In today’s pregnancy planning practice, the focus is solely on promoting the health of the future mother, while the importance of preconception health of the future father is overlooked. Although scientific research indicates the importance of good health for both parents for the success of conception, the course of pregnancy, and the health of the child, in practice, preconception care for fathers has yet to become a reality.

Preconception care is a set of measures aimed at recognizing and modifying biomedical, social, and behavioral risks that have a direct effect on the outcome of reproduction. Preconception care benefits for the future father include increased chances of conception because it improves the biological effect and genetic contribution of men to pregnancy and the birth of a healthy child. A key factor for conception, a healthy pregnancy, and a healthy fetus is the quality of the genetic material of both parents. Damaged DNA in sperm leads to infertility, reduced fertility, or miscarriage. Although pregnancy is possible when there is a low degree of sperm DNA damage, these pregnancies result in birth defects and cancers in children associated with this DNA damage.

Conception affecting factors

Genetic material damage can occur in various ways, such as exposure to nicotine, numerous drugs, alcohol, caffeine, poor nutrition, radiation, chemotherapy, and testicular hyperthermia. Some drugs associated with male infertility are marijuana and cocaine. Studies have shown that marijuana reduces testosterone production, sperm count, and sperm quality and can lead to erectile dysfunction. The use of anabolic steroids is also associated with lower sperm concentration and morphologically abnormal sperm occurrence.

Furthermore, medical conditions such as diabetes, varicocele (abnormal varicose veins in the testis, a condition that Čizmić et al. call the “silent killer of male fertility”), epididymitis (inflammation of the epididymis, the epididymis is a long tube located near each testicle whose role is to transfer sperm from the testicles) and obesity, can reduce the quality and sperm count. Specifically, the increased incidence of obesity is directly related to increased male infertility. Obesity in men is associated with decreased testosterone levels and sperm quality. Sallmén et al. state in their paper that the probability of infertility increases by 10% for every 20 lbs (approximately 9.10 kg) overweight. Therefore, normalization of body weight would be an essential goal of prenatal care.

Toxins: dioxins, phthalates, polycyclic aromatic hydrocarbons, cause oxidative stress leading to DNA damage. Numerous medicinal substances can affect sperm volume and quality. Some of those substances are alkylating agents (cytostatics that form covalent bonds with nucleic bases and ultimately prevent DNA replication and transcription), calcium channel blockers, cimetidine, colchicine, corticosteroids, cyclosporins, gentamicin, sulfasalazine…

The link between paternal age and neurodevelopmental disorders

Increased paternal age and the associated decline in sperm quality are one of the risk factors for the occurrence of schizophrenia in offspring. Scientists in a cohort study calculated the hazard ratio of schizophrenia in offspring associated with paternal age. For each increase in the father’s age by 10 years, the risk ratio was 1.47. Furthermore, new mutations in the germline of older fathers have been identified as a risk factor for the development of autism in children. Paternal age was associated with epigenetic changes in sperm DNA methylation, and these changes affected the overall health and disease susceptibility of the offspring. Specific genes associated with autism are affected by these changes. In addition to age, exposure to toxins, inadequate nutrition, and stress can affect DNA methylation and potentially cause disease in offspring.

Antioxidants and DNA damage

Antioxidants prevent DNA damage caused by oxidative stress; therefore, antioxidants have been recognized as an option in treating male infertility. Antioxidants used in practice are vitamin C, vitamin E, selenium, glutathione, carnitine, and zinc. However, the effectiveness and safety of such treatment have not been undoubtedly proven. Of these antioxidants, zinc has the best level of evidence. Studies have shown that a daily intake of 66 mg of zinc sulfate and 5 mg of folic acid significantly increases sperm concentration in men with reduced fertility. Another study showed an increase in sperm motility of subfertile participants after oral administration of 220 mg zinc sulfate daily for 3 months.

Ginger and testosterone

We have already established that the genetic integrity of sperm is crucial for the normal development of the embryo and the transfer of the father’s genetic material to the offspring. Since new sperm is produced every 42-76 days, damaged sperm can be replaced within 3 months of exposure to toxins. There is evidence that consuming ginger improves sperm quality. Improvements in concentration, viability, motility, and sperm morphology have been documented. Ginger increases the concentration of testosterone and with its antioxidant effect neutralizes reactive oxygen species that damage cells, furthermore it increases the production of nitric oxide. Nitric oxide increases blood flow to the testicles and thus increases testosterone production. Also, ginger exhibits an antidiabetic effect. Bringing blood glucose levels to normal boosts testosterone production. The antidiabetic effect was confirmed in a study where participants consumed 2000 mg of ginger orally daily over 10 weeks. An additional effect on fertility is due to the content of manganese, which increases the production of luteinizing hormone that stimulates testosterone synthesis and consequently improves sperm quality, improving parameters such as number, endurance, motility, morphology, and integrity of sperm DNA. Ginger shows potential benefits in repairing gentamicin-induced oxidative stress. Namely, studies in mice have shown that it reduces cell death (apoptosis) of sperm due to oxidative stress caused by gentamicin. Gentamicin is a broad-spectrum antibiotic that causes oxidative stress in the testes and thus reduces sperm count. Mice receiving 100 mg/kg of ginger intravenously showed a lower degree of apoptosis compared to mice that were not administered ginger. Regarding the results of this study, it would be advisable for men on gentamicin therapy to also take ginger.

The goal of prenatal care is a healthy pregnancy and ultimately a healthy baby. Success depends on the health of the parents. While care and support for the future mother are carried out in detail, pre-conception care for the father has not yet taken root in practice. In any case, the usual guidelines for maintaining good health apply. A balanced diet, regular physical activity, enough sleep, and avoiding toxins. If necessary, take steps to normalize body weight and good disease management.

Translated by Patricia Štriga



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