Male Fertility
It takes two. Here's what men can do to optimize their fertility.
Key Facts
- Male factor: Contributes to 40-50% of all infertility cases
- Sperm cycle: Takes ~74 days to produce new sperm
- Good news: Many male fertility issues are treatable or improvable
- First step: Get a semen analysis if TTC for 6-12 months
Male Fertility by the Numbers
Male fertility doesn't get talked about as much as female fertility, but it's equally important. Here's the reality:
- 40-50% of infertility cases involve male factors
- ~30% of infertility is due to male factors alone
- ~20% involves both partners
- 1 in 20 men has some form of fertility issue
Despite these numbers, male fertility testing often comes as an afterthought. Many couples spend months (or years) focusing solely on the female partner before getting a simple semen analysis that could have provided answers much sooner.
💡 Our Recommendation
If you've been trying for 6+ months without success (or immediately if the female partner is 35+), get a semen analysis. It's non-invasive, affordable, and can rule out or identify male factor issues early—saving time, money, and emotional stress.
What Makes Sperm Healthy
A semen analysis evaluates several key parameters. Here's what they mean:
| Parameter | What It Measures | WHO Reference Values |
|---|---|---|
| Count (Concentration) | Sperm per milliliter of semen | ≥15 million/mL |
| Total Count | Total sperm in the sample | ≥39 million total |
| Motility | Percentage that swim properly | ≥40% total motility; ≥32% progressive |
| Morphology | Percentage with normal shape | ≥4% normal forms |
| Volume | Total semen volume | ≥1.5 mL |
| pH | Acidity/alkalinity | ≥7.2 |
Understanding the Numbers
Count: You need enough sperm to make the journey. Low count (oligospermia) reduces the chances of one reaching the egg.
Motility: Sperm need to swim forward effectively. Poor motility (asthenospermia) means they can't reach the egg even if count is normal.
Morphology: Normal-shaped sperm swim better and fertilize more effectively. The 4% threshold seems low, but it's based on strict criteria—most men have many abnormal-looking sperm, and that's okay.
🔬 Important Context
These are reference values, not pass/fail cutoffs. Men with values below these thresholds can still father children, and men above them may still struggle. The numbers provide guidance, not guarantees. Also, sperm quality varies day-to-day—one low result doesn't necessarily indicate a problem.
Getting Tested
Semen Analysis
The first-line test for male fertility is a semen analysis (SA). It's simple, non-invasive, and relatively inexpensive ($50-200 at most labs).
What to expect:
- Abstain from ejaculation for 2-5 days before the test
- Produce a sample via masturbation (usually at the clinic or at home with prompt delivery)
- Results typically available within a few days
- If results are abnormal, a repeat test is usually done to confirm
At-Home Sperm Tests
At-home tests like YO Sperm Test or Legacy can provide preliminary information about count and motility. They're convenient and private but less comprehensive than a lab analysis. Consider them a screening tool—if results are concerning, follow up with a proper SA.
Advanced Testing
If initial results are abnormal, additional tests may include:
- Hormone testing: FSH, LH, testosterone, prolactin
- DNA fragmentation: Assesses sperm DNA damage
- Ultrasound: Checks for varicocele or structural issues
- Genetic testing: For severe cases
YO Home Sperm Test
FDA-cleared at-home test that measures motile sperm concentration. Uses your smartphone to analyze the sample. Good for initial screening, but doesn't replace a full semen analysis.
Factors That Hurt Sperm
🌡️ Heat Exposure
Testicles hang outside the body for a reason—they need to be cooler than core body temperature. Excessive heat damages sperm production.
Culprits: Hot tubs, saunas, laptops on lap, tight underwear, prolonged sitting, heated car seats.
Solution: Limit hot tub/sauna use while TTC. Use a laptop desk. Wear loose boxers. Take breaks from sitting.
🚬 Smoking & Vaping
Smoking significantly reduces sperm count, motility, and morphology. It also damages sperm DNA. Vaping may have similar effects, though research is still emerging.
Solution: Quit. Sperm quality improves within 3 months of stopping.
