I recall this story because it was a very emotional one; I first saw Laura by herself, she and her husband had been through two IVF cycles without success. She was a little older and her ovarian reserve, although not brilliant, was OK. Her husband Mark’s sperm test was quite poor, but they had been reassured that IVF ICSI was the solution, success would be theirs if they just kept going – “it’s a numbers game” they were constantly told. Mark repeatedly asked if there was anything he could do to improve his sperm and was told there was nothing. So finally he self-referred to a urologist and had a sperm DNA fragmentation test, which turned out to be so poor that even ICSI would not solve it. He did not have any obvious reason as to why this may be, there was no varicocele or infection so he asked the urologist what he could do about this and was informed that sperm donation was the only answer. He was distraught, they had already spend thousands of pounds on IVF, ostensibly treating his wife by proxy, for what was entirely a male factor issue, and no-one was giving him any explanation for why the sperm was poor in the first place. The urologist told him that the only thing that he could try (but it wouldn’t work) was see me for some nutrition and dietary advice.

So along he came, raging and furious and despairing. And he was a bit of a challenge I will admit! But he said he would do anything to try and help their situation. So the first thing I did was talk to him about his weight, he suffered from obesity, had a great deal of abdominal fat caused by a poor, highly processed diet and no exercise, he ran his own business and sat for hours in front of a computer eating snacks, not getting enough sleep and being very depressed.

Mark was highly motivated and when I explained to him how obesity and diet actually affects everything from testosterone metabolism to sperm count and quality, he got it. And he did everything I suggested. Three meals four days a week and intermittent fasting three days a week, no ultra processed foods, plain nuts as a snack, a Mediterranean Diet with loads of vegetables, berries, fresh fish, a few wholegrains, no sodas, one coffee a day, four beers a week and exercise every day, even if it was just a brisk walk. We set a time of six months and we saw each other every six weeks.

Then one day he came in with Laura with the most brilliant news. She was pregnant, naturally!  By this time he had lost 16 kilos and looked like a different man. Laura said his libido had also returned; he was like the man she first met! They subsequently went on to have a second child naturally.

This is not to say that changing your diet or taking up running will always change the outcome, but it sure does a lot of the time!