Why Is Getting Pregnant Difficult for Athletes?

Over the past 20 years, the Fertility Treatment Center has helped athletes from the Cardinals, Diamondbacks, Coyotes, Phoenix Suns, and their partners achieve pregnancy.

Whether you’re a weekend warrior or a celebrity pro, Dr. Craig and the staff of FTC are eminently qualified to help you achieve your goal of having a baby.

Reduced Fertility in Female Athletes

Athletes tend to marry other athletes, so reduced fertility is often a dual problem. Women who actively engage in sports have a lower fertility rate than non-athletes, often due to the effect of aerobic exercise or to medical conditions that are more common in female athletes.

Aerobic Exercise Level can affect female fertility:

• Level 0 – Equivalent to running less than 20 miles per week. This low level of aerobic exercise has no major impact on female fertility.
• Level 1 – Equivalent to running 20 to 40 miles per week. This level of aerobic exercise tends to reduce the female progesterone hormone level significantly after ovulation, resulting in reduced pregnancy rates.
• Level 2 – Equivalent to running more than 40 miles per week. Women who engage in this high level of aerobic exercise will often reduce their LH and FSH ovulation hormone levels dramatically, resulting in irregular menstrual periods or the complete absence of periods, reduced estrogen levels, and absence of ovulation. They have significant trouble achieving pregnancy. Certain medical conditions associated with low fertility , such as polycystic ovary syndrome and hyper-androgen syndrome, are also more commonly seen in women athletes.

Polycystic Ovary Syndrome ( PCOS ) Is a common syndrome that causes irregular menstrual cycles, increased body hair, easy weight gain and difficult weight loss. It is also associated with a increased female testosterone and androgen hormone levels, which enhance athletic performance and convey an athletic advantage in certain sports. PCOS is associated with a dramatic reduction in ovulation and significantly reduced pregnancy rates.

Hyper-Androgen Syndrome is associated with increased body hair, thinning of the head hair, and occasionally irregular cycles due to high androgen levels. These high hormone levels are advantageous for athletic training, but significantly reduced fertility.

Weight Loss is associated with long distance running, ballet dancing, and triathlon training. When the body mass index drops below 18, ovulation is suppresses and pregnancy is very difficult to achieve.

Androgen Insensitivity Syndrome is a relatively rare syndrome which dramatically increases female athletic endurance but is associated with inability to achieving pregnancy.

Fertility and the Athletic Male

Why do male athletes have more trouble getting their spouses pregnant? Men who actively engage in sports, from bicycle riding to basketball, are more likely to have reduced fertility for a variety of physiological reasons.

Testicular Trauma – from a low-grade repetitive minor injury to the occasional big hit, injury to the testicles can cause an immune reaction against sperm which reduces their ability to enter the uterus or fertilize an egg. Chronic testicular pressure is a problem in a bicycle riders, and occasional testicular hits are seen in all contact sports, including football, wrestling, and rodeo ridding.

Overheated Testicles – sperm production requires low testicular temperature, and sperm movement is compromised by anything that heats up testicles. This includes most outdoor sports during the summertime (especially in Phoenix) as well as the use of hot tubs or Jacuzzis.

High Testosterone Levels – while moderate levels of testosterone are required for good sperm production, high levels of testosterone paradoxically decrease sperm count, sometimes dramatically. Many athletes, especially those engaged in sports that require great strength, have naturally high testosterone and androgen hormone levels. Low sperm counts are common in men who engage in body building, wrestling, and track and field.

Training Supplements – many of the nutritional supplements and enhancers that improve muscle strength and agility are bad for sperm. High protein diets and steroid use can drop sperm counts dramatically, and some of the common alternative supplements (e.g. Echinacea, black cohosh, and St. John’s wort) can denature sperm. Although some alternative supplements such as saw palmetto and zinc might boost sperm performance, they cannot counteract the adverse effect of the enhancing supplements.

How to Find Out

Reduced fertility in male athletes can be evaluated by hormone testing and semen analysis.

Male Fertility Hormones include LH, FSH, testosterone, and prolactin. Abnormalities in these hormone levels are easy to treat with low-level male fertility drugs.

Semen Analysis the definitive male fertility test has three components.

1. Sperm Count – should be greater than 20 million/mL. Sperm are just a cell nucleus and a tail, so they are not very bright. They try to fertilize anything they bump into. That is why there are millions of them, so eventually one of them is bound to bump into an egg. If the sperm count drops below 20 million/mL, the chance of achieving pregnancy decreases dramatically.
2. Sperm Motility – the percentage of sperm that are moving in a forward direction is as important as the number of sperm. Sperm motility of less than 40% is associated with very ow pregnancy rates.
3. Sperm Morphology – means the shape of sperm. A large number of sperm have split tails, bent heads, and other abnormalities that prevent them from fertilizing eggs. At least 32% of sperm should have a perfectly normal shape to achieve pregnancy. Abnormal sperm tend to swim in circles and will never find an egg.

Keys to Getting Pregnant at the Fertility Treatment Center

A Matter Of Timing – Achieving pregnancy takes two, so our physicians and nurses will instruct you and your spouse how to determine the best time during her menstrual cycle to maximize the chances of pregnancy.

Intrauterine Insemination – A great success story in male fertility therapy is a procedure called Intrauterine Insemination (IUI), in which moderately low sperm counts can be increased to normal levels using a centrifuge. The concentrated sperm sample then inserted directly into the uterus using a special catheter. The IUI procedure, carefully times to take place om the day of ovulation, has a very high success rate with mild to moderately low sperm counts or motilities.

Male Fertility Drugs – in many cases, medications such as clomiphene, hcg, and Arimidex can increase sperm count enough to achieve pregnancy.

ICSI – a procedure called Intracytoplasmic Sperm Injection (ICSI) can be used to force fertilized eggs and achieve high pregnancy rates no matter how low the sperm count. This procedure is especially useful for men who have extremely low sperm counts or who have had a prior vasectomy, and want to avoid a vasectomy reversal procedure.