Unlocking Male Fertility: Sowing The Seeds Of Success

Introduction to Male Factor Fertility 0:00

Dr. Deb, thank you so much for joining us today. I am very excited to get into all of the things that are affecting male factor fertility and there are a lot of things. So thank you. Well, it's. So great to be here. And, you know, this is a really big deal because we are seeing more and more male fertility issues because of all the same things that are affecting women as well. But I think that we spend a lot of time talking about women. We don't spend as much time talking about the guys, do we? You know, we really don't.

And we should, because I truly believe that they are the other 50% of the equation, even though they're treated like they're 5% of the equation. Yeah. Yeah. So let's maybe start, if it's okay, by talking about some of the things that cause problems for male fertility, and then we can sort of dove into some of the solutions. Yes, absolutely. So one of the things that can interfere with sperm function with sperm count is a man's testosterone level. And we think of testosterone as the male hormone, of course.

And men, when they are young and in their childbearing years, ought to have pretty decent testosterone levels. But then it declines with age. So just like women go through menopause. Men go through end or a pause, so their testosterone levels go down. But we are seeing a whole epidemic of younger and younger men with low testosterone levels. I've treated men in their twenties for low testosterone.

Low Testosterone and Fertility 1:48

It's becoming more and more common. And if you are, you know, a guy in your twenties, in your throws, in your forties, you may not really be thinking about your testosterone levels, but there are some common symptoms that can be a clue that this might be a problem for you. Some of the common things are just feeling tired and and lack of motivation. Like you just kind of lose that spark, that drive, kind of just want to sit on the couch instead of going out to play golf for the things that you really used to do.

Libido can go down, so if you kind of lost interest in intimacy, that certainly doesn't help if you're trying to make babies. It affects brain function. So memory and focus and concentration and remembering things. It impacts weight. So men can be more likely to gain body fat and lose muscle mass. It impacts strength and stamina. And so there are many physical things that change. There are also emotional and mental things that change. Testosterone gives us out that confidence for men and for women.

So if testosterone levels go down, men can feel more anxious. They second guess themselves, worry about things more. Have a hard time making decisions. It impacts our mood in terms of depression, so low testosterone can have men feeling more depressed. But when men are depressed, if they're if the cause is a hormone issue and they go to the doctor and say, listen, I'm feeling down, you know, I don't want to get out of bed. I don't feel like doing things. What do we do? When you go to the doctor, right?

We got our prescription pad for the right problem. So it doesn't necessarily make them feel better from their mood point of view. And, you know, it doesn't really solve the problem for fertility either. So low testosterone is a really important factor in fertility for men. And I got a whole bunch more to say about it, but of course, it's by far not the only factor. Yeah. Another one that is just as important for men as it is for women is stress. When we are under stress, our cortisol levels rise because that's a hormone that helps us cope with stress.

And in the short term, that's great. It helps us cope with stress. But when we're under stress day in and day out, at work and at home and, you know, we've all got lots of stresses in our lives and it can be emotional stresses like your boss is a jerk or you got financial worries. But it can be physical things too, like back pain or allergies. And so any kind of stress, whether it's an emotional stress, a physical stress, they add up together and our body responds by making more cortisol. And cortisol shuts down fertility.

It shuts down testosterone levels, it shuts down for women, it shuts down ovulation. I'm sure you're talking a whole bunch about stress and the rest of the summit here. But for men, it's a really big factor. And again, if you go to the doctor, most men and women aren't going to go to the doctor and say, I am stressed. What we're going to do is we're going to say, I can't sleep at night. I don't feel good. I have no energy. And once again, what are our solutions? Sleeping pills and anxiety pills, but they're not really fixing the right problem, so they're not going to be the right solution either.

Sometimes they can help a bit, but they're not necessarily going to make it all the way. Well, they're certainly not going to help solve the problem of fertility. But it's interesting to think about it, because sort of in nature's wisdom, if your body is stressed, we react to stress the same way, whether there's a famine or a war or your boss is a jerk or you got financial troubles, we react the same way, which is to boost up cortisol. And so if there's a famine or a war going on in your body's innate wisdom, it's not the right time to bring children into the world.

