Zijn Health articulates a vision of paternal preconception care. Paternal preconception care emphasizes the importance of optimizing men's health before conception, recognizing their vital role in ensuring a healthy pregnancy and baby. Zijn Health helps men contribute to three outcomes related to pregnancy:
Time to pregnancy
Pregnancy loss
Offspring health
This blog post corroborates these assertions, drawing upon verified insights from scientific literature.
Time to Pregnancy
Time to pregnancy (TTP) is generally defined as the number of months it takes to conceive, based on the female partner's declaration (Slama, 2002). Sperm quality and quantity can be evaluated in terms of concentration, motility, and morphology.
Sperm concentration is measured in millions of sperm per milliliter. TTP decreases as sperm concentration increases, up to 55 million sperm per milliliter, beyond which the effects plateau. Morphology refers to the shape of the sperm, and a higher proportion of normally shaped sperm can reduce TTP by up to 39% (Slama, 2002). Assessing motility, or the sperm's ability to swim effectively, is more challenging to evaluate objectively. Herrera (2020) suggests that the threshold value for motility is 63%.
Pregnancy Loss
Pregnancy loss is a broad term that refers to the end of pregnancy before the fetus can survive outside the womb. It’s hard to estimate the risk of pregnancy loss. One estimate of the risk of pregnancy loss is 15.3% among recognized pregnancies (Quenby et al, 2021). However, when considering pregnancies that have not yet been recognized, the miscarriage rate increases to an estimated 26% (Dugas and Slane, 2022).
The most common cause of pregnancy loss during the first semester are chromosomal abnormalities. Sperm might carry fragmented DNA (that’s damaged DNA) or chromosomal abnormalities, which may lead to abnormal embryo development. Sakkas et al. (2010) write that “the integrity of the paternal genome is therefore of paramount importance in the initiation and maintenance of a viable pregnancy both in a natural conception and in assisted reproduction”.
Research indicates that DNA fragmentation is a predictor of pregnancy loss. A meta-analysis has shown that the risk of miscarriage is 2.16 times greater in men with higher levels of DNA damage compared to those with lower levels, for both natural conception and assisted reproduction (Robinson, 2012). Furthermore, when examining couples who exclusively use assisted reproductive therapy, the likelihood of pregnancy loss is 2.48 times higher among couples where the male partner has high DNA damage as opposed to low DNA damage (Zini, 2008).
Offspring health
There’s mounting evidence that the environment experience can influence phenotypes of future generations (Sharma, 2019). This concept, known as epigenetics, refers to changes in gene expression that do not involve alterations to the underlying DNA sequence. Epigenetic changes can be passed down through generations, which means that a father's health and lifestyle choices can have a lasting impact on the health of his offspring.
Several factors contribute to these epigenetic changes, including exposure to environmental toxins, diet, stress, and lifestyle choices such as smoking and alcohol consumption. Studies have shown that paternal exposure to these factors can result in offspring with a higher risk of developing chronic diseases, such as obesity, diabetes, and cardiovascular disease (Soubry, 2014).
Conclusion
Paternal preconception care is a critical component in ensuring healthy pregnancies and offspring. By optimizing men's health before conception, couples can improve the time of pregnancy, reduce the risk of pregnancy loss, and positively influence the health of their future children.
References
Dugas C, Slane VH. Miscarriage. [Updated 2022 Jun 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532992/
Romero Herrera, J. A., Bang, A. K., Priskorn, L., Izarzugaza, J. M., Brunak, S., & Jørgensen, N. (2021). Semen quality and waiting time to pregnancy explored using association mining. Andrology, 9(2), 577-587.Chicago
Sakkas, D., & Alvarez, J. G. (2010). Sperm DNA fragmentation: mechanisms of origin, impact on reproductive outcome, and analysis. Fertility and sterility, 93(4), 1027-1036.
Sharma, U. (2019). Paternal contributions to offspring health: role of sperm small RNAs in intergenerational transmission of epigenetic information. Frontiers in cell and developmental biology, 7, 215.
Slama, R., Eustache, F., Ducot, B., Jensen, T. K., Jørgensen, N., Horte, A., ... & Jouannet, P. (2002). Time to pregnancy and semen parameters: a cross-sectional study among fertile couples from four European cities. Human Reproduction, 17(2), 503-515.
Soubry, A., Hoyo, C., Jirtle, R. L., & Murphy, S. K. (2014). A paternal environmental legacy: evidence for epigenetic inheritance through the male germ line. Bioessays, 36(4), 359-371.
Quenby, S., Gallos, I. D., Dhillon-Smith, R. K., Podesek, M., Stephenson, M. D., Fisher, J., ... & Coomarasamy, A. (2021). Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss. The Lancet, 397(10285), 1658-1667.
Zini, A., Boman, J. M., Belzile, E., & Ciampi, A. (2008). Sperm DNA damage is associated with an increased risk of pregnancy loss after IVF and ICSI: systematic review and meta-analysis. Human reproduction, 23(12), 2663-2668.
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