🍺 Alcohol
Heavy drinking lowers testosterone, reduces sperm production, and impairs motility. Moderate drinking (1-2 drinks/day) may have minimal impact, but less is better.
Solution: Limit to occasional drinks while TTC.
⚖️ Obesity
Excess body fat converts testosterone to estrogen, reducing sperm production. Obesity is also associated with increased sperm DNA damage and erectile dysfunction.
Solution: Even modest weight loss can improve hormonal balance and sperm parameters.
💊 Medications & Substances
Several medications can impair fertility:
- Testosterone/steroids: Shut down natural sperm production
- Some antidepressants
- Certain blood pressure medications
- Cannabis: Reduces count and motility
Solution: Discuss medications with your doctor. Never stop prescribed medications without medical guidance.
🏭 Environmental Toxins
Pesticides, heavy metals, and industrial chemicals can damage sperm. BPA and phthalates (found in plastics) are endocrine disruptors.
Solution: Reduce plastic use, choose organic when possible, avoid handling receipts (thermal paper contains BPA).
😰 Stress
Chronic stress elevates cortisol, which can suppress testosterone and sperm production.
Solution: Prioritize sleep, exercise, and stress management techniques.
How to Improve Sperm Health
The good news: sperm regenerate every ~74 days, so lifestyle changes today can show results in 2-3 months.
✅ Diet
A Mediterranean-style diet is associated with better sperm parameters:
- Plenty of fruits, vegetables, whole grains
- Healthy fats (olive oil, nuts, fish)
- Lean proteins
- Limit processed foods, sugar, and red meat
Specific foods with evidence: Walnuts, tomatoes (lycopene), leafy greens (folate), fatty fish (omega-3s).
✅ Exercise
Regular moderate exercise improves testosterone and sperm quality. Aim for 150+ minutes of moderate activity per week.
Caution: Excessive endurance exercise (ultra-marathons, etc.) may temporarily reduce sperm count. Cycling for long periods may also be problematic due to heat and pressure. Balance is key.
✅ Sleep
Poor sleep is associated with lower testosterone and reduced sperm quality. Aim for 7-8 hours of quality sleep per night.
✅ Keep Cool
Avoid heat exposure to the testicles:
- Wear loose boxers instead of briefs
- Skip hot tubs and saunas
- Don't rest laptops directly on your lap
- Take standing breaks if you sit for long periods
✅ Ejaculation Frequency
There's a sweet spot for ejaculation frequency while TTC:
- Too infrequent (more than 7 days): Older sperm with more DNA damage
- Too frequent (multiple times daily): Lower count per ejaculation
- Optimal: Every 2-3 days, or every other day during the fertile window
Supplements with Evidence
Some supplements have research supporting their benefit for sperm health. Always consult your doctor before starting.
CoQ10 (Ubiquinol)
Antioxidant that supports sperm energy production and protects against oxidative damage. Studies show improvements in count, motility, and morphology. Use ubiquinol form for better absorption.
Zinc
Critical for testosterone production and sperm development. Deficiency is linked to low sperm count. 25-30mg daily is typical.
Folate (L-Methylfolate)
Supports healthy sperm DNA synthesis. Important for men too, not just women. Choose methylfolate over folic acid for better utilization.
Other Supplements with Some Evidence
- Vitamin C: Antioxidant protection
- Vitamin E: Works synergistically with C
- Selenium: Supports motility
- L-Carnitine: Energy for sperm motility
- Omega-3s: Support sperm membrane health
- Ashwagandha: May improve count and motility (stress reduction)
Beli Vitality (Men's Fertility Supplement)
Comprehensive male fertility supplement with CoQ10, zinc, folate, and other evidence-based ingredients. Convenient single product rather than multiple bottles.
The Bottom Line
Male fertility matters—a lot. If you're trying to conceive, don't overlook the male partner. Get tested early (semen analysis is simple and informative), make lifestyle improvements (they can significantly impact sperm quality), and remember that new sperm are produced every 2-3 months, so changes you make today will show up in your next sample.
Fertility is a team effort. When both partners optimize their health, your chances of success multiply. 💪