So the system really does get shut down. So stress is a big one. Yeah. Yeah. So I think you've hit on stress being like a big underlying factor. And then testosterone almost is a response to it. Yes, like. Absolutely. When cortisol goes up, it shuts testosterone down. So if we can reduce stress, we can often allow testosterone levels to recover. And the younger you are, the more likely it is because if you're 70 and your testosterone level is low, well, you know, age probably has a big deal if you're a 35, something is causing that testosterone to go down.

So another thing that is a huge one for. Oh, go. Ahead. I wanted to ask you a quick question about that, because there's been a little bit of buzz about this. It's it's been stated by multiple practitioners in this space that the markers or the the ranges of what we consider normal for testosterone has been changing. And like, we're just lowering the bar essentially for what's considered optimal for testosterone, is that. Yeah, I think that's a really good point because when the most common way to measure testosterone for men is just a blood test and there's these normal ranges, but every lab has a different normal range.

So depending on what lab you go to, you might land in the normal range or you might not. But also there's normal, which just means that 95% of the population lands in that bucket, but it doesn't mean it's optimal. And we're saying we've got this whole epidemic of men that are having lower and lower testosterone levels. So therefore, what's normal for 95% of the population just keeps going down. So

Stress, Cortisol, and Hormone Suppression 7:24

there's a lot of controversy over this. So sometimes it's hard. But I guess what I would say is if a man gets his testosterone level tested and he sit right down there at the very bottom of the normal range and you're, you know, in your thirties and forties, that is not where you want to be. You men are healthier and live longer. Studies show that men live longer if they are in the upper half of the normal range than if they're down there at the bottom, even if they're still landing in the normal range.

So, yes, it's a controversy. There's no exact science as to what the cutoff is. But if you don't feel good, if you're having symptoms, if your testosterone is sitting in the bottom section of the normal range, maybe that's not ideal for you. Yeah. Yeah. Okay. Thank you for shedding light on that, because I know it's a really hot topic out. It is. And I'll I can give you my opinion here for what I look at is if a man's testosterone level is 450 or below on a blood test, to me, assuming that he has symptoms and there's know reasons that we were checking it in the first place, to me, I would just say that's low.

We like to do both a total testosterone and a free testosterone, which are kind of two different ways of looking at it. So there's more to the story than just the testosterone level itself. But but the bottom line is you don't want to be at the bottom of the range. Yeah. And we like I've traditionally seen and gone by like 500 to 700 being optimal as far as fertility goes. So yeah, we're right in that area. So let's talk about another humongous epidemic that's just as important for men as it is for women, which is toxins.

We live in this world where we are exposed to thousands of chemicals every day. They are in plastics. They're in our cleaning supplies. You know, for women, we're putting cosmetics on our face that have toxins. But men to shampoos and lotions. And, you know, the big guys have their stuff, too. And our food that we eat are filled with pesticide residues and preservatives. We are just exposed to thousands of chemicals every day. And many of those chemicals are hormone disruptors. So they mess up how our hormones work, including for men, the hormones that affect fertility.

So an example is atrazine, which is an herbicide. So it gets sprayed on the plants to keep the weeds from growing, but it washes into the streams with the rain. And atrazine can actually turn a boy frog into a girl frog. So weed have good studies to show. What does atrazine do to boy humans? Because who's going to sign up for that study? Right. Who's going to be a guinea pig for that? Another one is the antibacterial soap ingredient in actually antibacterial soap was called triclosan. And they've taken it off the market now because triclosan in it was a hormone disruptor.

And we know that I don't remember if it's gerbils or hamsters, but but some kind of cute little furry animals. They found that when they were exposed to triclosan and it caused their testes to turn from pink to blue. So what does it do to male testes? Well, it's kind of hard to say because nobody's signing up to be a volunteer in that study. But we do know that many of the chemicals that we're exposed to are hormone disruptors. And this is a really important cause of low testosterone in men and thyroid problems, which are another fertility problem and lots of other things.

