Budgeting has never been in my nature, so it's no wonder I was unable to subsist on a measly student grant while at medical school. However, my parents made sure I never went hungry, and occasional sessions behind the bar brought in enough extra cash to keep me in booze and cigarettes. I do recall, however, how a few of my male colleagues helped to make ends meet by selling their semen to one or more of the fertility clinics in London's West End. At about £15 a pop, sperm donation remains a viable way for students to make some hard cash. Now that the government is planning to add top-up fees to students' financial burdens, I suspect even more male scholars will be tempted to take matters into their own hands with a little top-up of their own.
At the root of the demand for semen is a growing problem with male fertility: sperm counts in the West have fallen by half in just 50 years, and continue to decline at the rate of 2 per cent per year. While it is not known for certain what is causing this precipitous decline, pollutants are the chief suspects, particularly chemical entities known as xenoestrogens, which are believed to mimic female hormones and/or block the effect of male hormones in the body. Some scientists believe such hormone-disrupting effects are also a major factor in other male maladies that are on the rise including congenital abnormalities of the penis and testicular cancer. Xenoestrogens pervade our environment, but agrochemicals, plastic bottles and food wrappings, and tap water are believed to be highly potent sources. Avoiding xenoestrogens altogether is unrealistic, though eating organically and drinking mineral water from glass bottles are two big steps in the right direction for those wishing to minimise their exposure.
There is some evidence that fertility can be boosted using a nutritional approach. One nutrient that seems to be of benefit is vitamin C. The testes contain especially high concentrations of it, and low levels of this nutrient in the body have been associated with low sperm counts, increased numbers of abnormal sperm, and a tendency for sperm to stick together (known as agglutination). Research suggests that vitamin C can improve sperm counts, increase the percentage of viable sperm, and reduce a tendency to agglutination. From the studies, taking 1,000mg of vitamin C each day looks like a safe and economical fertility enhancer.
Another nutrient essential to sperm development is zinc. This is found abundantly in oysters, though a supplement is probably more practical. Take 50-75mg a day (with an additional 3-5mg of copper a day, as zinc can cause copper deficiency). Other nutrients that increase sperm counts include vitamin E (200IU per day) and selenium (100mcg per day). The evidence suggests that for men wanting to boost their fertility, supplementing with a handful of specific nutrients is certainly worth a shot.
Many mothers-to-be will be aware that smoking and alcohol are best avoided during pregnancy. Evidence suggests that coffee should also be added to this list. Hefty intakes of caffeine during pregnancy (equivalent to five to eight cups of coffee a day) have been associated with tremors and heart-rhythm irregularities in newborn babies. Also, in a study published recently in the British Medical Journal , drinking four to seven cups of coffee a day was found to be associated with a 40 per cent increase in the risk of stillbirth. Drinking eight or more cups of coffee a day appeared to more than double the risk. However, while this study showed that quite a lot of coffee may increase the risk of stillbirth, a small amount appeared to have the opposite effect: women drinking one to three cups of coffee a day were actually 40 per cent less likely to suffer a stillbirth compared to women drinking no coffee at all. All things considered, the current evidence suggests that drinking a cup or two of coffee each day is generally safe for expectant mums and their babies.
Two months ago, my wife and I came back from a holiday in Africa, where I contracted hepatitis A. I still do not feel well and can feel sick after large or rich meals. Even a small amount of alcohol makes me queasy. Is there anything I can do to help my liver?
Hepatitis A (infection and inflammation of the liver caused by the hepatitis A virus) often starts as a flu-like illness, after which jaundice (yellowing of the skin) may develop. The illness is usually self-limiting, though a proportion of sufferers may complain of vague symptoms for weeks or months after the original infection. For the time being, avoid eating or drinking anything that might stress the liver and slow your recovery, such as caffeine, alcohol, and rich or fatty foods. In addition, I recommend that you take a supplement of milk thistle. This herb is well-used in herbal medicine to help promote health in the liver and help its recovery after illness. Take 200mg of milk thistle twice a day for a month. Then I suggest you reduce the dose to 100-150mg, twice a day for a further two months. My experience in practice is that milk thistle is often effective in combating symptoms that may linger after a hepatitis A infection.