It’s hard enough to get a sperm sample - let’s face it, it’s an uncomfortable test and who wants to have to retest because the first sample collection was done wrong.  As a natural fertility expert, I often see sperm samples that are done correctly and therefore uninterpretable.  Tune into this episode to find out how to do a sperm sample correctly to get an insight into your partner’s fertility. 

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Key Takeways

01:32 Challenges in Sperm Analysis

07:09 Impact of Lifestyle on Sperm Quality

12:16 Understanding Sperm Analysis and pH Levels

18:21 Sperm Analysis and Health Indicators

27:00 Hidden Infections and Infertility

31:05 The Role of Nutrients in Sperm Health

32:06 DNA Fragmentation and Fertility Challenges

Memorable Quotes

“Everything, and I mean everything that the male does will reflect in his sperm—the food that he's eating, the amount of times that he's pooping, how much he's sweating, how much he's exercising or not exercising, the amount of stress that he's under, how much he's sleeping or not sleeping, how much alcohol he's drinking or smoking."

"If the male collects sperm analysis for three, not three days in a row, but three days apart, literally, you know, in a row. So in nine days, every single one of those samples will be different."

"When I see the abnormal heads, I'm thinking DNA fragmentation, I'm thinking oxidative stress. And when we're talking about oxidative stress, we're thinking the amount of damage that's going on in the body is not being caught up by the repair for, aka, antioxidants. And so diet, lifestyle, inflammation, blood sugar regulation, exercise, too little or too much smoking, drinking, lack of sleep, all of these things are going to be impacted."

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The problem is he lives about 50 minutes away. 50 from the clinic. So he collects the sample, and even if he gets into the car right there and then and hands it off to them, they only have. There's ten minutes left in order for that sample to be viable. And one, I don't have that sample that I'm sharing. But as soon as I saw that, I was like, you collected the sample at seven, but it didn't get analyzed until 830. That's too long. Why is that so? I didn't realize that some clinics were telling men to just collect at home and then drive over, which might be okay if you live two minutes away from the clinic, but it's not okay if you live an hour away from the clinic. Pregnancy is a natural process. So if it's not happening or if it's not sticking, something is missing. After having a family member go through infertility and experiencing a miscarriage myself, I realized how little support and education women have around infertility. I want to change that. I'm doctor Jane Levesque. I'm a naturopathic doctor and a natural fertility expert. Tune in every Tuesday at 09:00 a.m. for insightful case studies, expert interviews, and practical tips on how you can optimize fertility naturally. If you've been struggling with infertility, pregnancy loss, women's health issues, or you just want to be proactive and prepare yourself for the next big chapter in your life, this show is for you. All right, ladies, today I want to talk to you and probably, gentlemen, you probably are going to want to send this podcast episode to your partner about collecting a proper sperm analysis and understanding what a good sperm analysis actually entails. I will go through some of the samples that I've had with patients, but recently what I have seen is just the lack of knowledge and understanding and the lack of guidance from the conventional system, from your fertility clinics on how to complete the sperm analysis correctly. And then we're getting the sample. That's basically not interpretable because of the mistakes that were made, whether it's the days of abstinence or the amount of time that it took for them to collect from collection to the sample, to actually getting the sample analyzed. And then we're getting. Or maybe some of the sample got missed and not everything got into the cup, then we're getting an almost freaking out about these diagnoses that, oh my God, I have, that my partner has the worst sperm ever, or we're being told everything is fine. And in reality, nothing really got tested. So I want to shed more light on this today because, like I said, I'm seeing a lot of mistakes and I've literally had a couple recently where he said he did the sperm analysis and they just sent him a little, like, word document, like a note with all the numbers without any reference ranges. Like, it's literally just concentration. Like, you couldn't even tell if it was. That was the concentration. Is this the motility? Is this the ph? Like, what is happening here? And obviously, that's not a good clinic to go to. It's wildly unprofessional to not only make a mail, go in and do a test that, you know, let's face it, is not a comfortable one to do, but then to not provide any feedback or information on what was found and just kind of