But more and more men with the low testosterone at younger and younger ages are likely, at least partially, a result of the toxins in our environment. Yeah. So you talk you just mentioned thyroid and I had a little ding. How is there an optimal like approach at looking at thyroid labs for men? Because I can't seem to find any, like, consistent way to analyze these reports.

Normal vs Optimal Testosterone Ranges 11:30

Yeah. So I also haven't seen anybody really, like, dial in and try to say what's optimal, especially for men, because thyroid problems are so much more common in women than they are in men. So obviously men can have thyroid problems too. It's just less common. Men are less likely to complain. And so by complain, what I mean is they're less likely to march into their doctor's office to say, hey, something's wrong. What I hear men say all the time, women, women will say, This isn't me. I don't feel normal.

Something's wrong. What men say is, Well, I feel like this. I'm not sleep and I'm gaining weight. I'm tired of it. But maybe it's just my age. They say that all the time. Maybe it's just my age and I'm looking at going, Dude, you're 37. No, it's not your age. Like, talk to me when you're 97, then we'll blame it on your age. But so they don't think they they are less inclined to think, gosh, there must be something medically wrong with me. I better go get checked out. So for men, we don't have you know, for women we have functional ranges that we look at.

For men, we don't have that so much. So if it's outside of the normal range, obviously it's not normal. If it's getting to the edges of the normal range and somebody is having a lot of symptoms, then we may be likely to jump in and do something about it, whether that's by natural treatment or thyroid replacement therapy. And we want to get a full thyroid panel because the first thing is we want to know why is your thyroid test not optimal? Like, what are the and here we go. We've got stress. The cortisol can shut it down. We've got toxins.

They can get in the way of thyroid function. So we're going to be kind of doing the same things to help all the hormones. So at the end of the day, we got a plan for what we need to do. Absolutely. Give me 1/2. Just pause. Okay. Okay. Computer almost died. Do the doctors. Okay. Um. So if it's okay, I'll talk about oxidative stress, inflammation and medications and then we can start talking about what to do about it. Yeah. Yep. So let me let me just ask you. So what are some other factors? Okay, so were are there other factors that are impacting male fertility?

Yes, of course. Some of the other things are inflammation. When we become inflamed, what we mean by that, it's not like we mean that you twist your ankle and your ankle gets all swollen and red. What we mean is inflammation and chemicals that are just circulating through your bloodstream. And when you've got a lot of inflammation going on, it causes weight gain. Inflammation can cause testosterone to flip over to estrogen because men have some estrogen, too. But if too much testosterone flips over to estrogen, then our hormones get out of kilter.

And then that impacts fertility. When we gain more body fat, the body fat cells themselves can flip testosterone into estrogen and make more inflammatory chemicals. So it's just before we're processed. So being too inflamed does not help at all with fertility. Another one is oxidative stress. And oxidative stress is what happens when we generate energy inside our cells or the mitochondria, which are the Energizer batteries

Environmental Toxins and Hormone Disruption 15:00

in our cells. When they generate energy, we can get a little bit of cell damage on the inside by something called free radicals. And we have antioxidants. Everybody's heard about antioxidants. So antioxidants neutralize the free radicals, which protects your cells from that damage. So a little bit of that happens just normally with life and with aging, but with all the other stuff, the inflammation and the stress and the toxins, we can get so much more of this oxidative stress going on. And that's another factor that can interfere with sperm quality function and male fertility.

And then another one that I think is important to talk about is prescription medications, because there are some prescription medications that are that interfere with fertility. One of them is pain medications. So things like morphine and opioid pain medications, they have a really big impact on hormone production. So a common side effect of those kinds of medications is actually low testosterone and it becomes a really big problem because if somebody has chronic pain, they tend to not sleep well.

It can be depressing not sleeping and being depressed because of low testosterone. When you're testosterone goes down, you hurt more, you don't sleep well and you get more depressed. Like it just it's the cycle and it's hard to bust out of that. Antidepressants are another one, especially a certain kind of antidepressant, a class called SSRI. So that would be things like Prozac and Celexa. There's a whole bunch of them. Those decrease libido. So if you are trying to make a baby and mood is down, erectile function is down, it really gets in the way.

