Alina and Max came to see me together, fairly distraught. They were both 39 and had been trying to have a child for the last seven years. They had conceived twice during that time, but each time Alina had miscarried at 10 weeks. They didn’t know the cause of the miscarriages; the NHS will not investigate till it has happened three times.
Alina had, however, been through all the gynecological investigations: ultrasound scans showed a healthy womb lining, hormone tests were normal and laparoscopic surgery confirmed that everything was fine anatomically. Her periods were regular. The general practitioner told her there was nothing wrong and suggested that she “just relax” and it would happen. What she replied is unprintable.
Max had not had a sperm test until two years previously—when they’d already been trying unsuccessfully for a full five years. That test had been “borderline”—a few sperm were normal and could swim. This, he was told, was all right because “it only takes one sperm to fertilize an egg.” I wondered, however, about the quality of the sperm. Sperm counts are falling worldwide, in animals as well as in humans; Max was not alone.
I asked Max to do a repeat sperm test, as sperm counts can change rapidly. I then had them both complete a one-week diet diary and take blood tests for all the nutrients that are vital for healthy conception and full-term pregnancy: the B vitamins; vitamin D; vitamin E; the minerals zinc, iron, selenium, iodine and magnesium; and the essential fatty acids omega-3 and omega-6.
At our second meeting, Max showed me the result of the recent test; his sperm count was lower than two years before, just into the zone that the NHS considers low rather than borderline. His diet diary showed a lot of “stodge”—toast and cereal for breakfast, sandwiches or potato chips for lunch, pizza or pasta for dinner.
There was an absence of fresh fruit and vegetables, and an absence of protein foods, too; although he wasn’t vegetarian, Max rarely ate fish, eggs or good quality meat. He was a high-powered lawyer and said he was just “too busy to cook.”
Alina’s diet diary was quite different and far more varied; she ate plenty of fruit, veg, eggs, fish and meat, and also whole grains and pulses and nuts. She worked as a teacher and cooked a proper dinner when she got home, but Max got home much later and preferred getting pasta or takeaway pizza to reheating a proper meal.
I’m not saying pasta or pizza are terrible, but if that’s your staple diet, you simply can’t be well nourished; there are just too many nutrients missing.
The blood test results confirmed that many nutrients were indeed missing from Max’s body. He was low in several B vitamins, vitamin E, zinc, selenium, iodine, magnesium and both omega-3 and -6 essential fatty acids. His vitamin D was okay because he took supplements and could afford regular holidays in the sun. Alina’s tests showed no deficiencies at all, which is unusual and confirmed my sense that it was the sperm that were the issue here. At least 50 percent of “unexplained” infertility is “male factor infertility,” and poor sperm quality is implicated in miscarriage, too.
In the first consultation, I had asked about drinking and smoking, and they had both said they didn’t. At this second consultation, however, it emerged that Max wound down from his long and stressful workdays with a couple of large glasses of wine every evening and drank more on the weekends. As the topic came up, the tension in the room rose palpably; this was clearly an issue between them.
As gently as I could, I explained that sperm are very, very small and do not like being pickled. I also explained that alcohol depletes B vitamins and magnesium. Max looked rather shell-shocked; he had seriously thought it was only women who needed to avoid alcohol when trying for a baby.
He did agree, however, to try to reduce his drinking and improve his diet. Alina had obviously been saying this for years, but he hadn’t been listening; with my metaphorical white coat, I was able to get through. It takes two to tango, and their time to make a baby was running out.
However, Max’s long working hours were an obstacle to his good intentions. He accepted some help from Alina in making healthy packed lunches (which she had been doing for herself for years) and agreed to take supplements of all the relevant nutrients as well.
I gave him a B complex with extra B12 and a good-quality supplement containing all eight sub-types of vitamin E, not just alpha tocopherol. I also gave him liquid versions of zinc, iodine and selenium because these are best absorbed, and a high dose of magnesium bis-glycinate, the most absorbable form of magnesium. Finally, I gave him evening primrose oil for omega-6 and a high-quality fish oil for omega-3, taken at different meals for maximum benefit.
Then I gave them the most difficult task: I asked them not to try to conceive for the next few months but to use barrier contraception. This is because as the biochemistry starts to improve with nutritional treatment, it may after a couple of months become good enough to conceive, but not yet good enough to carry a baby to term. I didn’t want Alina to go through another miscarriage. This precaution was of course painful and counterintuitive for a couple of their age desperate for a baby, but to my relief, they did stick to it.
Four months later they came back, and Max brought me the results of a sperm test from the week before. It had improved considerably; it was at the top of the borderline range. I held my nerve and asked him to continue the regimen for another four months. At that point I retested the nutrient levels in his blood, and they were all normalized. We had also created a virtuous circle; the nutritional treatment had improved not only his sperm but his mental energy, too, so he was able to get his work done by 6:00 p.m. instead of 8:00 p.m. He was less tired and also less in need of the wine to wind down because he was less wound up.
Finally, a few weeks later, we had a “good” sperm test result, and I told them they could stop using contraception but needed to continue Max’s nutritional and no-booze program. Three months later Alina phoned me; they were pregnant. Of course, after what she had been through, she was still holding her breath, but they got past the crucial 12-week point and the pregnancy continued healthily.
Interestingly, after “job done,” Max could then have gone back to his junk-food and vino diet, but he didn’t—he felt better than he had for years and had no desire to revert to his previous habits.
Alina and Max had a healthy baby girl, and Alina breastfed successfully for two years, continuing her healthy diet. Max too has continued eating healthily and has plenty of energy to run around in the park with his daughter on the weekends.
He and Alina are wanting to try for another baby, but it’s too soon yet to say whether that will happen. They are in their 40s now. The key lesson from this case history is that it can be surprisingly easy to improve a poor sperm count; the sperm just need the same nutritional goodies as the rest of the body, but more so. It takes only a matter of months with a strong diet and the right supplements to make a real difference.