be send off on your way. So I don't want you to make that mistake. So let's get right into it. And I'm just going to actually do it. If you are watching this on YouTube, then you can see the samples as I'm walking through them. If you're just listening to it, I'm going to very much walk you through to what I am seeing. So all the information from the patient has been redacted to make sure that obviously we keep the patient's information private, but the big thing that I look for right off the bat is sample information. So we want to make sure that. And this is a good test in terms of the details. So they ask for completeness. And, you know, there's a lot of room for interpretation here. But what I think about completeness is, hey, we got the full sample in the cup versus we didn't and some got missed. And it's really important to know if that happened because for the most part, you know, let's be honest, when a man is ejaculating, like, he doesn't know if some got missed, he doesn't know if it's at the beginning of the sample, at the middle of the sample or the end of the sample. So we're going to make different assumptions and it's really, really important that we try to get all of the sample in. And that, in fact, does happen because sometimes the men are like, oh, I think maybe some missed. And I've literally had a sperm analysis that was completely different because the first little bit didn't make it in and the next time it did because the first little bit is where all the best sperm is going to be and the strongest guy. So we want to make sure that is very clear to the male that everything gets into the sample, then the method of production, usually it's the masturbation, the time the sample produced. What this is lab is missing is the time that the sample got analyzed. Now, if you are doing your sample in a lab and you're giving it off to the lab right there and then usually, and you want to double check this, they are analyzing it right there. And then within 15 to 30 minutes of collection, the maximum amount allowable time is 60 minutes. So if you are working with a fertility clinic, and I literally have a patient that we unfortunately could not read the sample because he was told that, no, no, you collect at home and then you just drive it over to us and then we'll take care of it. The problem is he lives about 50 minutes away, 50 from the clinic. So he collects the sample. And even if he gets into the car right there and then, and hands it off to them, they only have. There's ten minutes left in order for that sample to be viable. And, you know, one, I don't have that sample that I'm sharing, but as soon as I saw that, I was like, you collected the sample at seven, but it didn't get analyzed until 830. That's too long. Why is that so? I didn't realize that some clinics were telling men to just collect at home and then drive over, which might be okay if you live two minutes away from the clinic, but it's not okay if you live an hour away from the clinic. So that's really important. This sample is missing that information. So we have that the time that the sample was collected is at 08:07 a.m. but in reality. And then ideally there is a. Another bar right underneath, or another sentence right underneath where it says the time that the sample was analyzed. And that should be within 30 minutes, ideally 15 minutes, but definitely nothing over 60 minutes because sperm are very viable. Like, they're just. They're going to die within that time. It's really, really important that short, the time between collection and analysis is very, very short. As short as possible. And it also, in terms of what I will say is, I think most men are really underestimate this. But everything, and I mean everything that the male does will reflect in his sperm the food that he's eating, the amount of times that he's pooping, how much he's sweating, how much he's exercising or not exercising, the amount of stress that he's under, how much he's sleeping or not sleeping, how much alcohol, he's drinking or smoking, whether it's weed or cigarettes or vaping, every single thing that he does will reflect in his sperm. And so even if he's sick, I've had patients test and they just go in and they were exhausted and they had just Covid, and they're like, oh, but I got to get the sample done. And then the sample turned out to be terrible, of course. And so then here we are, freaking out that the sample. I'm not freaking out. The couple is freaking out that the sample is bad and he doesn't have good sperm, where in reality, we're not going to diagnose anything from just one sample. It needs to be, minimum two, but ideally three samples for us to say, hey, I think that this is a problem and there's something else going on, and you definitely want to get it from a place, like, even when you guys are trying to conceive, if both of you are exhausted, if both of you are stressed, it is reflected in your health and therefore in the quality of the egg and the quality of the sperm. And I know, I know infertility is stressful. I