And especially if you've got a lot of emotional stuff going on when you're dealing with fertility and you know all the things that go along with that, if you end up on a medication that's interfering with sexual function, that just adds to the stress and anxiety of the whole circumstances. So SSRI is are an important one to know about cholesterol medications. Some of the medicines, especially at higher doses, can shut down testosterone because testosterone has actually made out of cholesterol. So shutting it all the way down, lowering cholesterol really low, actually makes it so that men can't make enough testosterone in the first place.

So that's another one. Some blood pressure medications can get in the way, especially on beta blocker medications. So one of the things to do would be to maybe talk to your doctor if you're on medications just to see could any of these be having a role to play in fertility? Yeah, absolutely. And I feel like the medications are often overlooked and men are often told, oh, yeah, you're fine, you don't need to worry about it. There's no meds that are contraindicated for fertility. And I think when a lot of doctors are talking about fertility, they're looking at like, are there any studies linking to decline in sperm health?

Not necessarily a decline in testosterone, which is going to impact sperm health. So it's it's a little bit of a messy situation. So I think what you just shared in terms of like asking your doctor and really like ask about both things, not does this affect my fertility, but is it going to affect my sex drive? Is it going to affect testosterone? Is it going to affect sperm health. And erectile function and. All of that? And like be specific about it because your doctor just isn't going to doesn't come to you.

If I thought there's specialty does not compute. Yeah. And if we could sort of sum all of this up that we just said fertility is a marker of health right in order to have the best chances of fertility, you want to be as healthy as possible. And so you have to be on all these different medications. That's just a clue that something is not so great about your health. And so the more healthy that we can get you overall men and women, the better fertility we're going to have. Yes, absolutely. So let's get into it.

What can we do to improve our overall health and specifically our fertility? Okay. So the first thing for men would just be to do the obvious things that we all know we should be doing anyway, right? Quitting smoking, minimizing the alcohol, getting enough sleep. All of those things suppress hormones and, you know, get in the way.

Thyroid Health and Male Fertility 19:30

In fact, testosterone is made at night when you're in a deep sleep. So if you're not sleeping soundly, that's a cause of low testosterone. If you have sleep apnea, that's a cause of low testosterone because you get oxygen to your brain. And so you're not sleeping soundly because you keep waking up, because you're trying to breathe. And so even just fixing sleep apnea so that you can breathe can actually help to boost testosterone levels and then managing stress in a healthy way is really important for men and for women in order to normalize cortisol and allow testosterone levels to be optimized.

And there you can't always just wave a magic wand and get rid of all the stress in your life. If we could, that would be awesome, wouldn't it? But the thing is not how much stress you have, and it's so much more how you allow the stress to affect you. So if you are a worrier or if you jumped to the worst case scenario and you know, if you are one of those people that sees the glass as half empty, then you are taking that stressful situation and you're just making it worse. If you can try your best to be the glass half full person, if you can look on the bright side of things, if you can try to let things go and not sort of ruminate over them, you can have the exact same amount of stress, but you can actually really protect yourself from some of the harmful effects of stress on your body, including on your hormones and your fertility.

So some of the really simple I don't know, they're simple, maybe not easy, but some of the simple things that you can do is gratitude. So if you catch yourself kind of worrying and being upset over things and feeling stressed, if you can stop and think about three things that you're grateful for, it's so interesting. Your body can't feel gratitude and fear, bitterness, resentment, anxiety at the same time. So it's a way to shift your state and what goes on in your brain literally impacts the chemicals and hormones that are going through your body.

So breathing exercises, yoga, meditation, exercise, walking, anything that helps to reduce stress is going to be really important here. And the tricky part of this, just like exercise, is it's got to be part of your regular routine. It needs to be something that you just get in the habit so that you're doing it all the time so that your stress levels can come down over time. Yeah, absolutely. Okay. So we talked about stress and managing our stress better and really like our perspective on stress.

