Keen to father a second child, Stewart Hinds hung up his dancing shoes and turned his back on Hong Kong's partying scene. Hinds reduced his consumption of alcohol, and his wife quit smoking. 'The idea was to give the potential embryo and fetus the best possible environment for starting out,' says Hinds, 34. The couple are expecting their second child in September.
Hinds (whose name has been changed for reasons of patient confidentiality) is one of a growing number of men who recognise their role in creating a healthy baby requires more than the simple act of sexual intercourse. As women meticulously calculate their ovulation dates and clean up their diets, men are embarking on detox diets and fitness regimes to get their sperm in good working order.
'Previously, men did not appreciate their role in conceiving children; however, attitudes are now changing,' says Dr Patrick Chan, specialist in obstetrics and gynaecology at Matilda International Hospital. 'A man needs to be able to produce healthy sperm and the sperm must be able to reach and fertilise the egg.'
Male factors alone contribute to 30 per cent of all 'subfertility' cases, says the Family Planning Association of Hong Kong, which served more than 2,500 clients in 2010. Female factors contribute another 30 per cent, and the remaining is a result of either joint or unknown problems.
A number of factors can affect the production and transport of sperm. Medical conditions include undescended testes, varicose vein in the scrotum, damage of the genital tract from previous infection or operation, history of prostate infection, erectile or ejaculatory problems, and mumps orchitis in childhood.
Lifestyle choices such as smoking, drinking or exposure to chemicals can also make a difference. Daily exposure to bisphenol A (BPA) - sources include epoxy resin-lined food cans and hard polycarbonate plastics - caused lower sperm counts and testosterone levels in mice, a study last year from Banaras Hindu University in Varanasi, India, showed. Researchers from Queen's University in Kingston, Canada, also found that frequent cellphone use among men was associated with lower levels of luteinising hormone, an important reproductive hormone secreted by the pituitary gland.
Chan advises men to avoid excessive alcohol intake and smoking months before trying for a baby. 'For each ejaculation, the sperm is in production for the previous one to two months,' he says. He also suggests men steer clear of hot tubs, saunas and prolonged bike rides to avoid raising the temperature around the scrotum and impairing sperm as a result.
A poor diet can also lead to the destruction of healthy sperm. Chan says obesity or being underweight impair sperm quality. A diet high in saturated fats has also been linked with reduced semen quality, in a recent study by the European Society of Human Reproduction and Embryology. In the study of 99 men in the US, those in the third with the highest fat intake had a 43 per cent lower total sperm count and 38 per cent lower sperm concentration than men in the third with the lowest fat intake.
Consuming marine fish such as salmon and tuna - excellent sources of a certain omega-3 fatty acid called docosahexaenoic acid (DHA) - might help. University of Illinois researchers, in a study published recently in Biology of Reproduction, found that DHA is essential in constructing the arch that turns a round, immature sperm cell into a pointy-headed super swimmer with an extra-long tail. This arch, called the acrosome, houses, organises, and concentrates a variety of enzymes that sperms use to penetrate an egg, says study author Manabu Nakamura.
While Yoad Reiter, 35, has always maintained a healthy lifestyle, he appreciates that life as an investment banker can take its toll on his body. 'With extremely long hours, plenty of travelling, a highly stressed environment, topped up with wining and dining, keeping fit and healthy becomes tough,' he says.
Prior to the conception of his second child, now two months old, he engaged in more sporting activities, embarked on a detox diet refraining from alcohol, coffee and meat, and took multivitamin supplements. 'I was confident that this contributed to having strong healthy sperm.'
He had plenty of encouragement from his wife, Karin Graubard Reiter, a medical nutritionist and founder of Nutritious N' Delicious. Having previously worked in an IVF clinic in Sydney, she is an advocate of healthy eating when a couple is trying to conceive. 'A man's sperm is as fit as he is. As he becomes fitter they perk up and become more businesslike. The better his nutritional status, the healthier his sperm is and the more easily a woman can conceive,' she says.
Karin advises couples to opt for fresh, local, seasonal and organic produce, eliminate processed and junk foods, review medical drugs, and take supplements of zinc, folic acid, calcium, selenium, vitamin C, D, and E, with the advice of a doctor.
Parental age affects a couple's ability to bear children. Research findings suggest men have a biological clock that starts ticking at the age of 35. Recent studies show an increased likelihood of autism, schizophrenia, bipolarity, epilepsy, prostate cancer and breast cancer, as well as a reduced level of intelligence, in children born to men approaching 40.
Research published in the journal Nature Genetics found that Apert syndrome, a disorder characterised by malformations of the skull, face, hands and feet, is caused exclusively by advanced paternal age.
While Chan says that there is no conclusive evidence to link paternal age to specific problems in children, he adds that 'we do know that sperm quality is affected, and chromosome abnormalities are increased with age. This could lead to reduced fertility, abnormal embryos, miscarriages, and abnormal fetuses.'
Although one would assume that non-stop sex would be the key to conception, it seems that too much sex also needs to be added to the long list of what not to do when trying for a baby. The Family Planning Association warns: 'Too frequent sexual intercourse, say, once every night, may result in a decrease in the number of sperm in semen. Too infrequent sexual intercourse, say, less than once per week, may lower the motility of sperm.'
Chan says: 'As sperm live inside a woman's body for two days, sexual intercourse every second day around the time that a woman is ovulating would suffice.'
Trying to conceive can lead to an inordinate amount of stress on a couple - and stress can also result in reduced sperm count, according to Charlotte Douglas, a yoga instructor and homeopath who advocates yoga and meditation to maintain a healthy mind. 'We live in an increasingly toxic and stressful world and so doing everything possible to keep this to a minimum will ultimately aid healthy fertility,' she says.
Chan says that 'while the definition of infertility or sub-fertility is the inability to conceive after 12 months of regular intercourse, a couple can consult a doctor after six months to make sure that they are doing the right thing.'
-The percentage that male factors contribute to 'sub-fertility' cases, according to the Family Planning Association of Hong Kong