get it. I just think that sometimes we get so into our head where, like, it doesn't matter what's going on, we just gotta keep. We have to take a step back and look at the numbers, look at the data, and let the data guide us. And like I said, we do not want to. The reason I'm going on this tangent is like, okay, I know that the sample was collected first thing in the morning. What did he have? What was his level of stress? Is he going into work? Does he have a lot of stuff going on versus at lunchtime? Did he already have a stressful day? Was he exercising right before? What did he have for breakfast, for lunch? What did he do the night before? How is this quality of sleep? So ideally, you want to get it on a day that's quote unquote regular, where there's nothing going on that's extra, you're not doing anything the day. It's literally to get an idea of what's going on. Yeah, but it is important to take that into consideration because I've seen sperm analysis change within two weeks. Miraculously. It's like. It's not miraculous. Even though the sperm production is 72 days about right, we're looking at that. Two and a half, three months mark the maturation. Males make new sperm every day. And so the sample that comes out is everything that they're making. They'll have mature sperm and brand new sperm in that sample. And that's why we're not expecting to see 100% great morphology or good swimmers, because the male is producing sperm every single day and what comes out of the sample is brand new sperm and matured sperm. The reason that we can have a big impact over the three months is, of course, if we understand why the morphology is off or the concentration is bad, or that the progression isn't there, like the motility or the ph, then we can do an appropriate treatment to obviously fix the issue, if you will. But the. If we have no idea what's going on and we're trying to just take supplements and hope that's the thing that works, then we're not as accurate for obvious reason. But the two weeks of maturation that happens. So while the sperm is made and then it kind of sits in the testicles for two weeks before it's quote unquote mature and ready to go, we can have and see a big difference in. There's not a single sample that's going to be the same, but you could see a big difference in this two weeks, Mark. So for example, I had somebody who had COVID test and they had an awful sample. And then they just waited for a couple of weeks until their infection went away, the energy went back up and they felt good and all of a sudden the sperm changed. It's because even two weeks is going to make a difference because every day the male is making new sperm. So I really just want to get that across. So that's the first thing is the time of day and then how quickly is it analyzed? The next thing is abstinence. So big mistake always is more than three days. I wanted two to three days of abstinence right here in the sample it's four days. And you could see that the reference range is two to five. And that's not accurate enough. If it's five days, four days, five days, six days or even more. I had a patient come in and was like, six days. That sperm is going to be quote unquote rubbish. It's not, it's too old and you're not going to have a very good sample. We want fresh sperm. And for guys it's a supply demand. If there is no demand, the supply goes down. And very much with infertility. And just in general for guys, it's important to have that release on a regular basis for women as well. But we have, again, more complexities when it comes to the hormones. So abstinence here, four days, I'm right away going to take that into account that this form is probably a little bit old. And then there is a physical observation. So we're looking at the appearance, the liquefaction, the consistency and the ph. What I don't like about the sample is just kind of says normal versus abnormal. Liquefication is usually normal. It either liquefies and comes back or it doesn't. The consistency is the same, normal versus viscous. And then the ph, they have a huge range, 6.5 to ten. If the sperm is ten or 9.5, like, that's a crazy high level ph, and that signals a big infection for me. So I like to see it between 7.5. Usually it is to eight. Just because it's like sperm is going to be more basic and more alkaline versus the female reproductive system is more acidic. But during ovulation, the woman produces more white cervical fluid production, which is actually more alkaline in nature, which allows the sperm to survive in the female reproductive system for longer. But it also allows it to swim for, you know, higher up so it can survive and it can swim right upstream. That white cervical fluid that's really stretchy. It, like, creates these lines for the sperm to just get right through. So I always want to make sure that ph is definitely not higher than 8.5. I consider even 8.5. It's like, oh, it's starting to get a little bit high. And then typically we start to see whether we start to see some debris or we start to