Male Fertility Basics
Everything men need to know about sperm health and fertility.
Key Facts
- Male factor matters: Contributes to 40-50% of all infertility cases
- Sperm basics: Count, motility (movement), and morphology (shape) all matter
- Good news: Sperm regenerates every ~72 days—lifestyle changes can improve it
- Get tested: A simple semen analysis can identify issues early
Why Male Fertility Matters
When couples struggle to conceive, there's often an assumption that the issue is with the woman. But the reality is very different:
This is why both partners should be tested when a couple is having difficulty conceiving. A semen analysis is quick, non-invasive, and provides valuable information.
🔬 The Numbers
A healthy man produces 40-300 million sperm per ejaculation. But only about 200 sperm will make it to the vicinity of the egg. And only one can fertilize it. The journey is brutal—which is why having healthy, abundant sperm matters.
Sperm Health Basics
Sperm quality is measured by three main factors:
1. Count (Concentration)
The number of sperm per milliliter of semen. More sperm = more chances for one to reach the egg.
- Normal: 15 million+ per mL (or 39 million+ per ejaculate)
- Low (oligospermia): Less than 15 million per mL
- Absent (azoospermia): No sperm in ejaculate
2. Motility (Movement)
How well sperm swim. Sperm need to travel through the cervix, uterus, and fallopian tubes to reach the egg—a journey of about 6-7 inches, which is massive relative to their size.
- Progressive motility: Sperm swimming in a straight line or large circles
- Normal: 40%+ total motility, with 32%+ progressive motility
- Low (asthenozoospermia): Poor movement makes it hard to reach the egg
3. Morphology (Shape)
The shape of sperm—head, midpiece, and tail should all be correctly formed for optimal swimming and egg penetration.
- Normal (WHO criteria): 4%+ normally shaped sperm
- Normal (strict Kruger criteria): 4-14% is normal
- Low (teratozoospermia): Abnormally shaped sperm may have trouble fertilizing
💡 Don't Panic About Morphology
Morphology is the most controversial parameter. Even with only 4% normal forms, conception is very possible. Many fertility specialists focus more on count and motility.
Understanding Semen Analysis Results
A semen analysis is the first-line test for male fertility. Here's what the results mean:
| Parameter | Normal Range (WHO 2021) | What Low Means |
|---|---|---|
| Volume | 1.4 mL or more | Low volume may indicate blockage or hormonal issues |
| Concentration | 16 million/mL or more | Fewer sperm = fewer chances at fertilization |
| Total count | 39 million or more | Overall number per ejaculate |
| Total motility | 42% or more | % of sperm moving at all |
| Progressive motility | 30% or more | % swimming forward effectively |
| Morphology | 4% or more normal forms | Abnormal shapes may affect fertilization |
| pH | 7.2-8.0 | Abnormal pH may indicate infection |
| White blood cells | <1 million/mL | High WBC may indicate infection |
What If Results Are Abnormal?
A single abnormal semen analysis isn't necessarily cause for alarm. Sperm production fluctuates, and illness, stress, or heat exposure can temporarily affect results. If the first test is abnormal, your doctor will likely repeat it in 2-3 months.
If consistently abnormal, further testing may include hormone tests (FSH, LH, testosterone), genetic testing, or ultrasound.
Factors That Affect Sperm Health
🔥 Heat
Testicles hang outside the body for a reason—sperm production requires temperatures 2-4°F cooler than body temperature. Heat exposure can significantly harm sperm.
- Hot tubs and saunas
- Tight underwear
- Laptops directly on lap
- Prolonged sitting (truckers, office workers)
- Heated car seats
🍺 Lifestyle Factors
- Smoking: Reduces count, motility, and morphology; increases DNA damage
- Alcohol: Heavy drinking lowers testosterone and sperm production
- Marijuana: Can reduce count and motility
- Obesity: Associated with lower sperm count and hormonal imbalances
- Poor diet: Lack of antioxidants and nutrients affects sperm quality
💊 Medications & Supplements
- Testosterone/steroids: Paradoxically, external testosterone shuts down natural production, often causing azoospermia
- Some antidepressants
- Some blood pressure medications
- Chemotherapy drugs
🏥 Medical Conditions
- Varicocele: Enlarged veins in scrotum; most common treatable cause of male infertility
- Infections: STIs, mumps, prostatitis
- Hormonal imbalances: Low testosterone, high prolactin, thyroid issues
- Genetic conditions: Klinefelter syndrome, Y chromosome deletions
- Retrograde ejaculation: Semen enters bladder instead of exiting
⚠️ Warning About Testosterone Therapy
If you're taking testosterone (TRT) or anabolic steroids, stop if you're trying to conceive. External testosterone signals your body to stop producing sperm. This effect is usually reversible after stopping, but it can take 3-12 months.
How to Improve Sperm Health
Because sperm takes about 72 days (roughly 2.5 months) to develop, lifestyle changes can show results in 2-3 months.
Lifestyle Changes
- Keep cool: Avoid hot tubs, saunas, tight underwear, laptops on lap
- Quit smoking: Improvements seen within 3 months
- Limit alcohol: Stick to moderate consumption
- Maintain healthy weight: Obesity affects hormones and sperm
- Exercise moderately: Too little or too much can be problematic
- Manage stress: Chronic stress affects testosterone
- Get enough sleep: Poor sleep linked to lower sperm quality
Diet
Focus on:
- Antioxidants: Fruits, vegetables, especially berries, tomatoes, leafy greens
- Zinc: Oysters, beef, pumpkin seeds, chickpeas
- Omega-3 fatty acids: Fatty fish, walnuts, flaxseed
- Folate: Leafy greens, beans, fortified grains
- Vitamin D: Sunshine, fortified foods, supplements
Avoid: Processed foods, trans fats, excessive soy, and processed meats.
Supplements
Some supplements have evidence supporting their use for male fertility:
CoQ10 (Coenzyme Q10)
Antioxidant that supports sperm motility and protects against oxidative damage. Studies show improvement in both count and motility. Typical dose: 200-600mg daily.
FertilAid for Men
Comprehensive male fertility supplement with L-carnitine, vitamins C and E, zinc, selenium, and other nutrients shown to support sperm health.
L-Carnitine
Amino acid that provides energy for sperm movement. Multiple studies show improved motility. Typical dose: 2-3g daily.
When to Get Tested
Men should get a semen analysis if:
- The couple has been trying for 6-12 months without success
- There are known risk factors (previous surgery, infections, medication use)
- The female partner is over 35 (time is more critical)
- There's a history of testicular issues
How to Prepare for Semen Analysis
- Abstain: 2-5 days before the test (not too short, not too long)
- Avoid: Hot tubs, saunas, and excessive heat for a week before
- Don't: Use lubricants when collecting the sample
- Deliver quickly: Sample should reach the lab within 30-60 minutes
At-Home Testing Options
If you want preliminary information before seeing a doctor:
YO Home Sperm Test
FDA-cleared home test that measures motile sperm concentration using your smartphone. Provides a video of your sperm. Good for initial screening, but doesn't replace a full lab analysis.
The Bottom Line
Male fertility is often overlooked, but it's a factor in nearly half of all infertility cases. The good news? Sperm regenerates every ~72 days, so lifestyle changes can make a real difference.
If you're trying to conceive, get a semen analysis early in the process. It's simple, informative, and can save valuable time. And regardless of the results, focusing on a healthy lifestyle, avoiding heat, and considering targeted supplements can optimize your fertility. 💚