I was quoted in Time Magazine in an article on “Frontiers of Fertility“. For those interested, it’s a nice read.

Are cell phones bad for sperm? They emit electromagnetic radiation, and some have questioned whether that may be harmful for sperm.

Researchers exposed sperm in a test tube to the typical 850 and 900 MHz frequencies of cell phone transmitters and found that its movement worsened, its inner cell life decayed, and bad reactive oxygen molecules that are thought to damage sperm increased.

But a man doesn’t commonly hold his sperm up against his cell phone’s transmitter, and there’s a lot of distance and stuff between his cell phone and his sperm. So what’s the information about cell phones and sperm in real life?

In a study of sailors in the Norwegian navy, men who were exposed to high power military equipment transmitting radiofrequency electromagnetic radiation had problems with infertility. The higher the exposure, the worse the infertility, which argues that the electromagnetic radiation was the factor damaging a man’s reproductive chances. (An interesting observation in the study was that higher exposure resulted in less boys and more girls at birth.) But the high power electromagnetic radiation in that study is still not quite real life use of a cell phone for a typical man.

In another study of men going to a fertility clinic, researchers divided them into four groups based on how much time they spent talking on a cell phone each day: none; less than two hours per day; two to four hours per day; and greater than four hours per day. As talk time went up, sperm count, motility, inner sperm cell life, and the number of normally shaped sperm went down.

Should men stay away from using cell phones to protect their sperm? The pieces of the puzzle aren’t enough to make a blanket recommendation like that yet. But in the meantime, it’s probably a good idea not to go wild on the cell phone if a man is trying to impregnate his partner.

Wiki (not sure if that’s his real name) wrote in a comment, “is low Testosterone unusual for young athletic men (under 25) , what will be your minimum level (red line) for Testosterone of men under 25, as i found the minimum level varies according to each lab … mostly skewed based on the middle aged men they usually test.”

Great question! A while ago, many used “age-indexed” testosterone, meaning that lower levels were considered normal in older men. Most in the field have abandoned that approach as it’s like saying, we know that diabetes is more common as people age, so we’ll just use higher blood sugars as normal when they get older. That would be an approach ignorant of the basis of the disease. To make matters worse, to create the age-indexed thresholds of normal testosterone, each lab essentially was required to do that themselves. So you had a lot of labs with different numbers, and that made interpreting those lab results really difficult.

Your question gets to another point, though, which is what is a normal testosterone for an individual man? Testosterone doesn’t work by itself; a whole machine inside the cell uses it. It’s like gas in a car: you can have the same gas, but a Ferrari will drive differently than a Volvo. (No offense to Volvo owners intended.) So one man’s testosterone of 350 ng/dL may be perfectly fine, but for another, that may be low.

That’s why guys need to do evaluation and treatment with their doctors. (If you are trying to figure out a good doctor who knows about hormones in men, check out that part of the FAQ.) A doctor can evaluate the whole man and see other signs of low testosterone, and tailor treatment with different medications (many of which are described elsewhere in this blog.)

Thanks, Wiki, for the great question!

As I’ve written before in this blog, clomiphene is an effective if off-label treatment for men with low testosterone who want to preserve their fertility. If used directly, testosterone itself actually decreases the making of testosterone and sperm in a man’s testis. Clomiphene increases testosterone production in the testis by increasing the pituitary hormones that tell the testis to make testosterone.

In the March issue of Fertility and Sterility, a journal that I co-edit with Dr. Antonio Pellicer, Drs. Kim and co-authors review the published medical literature on treating low testosterone with clomiphene and other drugs besides testosterone. They conclude that clomiphene is a safe and effective treatment for men with low testosterone and note that less than one year of treatment with testosterone is usually reversible if a man wants his fertility to return. Unfortunately, we don’t know all that much about longer treatments with testosterone, and many men who have been on testosterone for several years do not have sperm return even with other forms of treatment.

Drs Kim and co-authors give us a nice review that supports the use of clomiphene for men with low testosterone who want to preserve their fertility.

While this isn’t specifically male health, I do write from time to time about important developments in reproductive medicine. Dr. Munire Akar from Aktinez University In Antalya Turkey reports in Fertility and Sterility the results of the world’s first human uterus transplant from a multiorgan donor. While transplant surgery has been around for a while and is a well accepted form of medical therapy, reproductive organs have come late to transplantation. This is undoubtedly the beginning of a new world for men and women previously unable to conceive for reasons of anatomy. If you’d like to hear Dr. Munire Akar talk about her work, click here. If you’d like to participate in a discussion on her article, click here.