see some viscosity or liquefaction issues, lip faction issues. So basically, the sperm is not separating, it's just kind of clumping together. Huge sign of infection that we want to address ASAP, because if the sperm is clumpy, it's like it can't swim. Right. It's just trapped. And again, so many males have issues with their blood sugars, their livers, they have infections, prostate testes, urethra, and they, like, first of all, they just don't pay attention to it because it's, oh, women get bladder infections, men don't. But if the male is going to the bathroom frequently, waking up in the middle of the night to pee, and it's like, oh, it's because I'm drinking a lot of water. Okay, we'll stop drinking water. Oh, you're still going to the bathroom frequently. Then we're just not addressing an infection that's going on whether, like I said, it's in the urethra or the bladder or the prostate. Like, for males, it's very, very common. And I do test the prostate all the time and always see the prostate elevated is not a test like the psa is not a test that you just start doing in your fifties. If you're struggling with infertility, your male should be getting his prostate checked now, at least through the blood work first, and then potentially having to do more of a thorough prostate check with ultrasounds and, you know, more of a physical exam to understand what's going on. But I. It is a sign of infection. When we have these phs that are really high and there's a lot of viscosity and appearance debris, anything like that should not be there. Then we get into things like volume and sperm concentration and then into the motility. And this is where I know, okay, well, this male is four days of abstinence instead of two to three. So it's going to be a bit of the older sperm and it's probably going to be a bit motile. When I see that there's some numbers that are missing. For example, the vitality percentage is missing and I'm not sure, but the slow progressive, we see that it's at 3%, the rapid progressive is at 46, and the reference range is at 32. Now, you have to understand that reference ranges, like, for every lab, it's different. And this is, you know, what's mind boggling to me. But I want that sperm over 50%, 60% to be rapid progressive. We want it to be moving forward. We want it to be moving in the right direction and right there. And then I can tell, like, oh, it's not moving. Not as much of it is moving as it should. And then, of course, you look down and you see that the motile percentage is 48. So 48% of the sperm is just not moving at all. And I know now I'm like, okay, something else is happening here and we're going to keep going down. In the sample, the immunology, so there was no clumping, there was no any immune markers, igG, igA, igM, all of that is really good to check. And I would say that most couples do not have these levels of tests. I'll show you another one where it was just the bare minimum. And literally the guy was told that everything is normal and he's not part of the issue and absolutely part of the issue. Absolutely part of the issue. And it's frustrating because, of course, they've been struggling with infertility for four years. They haven't. And she's been breaking her head, trying to figure out what's going on. And, you know, it's just been obvious for however many years they've been doing the sample analysis and going through their journey that the male is absolutely part of the journey. And, I mean, he is part of the journey. Anyways, the next piece is the morphology. So this is where we can see the quote unquote red flags. The normal forms are only 2%, so it doesn't mean that there's only 2% normal sperm. It kind of means that it's 2% is best of the best. And, you know, in the conventional world, if you're going to be anything lower than 4%, chances of you conceiving naturally is going to be quite low. And so we want to get it to that 4%. What I love about the sample is that they actually break down what, where the abnormality is. So the abnormal heads is at 98%, and then we have midpiece at four and abnormal tails at one. I'm not sure how they're adding that up to 100, to be honest. But we see that the neural heads is really high. And when I see heads that are abnormal, this is exactly where the DNA is going to be, the part of the DNA, the genetic code that's going to be passed onto the egg. And we do not have a DNA fragmentation test. Now, a lot of people do not get this done. Highly recommend to get it done, but my assumption is that the DNA fragmentation is probably going to be pretty high for this fella, and we're not surprised. He was high stressed, didn't drink way too much coffee, didn't drink enough water, smoked pot, drank pretty, I would say, on a regular basis. So even if it was once a weekend, but going out and having 3456 drinks, even if it's once a weekend, it's still a pretty big toll. Like, it's pretty big. Inflammation, high hit on the liver, the microbiome, biome, everything. So when we're struggling with infertility, I'm always very