• Stop smoking or vaping, this smoke contains substances that have a harmful effect on spermatozoids.
• Reduce consumption of alcohol to the minimum. Alcohol decreases ability of the body to produce testosterone that is essential in the formation of sperm.
• Avoid hot bath, sauna and tight underwear. For the optimum functioning of testicles body temperature should be lower than 37°C. Do not expose your manly parts to the elevated temperature of the external environment for more than 30 minutes per week.
• Test for the possible infections with sexually transmitted diseases. If you get infected from the partner, for example, with Chlamydia, it can cause infertility.
• Learn to relax and improve your sleep quality. Stress affects reproductive system and fertilization ability, impacting quality of sperm and number of spermatozoids. A balanced work and life routine is very significant, also a good 8 hours sleep at night.
• Exercise regularly in fresh air with a moderate activity at least 2 times a week, it will help to maintain your body in a good physical form and reduce the negative impact of stress. Sedentary lifestyle and excess weight significantly reduces the quality of sperm.
• Decrease the consumption of caffeine containing drinks. Caffeine stimulates adrenal glands and causes the same effect as stress.
• Drink sufficient amount of liquid at least 1.5 – 2.0 litres a day. Sperm requires the body to have sufficient amount of liquid as 80% of sperm consists of water.
• Have sex regularly at least 2 times a week. Quality of sperm reduces if it is stored in the body for a prolonged period of time. Also too intense sex harms sperm.  48 hours are needed for it to restore. Do not use any kind of lubricants.
• Include fatty fish in your diet. Fatty fish contains fatty acids necessary for the formation of qualitative sperm. It is recommended to consume mackerel, sardines, salmon etc.
• Include vegetables and fruits in your diet. They contain vitamins, antioxidants and minerals that increase the number of spermatozoids.
• Eat products rich in zinc and folic acid. You can find zinc in meat, fish, eggs but folic acid in leafy vegetables, legumes and wholegrain bread. If the body lacks folic acid, number of spermatozoids can reduce by 90%.
• Quality of sperm improves if you consume sufficient amount of fruits and vegetables, grain fibres, polyunsaturated fatty acids, for example, omega-3 (fish, shell-fishes and seafood), poultry, products containing antioxidants (vitamins E, C and D, β-carotene, selenium, β-cryptoxanthin, lycopene) and folates, low fat dairy and skimmed milk.
• Quality of sperm declines if you consume too much caffeine containing products and alcohol, sweets and sweetened drinks, saturated fatty acids (beef, goat, sheep, pork, as well as milk and butter), trans fats (margarine, fatty spreads, cookies, pies, cakes, pastries, fried products), protein (processed red meat), soya products and potatoes, cheese and whole milk products.

• Refrain from sexual activity for not less than two and not more than seven days
• Refrain from alcohol, and preferably also smoking
• Refrain from saunas or hot baths
• Sperm sample should not be provided until two weeks after an antibiotic treatment or cold
• Sperm sample is given in a designated room - with magazines and video provided

• Providing of material (sperm) in the Clinic EGV takes place in a discreet manner, observing strict confidentiality rules. Room where you can provide sperm sample is located separately from the doctor’s offices of the Clinic. Patients can use magazines and videos provided
• Patient obtains sperm with the help of masturbation
• You are not allowed to use lube, cream or other ointments when you obtain sperm
• DO NOT obtain the material in the condom, also DO NOT pour the sample from the condom into the container
• It is important to gather all sperm in the container

• Reception employee of the Clinic EGV laboratory will provide you the container for delivery
• Sample gathering time should be documented in a special referral form
• Sample should be transferred to the laboratory not later than one hour after obtaining, keeping the sperm container close to the body to keep necessary temperature. Recommended place is the pocket of trousers or breast pocket or the inner pocket of jacket/coat

• Spermogram
• Sperm oxidative stress test
• MAR test
• HBA test
• DNA Fragmentation test

Patients after spinal injuries using a wheelchair are of various ages in Latvia. For men in reproductive age a crucial question is can I become a father even with a spinal trauma. Urologist-andrologist Dr. Andris Ābele of Clinic EGV answers this question.

Number of spinal patients in Latvia is much bigger than we think and sexual function of these men is disturbed in majority of cases. Practically all types of ejaculatory dysfunction decrease the fertility of the couple. This can be delayed ejaculation, anejaculation, painful or premature ejaculation and others.

Urologist-andrologist Dr. Andris Ābele of Clinic EGVtells that there are several non-surgical methods for the obtaining of spermatozoids for spinal patients. One of them – penile vibratory stimulation, second – electroejaculation. Although both methods are very effective, penile vibratory stimulation is recommended choice for men with anejaculation or delayed ejaculation after severe spinal cord damages. “I recommend this method taking into account safety profile, reliability, cost efficiency and better quality of spermatozoids. Using penile vibratory stimulation, currently in Latvia it is possible for the couples with the young dad using a wheelchair to become parents“tells Dr. Ābele.

How does the treatment take place?

Penile vibratory stimulation is based on the causing of the ejaculation reflex with the help of specially developed medical vibrator placed at the base of glans penis with a certain frequency and range. Method is based on the mechanical action, it is not painful and anaesthesia is not required.

Separate unit is available for the spinal patients at the Day Hospital of Clinic EGV where they can feel comfortable. An appointment with the doctor is required before the treatment to train the patient how to use the device correctly, if the patient wants also the partner can participate in the treatment. Patient himself or the partner uses the device. Setting is discreet, there are no other medical staff located nearby, if not confirmed in advance. The total duration of the treatment is 30 to 45 minutes. If the patient has hypertension, perspiration, headache, then doctor prescribes medication before the treatment to reduce the autonomic dysreflexia risks which are a mandatory requirement for patients with the spinal cord damage Th6 and higher. If any of the indicated symptoms occur during the treatment, operation of the device is stopped.