Do you find that a lot of men specifically are less in touch with how things are actually impacting them? So like this, I see this a lot with like guys are like, oh no, I'm not stressed. Oh no, everything rolls off my back and and then like you asked a partner and they're like, yeah, no talking about. It's not, it's not so manly to admit that your worried, anxious, scared that you don't have it all together, you know. I mean, so guys are sort of socialized to suck it up and just keep on moving right on through it, right?

And so sometimes that makes it hard. Exercise is a great stress reducer. Exercise is good for boosting testosterone.

Inflammation, Oxidative Stress, and Medications 23:00

So if a guy is less inclined to sort of come right out and say, yes, I'm very stressed and maybe is less open to the idea of meditating, which I mean, there's so many wonderful benefits to meditating and beyond way beyond fertility. But but if they're maybe not so open to that exercise is something that is a good stress reducer as long as it's not like really hard core exercise. So, you know, the CrossFit people that are super intense, sometimes that's more of a stress than a stress reducer. But generally speaking, exercise is a good stress reducer and lifting weights is a good way to boost testosterone for men.

So kind of a win win. Mm hmm. Mm hmm. Awesome. I love that in terms of other things to do. So we've talked about, like, medications. Talk to your doctor about which ones are might be affecting your testosterone or fertility stress reducers. Toxins kind of like going through and getting rid of the toxins that are potentially in our environment. Yeah. So and for the toxins, some of the things that we can all be doing is getting rid of the plastic in our kitchen and turning to glass reading labels when we're purchasing personal care products and looking for things like parabens, avoiding fragrances.

Because a lot of times you can smell the scents unless it's made with essential oils, it's probably got chemicals in it that we don't want, like phthalates and then BPA is another chemical in plastics. Better just to try to get rid of the plastics because even if it says BPA free doesn't mean that the replacement chemicals are any better. We just haven't studied them yet to find out how bad they are. So that's all important for women, just as it is for men. Nutrition is another really important factor here.

For men. And what we want is we want to make sure that, you know, there's all this controversy, right? Vegan carnivore, you know, Paleo, Kita, but the bottom line is we want Whole Foods. So we want foods as they're found in nature, not the processed stuff. We want to be getting enough protein in the diet. We want to get all the fruits and vegetables. All those colors in the fruits and vegetables are phytonutrients, the plant compounds that are really important, antioxidants. We want lots of antioxidants because that's going to help protect us from oxidative stress, which is one of the factors going on.

We actually need enough healthy fat in our diet to be able to make hormones. So healthy fats would be like the olive oil, avocado oil and coconut oil, as opposed to the processed seed oils like the. Corn. Oil and all those vegetable oils. So that's a really important one. So a healthy diet is really important for healthy hormones, healthy fertility, and there are also some nutritional supplements that can be helpful. There is there is some research on male fertility and nutritional supplements, not as much as we would like.

But some of the things that can be important is vitamin D. And the best way to go about this is actually get your vitamin D level tested. So if men are low in vitamin D, then you can get sunlight in order to. That's how we get our vitamin D right from the sun, not so much from our food. But then also we can take a vitamin D supplement and then you go back and get your vitamin D level test it again to see if you are taking the right dose. And what I generally tell people is, at least we want you to be in the middle of the range.

So for most labs, the range goes 30 to 100. So 65 would be the halfway mark. So somewhere in the general vicinity of 50, 60, something like that, it's kind of a place to hit for. And there have been studies that have suggested that male fertility improves with better vitamin D levels. And I would argue probably to some degree, your vitamin D level is kind of like a marker of your overall health. And so if your overall health isn't that great, sometimes your vitamin D level slides down. So we want to get to another one that is worth thinking about is omega threes.

Omega threes are found in wild caught fish, but not farm raised. They are found in walnuts, flax seeds. But honestly, it's hard to get enough omega threes in the food that we have available to us at the grocery store. If you're a hunter and you get venison and things like that, the wild animals have omega threes because they're eating the grass. But at the grocery store it's hard to come by. So that's where an Omega three supplement can be helpful. Omega threes are very anti-inflammatory, which is what we want.