transparent with my male patients. It's like, hey, if I know your sperm is not going to be perfect if you're drinking, if you're smoking pot, if you're not sleeping enough, all that jazz, and it's. I know the conventional doctor said it's fine, but it's not. And so we need to take, you know, understand that everything that the male does will reflect in his sperm quality. And it absolutely makes crazy difference in the quality of the sperm. When he changes in this couple, when he saw this, he was in shock because, of course, his doctor told him it was normal and he didn't know any better. And this is why I'm making this content, because I don't want you guys to fall into the same trap. But he was smoking quite a bit of pot and literally stopped. And then within three months, they got pregnant. So they were this unexplained infertility case that was really, really difficult for everybody. Nobody knew what was going on. And the male was never on board. And no one put enough weight and said, hey, it's, you just need to stop smoking. And he was more than happy to do that. He. We just needed to figure out some things would work for him. It's more stress management. But, you know, obviously him and her, they had the same goal of bringing a healthy child into this world, and nobody just gave him this. No, you need to stop smoking pot like it is the thing that's impacting your sperm. He just thought that. That, you know, his body was handling it fine and he was bypassing it. But that perfect example, three months, you stop the body get. And he was taking good supplements where you fix his digestion. And within three months, you know, we didn't retest the sperm because he got pregnant. They got pregnant. But it's. To me, it's pretty obvious that that was the case. So when I see the abnormal heads, I'm thinking DNA fragmentation, I'm thinking oxidative stress. And when we're talking about oxidative stress, we're thinking the amount of damage that's going on in the body is not being caught up by the repair for aka, antioxidants. And so diet, lifestyle, inflammation, blood sugar regulation, exercise, too little or too much smoking, drinking, lack of sleep, all of these things are going to be impacted, okay? And for every single male, we just need to sit down and figure out what's the easiest, lowest hanging fruit that makes them feel better, what's the data? Because once the men understand the data, they go, oh, yeah, I want to change that. And of course, I run lots of testing on all of my males because the semen analysis just gives me a window into, like, okay, something is wrong, but it does tell me why. I'm still making a lot of assumptions. And so when we ran a full blood work panel, guts to analysis, you know, environmental toxic panel, and we saw, oh, my God, there's so many heavy metals, and you have mold and yeast, fungal overgrowth, and your gut is a mess. And look at this cholesterol that's elevated, and these inflammatory markers. When men see that, they're like, oh, my God, I want to change that. Because chances are they have parents, whether it's their dad or their mom or uncles, brother, someone who's struggling with cardiovascular disease or metabolic disease, whether it is full on diabetes or just the start of it, where we're having. Struggling with, you know, losing weight and blood sugar, dysregulation or cancers in the family. Right. We see our parents developing those things, yet we don't think that has anything to do with the lifestyle. And. And it absolutely does. And usually I say that metabolic issues start very early on. It's just the body tries to adapt in trying to do its best for as long as it can. But by the time we turn certain age, it's just been adapting for so long, you know, the weakest link is going to go. So there's another analysis here. And this you'll see that is very little information into comparison to the other one. The days of abstinence is three days. So that's much better. You see the collection times at 736 and the analysis time is at 740. Fantastic. Four minutes right there, in and out versus, like I said, hey, it's been an hour and a half. Your sample, the sperm is going to be pretty much dead, and the motility is going to be very low. So we want to, like I said, we want to make sure that analysis, collection time, and analysis time is very, very close. So this is good. The volume here. And we see it again. This male wasn't flagged, but it's low. It's 1.4 after three days. Right away I'm thinking, okay, is this a dehydration? Because usually, like sperm is 95% water, there could be an impingement on the actual ducts, the ejaculatory ducts. So then you're not getting all the stuff out. And again, prostate is going to come in here like anything that's inflamed in that area is going to impact the quality of the sperm and how much comes out. The viscosity was good. The ph here they had, if you. The range was 7.2 to 7.8, which I think is a very narrow range. I don't. I see quite a bit of sperm. That's at 8.0 and it's okay. He is at 8.1, so it's a little bit