañón. He also specialised in Assisted Reproduction (MSc) at the Complutense University of Madrid. Dr Caballero recently joined the IVF-Spain Madrid Medical Team, where he is highly regarded for his empathy, patient orientation and high professionalism.

When there are so many theories about the causes of infertility, it can be difficult to separate fertility fact from fertility fiction and we can be curious about whether there is any truth behind the belief. We’d like to thank Dr Caballero and IVF-Life for demystifying these common questions about fertility.

Book an appointment with IVF-Life here to take the next step in your fertility journey.

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