They they can act like an antioxidant, which is what we want. They really help with our hormones. They help keep our cells healthy. So there's many, many different ways that omega threes make us healthier and can help with fertility. Another one that can be really especially helpful for men is zinc. Zinc is really important for male health, for testosterone function, for prostate health. There are studies that show that boosting zinc levels can actually improve sperm motility and sperm count. So that's another thing that you can actually have your zinc level tested.

And goodness knows if it's low, you want to take some and get it to a better range. But even if it's kind of in the normal range, sometimes adding a little bit of zinc can be helpful. Vitamin C is another one that could be somewhat helpful. There's actually quite a bit of vitamin C in sperm and it's a really important

Lifestyle Changes to Improve Fertility 28:30

antioxidant has been shown to potentially improve male fertility. And the one last one I'm going to mention is ashwagandha. Ashwagandha is an herb and it's been used for thousands of years. It's from Indian traditional medicine historically, but it's been shown to do lots of different things. So it's really helpful for modulating the effects of stress on our body for helping to normalize cortisol. So that's good. It has positive benefits on thyroid function, so that's good. It has positive impacts on mood.

So it helps with depression, it helps with anxiety. It helps us with not feeling so exhausted when we're stressed. So all of those things are going to be helpful for fertility. It's it's fairly safe, I mean, unless you're allergic to it. And so that's something that is worth trying, especially for people who feel run down, burned out, kind of exhausted, stressed out. This can be something that can really make a big difference. Yeah, I love it. Those are all amazing tips. Astro Ganda is probably my favorite.

I feel like we should just put it in the water supply because I don't know too many people that don't need it. But we ajoke though. So thank you so much. Those are amazing. Is there any anything you want to highlight in terms of like medical treatments that are available for male factor fertility? So let's say we've got a man and he's doing his best with getting the toxins out and eating healthy, doing all the things. And yet, you know, it's just not really happening. And especially it's because sperm function, sperm count is just not really that great.

If testosterone levels are low, which can be part of what's contributing to the problem. We actually want to steer away from testosterone replacement therapy because if we were to give men testosterone replacement therapy, what it does is it tells the brain, oh, there's plenty of testosterone here. And the messages from the brain that are telling the testes what to do kind of get turned down. So now the message to make more sperm gets turned down so sperm count can actually drop when men are on testosterone replacement.

It's not reliable enough for us to count it as birth control. But for somebody who is trying to get pregnant, it would actually be recommended not to be on testosterone replacement therapy. There are other things, though, that we can do in order to try to ramp up production of sperm and testosterone. And one of those is a medication called H, C, G or human chorionic gonadotropin. It's something that's given as an injection. It's a prescription. You know, you'd have to get a prescription from your doctor.

But what it does is it directly tells the testes to boost test Armstrong, boost sperm count. So that's something that is used in in regular, traditional fertility clinics in order to boost male fertility. Another one is actually the flu vaccine. So we know that for women, Clomid is a pill. I got pregnant with my first baby using clothing because I was hypothyroid for many, many years and nobody figured it out. And I wasn't having any periods and I couldn't get pregnant. And they gave me clomiphene and then they found out that I was hypothyroid.

And then I had four babies. But for men it works too, because what the Clomiphene does is a clone machine tells your brain to send the message to the testes to get some action going here and boost testosterone and boost sperm count. So the ACG and the CLOMIPHENE can be used just short term in order to try to boost fertility until somebody gets pregnant. They can also be used in the longer term, though, in order to support testosterone levels. If somebody has a low testosterone, it's probably something that your regular doctor wouldn't deal with.

I mean, you probably would need either a functional medicine practitioner or a fertility specialist to help with that. Is there is there an upper limit on like how long someone can stay on clomiphene? I don't believe that we really have researched on cluelessly for the long term. It is newer. ACG has been around for a really, really long time and there are some you know, there are some young men who don't make testosterone

Supplements for Male Fertility 33:00

to go on HCG, like at puberty, and they're on it for many, many years. So we do have data. I don't generally recommend it for the long term, but but we do have data for that clomiphene we don't really have a lot of data for men on it for the long term. Generally, what I like to suggest is if if we're doing it just to boost sperm count, you know, maybe you could just be on it for the short term and be done if we're doing it because we also want to boost testosterone. And that's going to be a long term issue.

