Sheldon Marks, MD
Biography

	Can I pass Propecia to my wife via my sperm? What can a man do to increase his fertility? How does marijuana affect male fertility? Are there any risks with ICSI? How often should we have sex for the best sperm counts?

Did you know male infertility contributes to 50% of all infertility cases? Learn about the causes of, and potential treatments for, the male side of conception problems from urologist Sheldon Marks, MD. We welcomed him on Oct. 26, 2005.

If you have questions about your health, you should consult your personal physician. This event is meant for informational purposes only.

This WebMD conference is brought to you the WebMD Fertility Center and RESOLVE.

MODERATOR:
Welcome to the 4th annual WebMD/RESOLVE Fertility Cyberconference. As part of National Infertility Awareness Week, the WebMD Fertility Center is teaming with RESOLVE: The National Infertility Association, to bring the top fertility experts to you! Our guest is Sheldon Marks, MD.

Welcome, Dr. Marks. Please tell us a little about yourself and your area of expertise.

MARKS:
I am a urologist whose practice specializes in male fertility and vasectomy reversals.

MARKS:
Excellent question. Yes. The active ingredient in Propecia is very, very dangerous for a growing fetus and any man who is trying to father children should not take Propecia.

Something you need to know: the vaginal Ph is designed to kill sperm. When a man ejaculates, the semen clumps, protecting the sperm from the hostile vaginal environment while the semen changes the Ph to make it a positive happy place for sperm.

MEMBER QUESTION:
My husband smokes a couple of cigars on the weekends. How much of an impact would this have on his sperm?

MARKS:
Tobacco in all forms is bad for sperm quality and sperm production. Ideally, he should stop the cigars. Chances are great, though, that an occasional cigar probably will not drastically damage his fertility.

MEMBER QUESTION:
My husband and I have been trying for about a year and half. His sperm analysis came out low motility but high count and the morphology was normal. Can the motility continue to decrease? It is 20% right now.

MARKS:
The motility itself is only important when looked at with the volume and the total count.

"Semen analysis numbers vary widely from day to day, ejaculation to ejaculation."

When you multiply these three numbers together, you get a total motile count -- that is the total number of motile sperm. If his numbers are high, and his volume is good, then even having a 20% motility, he could still have many tens of millions of motile sperm, which should be enough for natural conception.

Motility can be damaged by:

• Exposure to heat (such as hot tubs)
• Chronic vibrations (such as truck drivers)
• Alcohol
• Tobacco
• Marijuana
• Other environmental factors

MARKS:
I would suggest he avoid all heat, such as hot tubs, hot showers, Jacuzzis and hot saunas. He should also stay well hydrated, take antioxidants, and ejaculate every 24 to 48 hours to keep his system revved up.

In addition, excessive exercise can be detrimental to sperm counts, as can significant emotional stress. This time of year we usually see lower sperm counts in the fall and winter. So a slight reduction is nothing to worry about.

He also should repeat a semen analysis every few months after three days of abstinence. Semen analysis numbers vary widely from day to day, ejaculation to ejaculation.

MEMBER QUESTION:
My husband's count dropped from 16 million to 4.6 million. He is a healthy 30-year-old man with no recent colds or viruses. Would acupuncture help him?

MARKS:
Recent studies show that acupuncture may benefit men with low sperm counts. There are nutritional supplements that have been shown to boost sperm quality in numbers in many studies. These supplements are derivatives of beef protein. If you want, you can spend lots of money importing exotic supplements, or simply have a cheeseburger three times a week.

The opinions expressed herein are the guests' alone and have not been reviewed by a WebMD physician.