higher ph. So again, that kind of signals me that there is an infection when they do a forward progression between zero and four. I don't love that. So at a 1.5 I'm not sure what standards they're using as a lab. I like to see more of a percentage for the progression and the motility we see at 62.5. And again, we don't have the breakdown of motility. So the breakdown of like, when the sperm is progressive, that means it's moving in the right direction versus motility is just the sperm is moving. And so you can have abnormal tails and abnormal mid pieces. And so the sperm will move, but it's not moving in the right direction because the mid pieces and the tail is what creates that kind of flapping movement, if you will, of the sperm that allows it to move forward in the right direction. And so for him, he had a normal forms of 3.4%. So that is below 4%. And like minimum we want is 4%, but ideally, you know, above that, 6%, 9%, 10%. Again, it depends on the age of this person. So if somebody is in their early thirties versus in their early forties, we need to. To analyze that sample appropriately. And he was in his early thirties. So to have a 3.4% and be told that been struggling for infertility for four years, he had a really high alcohol consumption. To be told that it's normal is, you know, it's a huge disservice to this couple. And of course, the sport couple is waiting to get pregnant, thinking that there's nothing wrong. And you see in the additional comments there, it says extensive cellular debris observed that cellular debris is usually signs of infection, again, because there's extra stuff floating around in the fluid that's just not supposed to be there. And that's going to come down to your immune system function and the levels of inflammation and the diet that he's eating and what's going on with his microbiome and all of that stuff. And, you know, like I said, this sample, they were told everything is fine and it wasn't. And so the last thing that I want to share with you guys is, first of all, what I do on all my males is I would screen an stihenk, an STD panel, even though they don't have quote unquote symptoms. I cannot tell you how many times I catch things. We do not have to have a lesion on our genitals to have some of these infections at a very low grade level. And some of these infections, even at the lowest grade level, just should not be there. And even if they pop up, for example, like the Herbie simplex virus, the HSV two, if it's popping up on a regular basis. There's issues with the immune system, and, you know, it's being upregulated. And I'm getting into a whole lot more research with viruses and how to deal with them and how to understand why they're there and then how to actually overcome them and approach them. A lot more to come on that. But I do recommend that Sigurin in a penile swab, the analysis by PCR, as well as just like, a good genital STI screen to get to make sure that there is nothing. Like I said, most women have some sort of debris, low volume, some sort of inflammation, some sort of ph issue, and they're told that, oh, no, there's. Because as soon as we think infection, we think like, oh, not me, I don't have an infection. There's a lot of shame that's associated with it. But in reality, it's like, well, there's so many different HSV strains. Like, everybody has, like, one to two strains of at any given time. And so it's becoming aware of when it's activated in your system and when how to deactivate it, but also creating this terrain, this good microbiome that can help to actually fight off some of these pathogens before they take control of, you know, because if there's too high levels, they're going to cause issues. Right. It's a huge issue for the immune system. And all the resources are now going to the immune system instead of producing good quality sperm or good quality eggs. And then, of course, there's the piece of reinfecting each other back and forth. Even when you're not intimate, you're still sharing a microbiome. So I think it's just something to think about and to plant a seed for you guys that we do need to screen ourselves if we have been struggling with infertility, because if you don't have anything, then you're good. Good. We've ruled that out. But there is also, if you do have it, then here's our answer and here's how we go about it. And, you know, here's the approach. And, you know, I personally, like, I'll catch a lot of this stuff in both my males and my females. Both partners get treated. But even before I do the treatment, I bring the energy up. I make sure the drainage is working well, I make sure the gut is moving well. We have good practices in place because if you just go in there and start to kill things and not support the terrain and not give any feedback in terms of the diet and the lifestyle changes that need to happen in order for this infection to truly go away, then we're kind of. Most people are just being given some sort of an antibiotic or an antiviral and then not even being retested and assuming that it did the job where a lot of the times it did not. So we always, always want to retest. The one that I do want to talk to you about is the semen analysis. Like, here's what I love to see. So the semen analysis, that's standard. Seeing the concentration ceiling, the motility, the progression, the ph, the morphology. Like, I consider morphology as a standard, but I've had lots of. Of males come to me with analysis, and there's no morphology on there. You need to understand the breakdown, because, as you saw, the sample, the first one we talked about is, like, his sample wasn't that bad until we got to the morphology, and it was like, 2%. 