Sometimes what we can do is use it for a short time, say six months or so, to just try to reset the system while you're getting the toxins out, reducing stress, eating well, exercising all the things. And then we can try stopping it to see if your system has kind of picked back up again and you can maintain testosterone levels on your own. It doesn't always work. A another thing maybe if we can mention here is there's a blood test that I would recommend men get. It's called LH Luteinizing Hormone and that will tell us if if the LH level is high, that means that the testes aren't working properly and your brain is releasing this LH To try to yell at the testes, to try to get them to do something.

So if that's the case, then these medications are probably not going to work for you. On the other hand, if the LH is too low, the problem is probably not that your body can't produce testosterone or do a better job with sperm count. Is that your brain is not giving the message. And in this case, partly we want to understand why is your brain not giving the message? Maybe it's the toxins and the stress, etc., but maybe there's something else going on in a more more of a medical evaluation as needed.

But in that case, you're actually a really good candidate for the data, for the HCG or the CLOMIPHENE to really make a big difference for you. But if you go on testosterone replacement therapy, it's going to dial down the LH and it'll always be low. So if you go get your bloodwork done after the fact, it's irrelevant. It's always low. It doesn't give us the information. So it's better to get it done ahead of time. Yeah, absolutely. I love that you just gave that analogy of your brain yelling at the testes, because that's literally what I say to women all day long.

My job is all year ovaries. So that's perfect. Do you have a range of optimal that you like to see men for? LH You know, I guess I would say we sort of want it to be in the middle of the ring. We don't want it to be up, we don't want it to be too low. So definitely if it's below the lab range, that's when I sort of think about do we need to send them off to an endocrinology just for like a more thorough medical evaluation to rule out other things? But if it's in the bottom quartile, that would be where I would say, you know, maybe stress, maybe inflammation, maybe toxins.

Some of those things are what we need to work on to try to improve it. Awesome, awesome, awesome. We let's end with this one question that I think is really it's a beautiful question because it flips the script usually when it comes to fertility men, a question is always, how can I support my partner? So instead, like, how can their partner support the the males side yet when a couple is going through this fertility journey? So I think that there's probably a lot of psychological stuff going on, right?

Like just like as women, if we're not able to become pregnant, there's a lot of emotion that goes on.

Medical Treatments and Partner Support 36:30

So for men, too, and sometimes it's hard for them to put that into words. And and so they may be feeling it without speaking it. So the empathy, you know, trying to be open and trying to create space for that conversation, I think is really important. A lot of this other stuff, the eating well and reducing stress and things like that, there's actually a lot that we can do to help our partners because a lot of time women do the grocery shopping or at least participate in, you know, the grocery lists and what we want.

So if we, as women are trying to eat healthy, that's going to rub off on our spouse right when we're at the grocery store. If we buy the healthy kind of oils instead of the inflammatory seed oils, those are simple things. He doesn't even need to know about it, you know, just cope with it. But if we can be doing our best to do the right things, create the environment where it's just natural for him to be doing it too, right? Inviting him to go for a walk or a bike ride so that you're exercising together.

You're going to be reducing stress if you're doing that together. So if you can be partners in a healthy lifestyle, that's going to result in better fertility for him too. So I love it so much. This is an awesome conversation. Thank you so much, Dr. Deb, for joining me today. Where can people find you and where can they be? Connect with you. So my office is in Charlotte, North Carolina. It's called Signature Wellness. Our website is signaturewellness.org. We've got lots of information on the website about women's health and about men's health.

So that would be a good place to start. I love it. Thank you so much for joining me today. For those of you listening and thank you for joining us. And we hope that we will continue having this such an important conversation around male factor fertility. And we'll see you next time. Thanks.