EXPERTS - VICES MAY IMPAIR POTENTIAL FATHERS' SPERM

Thinking about starting a family? Men contemplating fatherhood have
been bombarded with pitches for virility boosters. But it makes sense
to check your lifestyle first.

Whether it's bodybuilding or hot tubs, herbs, alcohol or cigarettes,
the residue of daily living gets into sperm. Prescription medicine,
recreational drugs and even lubricants can stack the odds against conception.

"You really have to be careful," says Dr. Harry Fisch, director of the
Male Reproductive Center at Columbia-Presbyterian Medical Center and a
professor of urology at Columbia University in New York. "A lot of
things people take can have an adverse effect on sperm function."

Antibiotics like nitrofurantoin (sold as Furadantin or Macrodantin)
can impair sperm, as can the ulcer drug cimetidine (or Tagamet), he
adds.

Another culprit is infection. "Many men harbor pelvic infections and
don't know it," says Fisch. Infections such as prostatitis can foil
fertilization. The antibiotic treatments temporarily suppress sperm,
but post-cure conception rates can improve.

Sperm thrive at moderate temperatures, so steaming-hot tubs steep men
in risk, says Larry Lipshultz, a professor of urology at Baylor
College of Medicine in Houston. Skip the whirlpool for a while if
you're trying to conceive, he says.

Sperm have to swim fast and straight to hit their mark, so some
fertility specialists advise patients to avoid lubricants, whether
water-soluble or not. This includes everything from KY Jelly to Vaseline.

Many men ask about vitamins and antioxidants. Some fertility doctors
prescribe modest supplements of the antioxidant vitamin E. But doctors
advise against megadoses. High doses of vitamin C, for example, can
change semen's acidity.

Bodybuilding supplements such as DHEA, androstenedione and
testosterone may suppress fertility. Boosting testosterone levels
curbs the body's own output, depressing sperm production.

Compounds Lower Libido

Dr. Lawrence Ross, chairman of urology at the University of Illinois
at Chicago, says he sees one or two men a month whose libido or
fertility is poor.

"They're taking over-the-counter androgenic compounds, or getting hold
of illicit prescriptions," he explains. "Usually, it's reversible. But
I can tell you of an Olympic-class weight lifter taking large doses of
testosterone whose testes became scarred and shrunken." The
32-year-old man was rendered permanently infertile.

Some herbs can tweak hormones, too, by mimicking testosterone and
shutting down sperm production. Columbia's Fisch says ginseng in high
doses acts like estrogen, damping male hormones.

A new product called Proxeed containing the amino acid carnitine is
being heavily promoted as a fertility booster. Aside from a handful of
small European clinical trials, the $100-a-month supplement has yet to
prove its worth. Some doctors are trying it in men whose infertility
hasn't responded to other interventions.

That includes men like 29-year-old Houston software company
administrator Glenn Armbruster. He had his enlarged scrotal veins,
called a varicocele, surgically repaired two years ago. Still
childless, his wife trolled the Internet for supplements. Under
Lipshultz's supervision, he's now trying Proxeed, but says, "It's too
early to notice anything."

Say `no' to alcohol, tobacco

For other men, it makes sense to limit exposure to alcohol, tobacco
and other chemicals. "Alcohol is a toxin to the testicles," says
Lipshultz. Safe levels aren't known, but he and others advise patients
to hold consumption to two drinks a day.

"Cigarettes also impair semen quality," he adds. "Studies have shown
smokers have more DNA breaks in their sperm." He routinely offers
infertile smokers a prescription for Zyban to help them quit.

Heavy marijuana and cocaine use also depress sperm counts. Likewise,
chemicals such as agricultural pesticides and vapors from smelting or
welding long have been concerns. One insecticide in particular,
dichlorobromopropane, renders workers temporarily infertile, says
Harris M. Nagler, chairman of urology at Albert Einstein College of
Medicine and Beth Israel Hospital in New York.

A spate of reports have linked declining sperm counts to chemicals
with estrogen-like effects. But some researchers think normal
geographic and seasonal variation in sperm counts may have confounded
some of the research. This year, Fisch and his colleagues offered a
reassuring review of 29 U.S. studies from the late 1930s to the late
1990s. His study in the Journal of Urology found "no significant
changes in sperm counts during the last 60 years."

Troubling Trend

One demographic trend troubling fertility researchers is deferral of
childbearing to the 40s from the 20s. "One of the big debates -- it's
almost too hot to handle -- is postponing having kids.

It's a big decision," says Lipshultz. "People come in and say they've
been married for 15 years and trying for two."

Sperm counts start dropping after a man reaches 45, although not to a
level posing a significant problem. If other problems exist, though,
age complicates them.

One thing that apparently doesn't matter is your underwear. A study at
the State University of New York at Stonybrook, published in the
Journal of Urology, said fathers-to-be can select either briefs or
boxers. Pelvic temperatures in wearers are barely different between
the two, debunking an old husband's tale.