2%. Oh, my God. There's probably a lot of DNA fragmentation going on. Oh, and you're drinking in your smoking pot. That's exactly what it is. So I would make sure that the morphology is included. Sperm antibodies, that's not done a lot, but I think it's a good. And especially if there's autoimmune conditions. And again, most males do not know that they have autoimmune conditions because nobody's testing males. And we're kind of like, oh, I'm fine. I just have some stubborn weight, or I just can't sleep, or just my hands hurt once in a while. Literally, I always screen for autoimmune for all my males, and I can't tell you how many times. It's like, you have autoimmune disease. You have hashimoto's. Yes, males can have hashimoto's, and they do have autoimmune disease. It's not as frequent as females, but males still get it, and it's an upregulated immune system. There's so much inflammation. There's a leaky gut, there's all these pathogens. Of course they're not going to make good sperm. And then forming sperm antibodies, where the sperm literally just gets destroyed, it's, you know, attacking itself. Yeah, that's not going to be very good sperm. So I want to educate you guys so you can come in and start asking for the right testing instead of thinking. If you feel like something is missing, chances are something is missing. Okay. And even myself, as a practitioner, the more that I learned, I'm like, oh, my God, I didn't even know this was missing. But when I learned from an expert who is, you know, my senior, by 20 years, I'm going to listen because she has 20 years of experience, and, oh, this is. I didn't even know that was missing. But if you have a feeling that something is missing, 100% it is. I love to see the DNA fragmentation screen, I think so if we can get a morphology and the breakdown of whether it's the heads, the midpiece, the tails, because, again, that tells us kind of what the body needs, the male body needs. So if it's a lot of DNA fragmentation, that oxidative stress versus it's the mid piece that's going to be more mitochondria, and the. The tail is going to be like, selenium is huge for the tail, and calcium also. So then we can kind of start to piece together some nutrients that we know. Okay, if it's the head, this is what we really need to focus on. But again, I like to get as specific as I can. I do a lot of testing, because, again, the more specific we can be, the kind of. The quicker we can get to the result. And, of course, with being in the fertility space, I think time is of an essence. So then if we can get a DNA fragmentation screen where you could actually test a lot of the times where they're saying, oh, 30% fragmentation or 25%, that's good. We definitely want it under 20% and ideally under 15% fragmentation. If it's really high fragmentation, the chances of miscarriage go way, way up, because now, when we're talking about fertilization, the sperm has to come into the egg, and the egg goes, well, there's a lot of fragmented pieces of the DNA. Let me fix that. And so it spends all its energy fixed in DNA fragmentation. Then it fixes anything that it has for itself, and then the fertilization process starts, and then, you know, the embryo genesis can move forward. But if there's a lot of DNA fragmentation, it's the egg just gets overwhelmed. And so by the time. Time it even fixes some of the DNA fragmentation, there's no energy left for the embryogenesis to go on, which, of course, is a huge piece of, like, mitochondrial function, all that jazz. So we want that DNA fragmentation below 20 and ideally below 15%. Otherwise, I'm thinking oxidative stress for the male, and we need to assess and understand where it's coming from and what I will say for men, the hardest thing is compliance. But I don't have a lot of compliance issues with a lot of my males because, well, first of all, they've been struggling for a long time. And of course, they're like, now they I put tracking devices on them so they could see it. And I do a lot of testing. So if your male isn't into tracking devices or doesn't want to do the testing, is not ready to spend money on the testing because he doesn't think it's important. And part of that is that hes not really ready to see whats wrong. And he doesnt really want to admit to the fact that he might be the issue because thats a huge blow to the ego. Theres probably some stuff for him to process, but just know that thats what it is. Hey, Im happy to show you, and this is why Im educating you, because if the common goal for you guys is to make a baby and unfortunately, or maybe fortunately, most of us, now, when I say most of us, I just mean, like, there's a lot more people who have to work really hard to have a baby. And I'm not in the business of just making babies. I want you to have a healthy baby. And I think to have a healthy baby, you have to do a lot in our day and age because of the high toxic load, because of the environmental, you know, all the environmental factors and even, just like, the stress and the quality of the food that has gone down, the lack of sleep that we're getting, how much we're sitting in front of screen times, all of that jazz, we are seeing that decline in the population of the health of the population, in the population of the children's health as well. And then, of course, it's reflecting in infertility. So it breaks my heart that more of us have to work hard. And that's why I'm here, because I want to support couples in helping them have healthy babies. But we don't want to be ignorant to the fact that, well, I don't think I should be working that hard to have a baby because my parents didn't have to do that or this couple didn't have to do it. In the world that I am, lots of couples have to work very hard. And when I see couples who get pregnant easily, usually they're having issues that a lot of people are just not talking about, you know, even patients that I have who are pregnant and getting fantastic compliments like, oh, my God, you look amazing. And but then when I see them and they actually talk to me about everything that's going on, for them and things that they're dealing with, whether it's, you know, mental and emotional turmoil that they're going on through and maybe even some physical stuff where it's. It's their feet are swelling or they're getting yeast infections all the time. Like, you don't know any of those details. So for you to make a judgment that, well, this person didn't have to do anything to get pregnant is like you just looking at a picture and making a judgment that they didn't have to do anything. I think you just have to decide what is it that you want in your life and you might have to work really hard for it. And I don't think that's bad. But, you know, it's, like I said, it's going to. It takes two to make a baby. And the reason that I wanted to share this podcast with you and this information with you guys is because, like I said, I'm seeing so many males being misdiagnosed. Whether they're being told that the sperm is good and there's no problems and there are, in fact problems, or they're being scared and told that, oh, my God, your sperm is terrible, you're definitely going to need IVF where they haven't really. It's only based on one sample. That sample wasn't collected at the right time. There was too many days of abstinence. The analysis time was too long. So. Or it was just based on the one sample, which we cannot make a diagnosis. If the male collects sperm analysis for three, not three days in a row, but three days apart, literally, you know, in a row. So in nine days, every single one of those samples will be different. We're not going to ask our males to do that, but if we could do it, then you could see that, wow, the sperm is very different between each of those samples. But then there's probably going to be similarities. You'll probably note, like, if I. The morphology is the issue, you're going to notice that it is the issue. So then we want to address it. If it's going to be concentration, that's the issue. You're going to notice that the concentration is the issue, and we want to address that appropriately. So I hope you guys find this helpful. Like I said, I'm looking through some of the samples, helping you understand the. What it is that you're looking for. And like, let's make sure that it's hard to get this sample done already. Let's make sure when we do it right, when we do it we do it right because it's the worst when I get a sample and I'm like, I can't interpret this. There's been too many days. It's the time between analog. Like it's this is a throwaway sample, so I just want to help you guys prevent from making that mistake. I hope you find this helpful. Please send it to your partner if you think he is open to listening to this and learning from it as well. But that's it for this episode, and I'll see you next time week. Thank you so much for listening. To read the full show notes of this episode, including summary, timestamps, guest quotes, and any resources that were mentioned on the episode, visit drjanelevesque.com podcast and if you're getting value from these episodes, I'd love it if you took two minutes to share it with a friend. Rate and leave me a review at ratethispodcast. The reviews will help with the discoverability of the show, and who knows, I might share your review on my next episode. Thank you so much for tuning in, and let's make your fertility journey your healing journey.