Here’s an interesting thing. I’ve noticed that the vast majority (in fact, to date, 100%) of my fertility enquiries come from women. Which, to me, seems strange considering it takes a woman and a man to make a baby…
So what’s going on?! Are women more responsible for fertility problems, or has fertility just become another thing for women to take responsibility for?
In this article I’m going to talk about male fertility and why it’s so important to consider when we look at fertility in general. We’ll look at what can go wrong for men, what kind of testing is available, and what we can do about male fertility issues.
Male fertility is on the decline
If you’re reading this, you probably already know about the rising numbers of infertility cases in the past few years. But did you know that the male factor contributes to about 50% of all cases of infertility?[1] That’s around 7% of men affected by male fertility all over the world.[2]
So infertility or sub-fertility are not just female problems, although the observant amongst you will perhaps have noticed that most of the information out there on social media and online is targeted at women.
Why it’s so important to involve men in fertility work
Of course, sperm provides 50% of the baby’s DNA, so it follows that we want to ensure that male health is optimal before conception.
It takes around 75 days for sperm to mature (conveniently similar to an egg’s 90 days) which means that we have a unique opportunity of time in which to improve sperm quality, thereby increasing the chances of conception and reducing miscarriage risk.
As male and female causes of infertility often co-exist, it is essential that both partners are investigated for fertility and managed together.
When I’m working with fertility clients, I want to find out about both partners. For men, that’s asking (lots of!) questions about:
- Diet
- Lifestyle and work
- Sexual health and fertility
- Hobbies
- Medication and illnesses
And as an important aside, making changes to diet and lifestyle inevitably involves a degree of work, so I think it’s also nice to share the journey together, rather than leaving all the planning, shopping and meal prepping to one partner.
Male factor: What can go wrong
There are a few things that might go wrong when it comes to men’s fertility. The most common issues are:
- Structural issues like varicocele (enlarged veins near the testicles)
- Oxidative stress, which can cause damage to sperm. This can be caused by things like poor diet, stress, chemical exposure, smoking, drug and alcohol use, or overexercise
- DNA fragmentation – DNA damage within the sperm’s genetic material
- Infections like chlamydia, gonorrhoea or mycoplasma, which can impair male fertility
- Hormonal issues – e.g. low testosterone
- Azoopermia – where the semen contains no sperm
Unfortunately, many of these issues might go unnoticed by medical professionals, who don’t routinely test for DNA fragmentation or oxidative stress.
What testing can be done?
A semen analysis is the most common test for male fertility. This will usually test for sperm volume, concentration, sperm count, motility, morphology and viability, and should be offered by the NHS if you’ve been trying to conceive for a while without success.
However, even if a semen analysis comes back ‘normal’, further testing may be helpful, such as an ultrasound, infection screening, oxidative stress test, DNA fragmentation, anti sperm antibodies and hormone profile. I would also usually recommend a blood panel that includes certain vitamins and minerals, hormones and inflammation markers.
Does diet really make a difference?
The short answer is – of course!
A balanced diet with sufficient protein, healthy fats and plenty of antioxidant-rich plant foods is a good place to start. When you go shopping, fill your basket with as many colourful fruit, veg, whole grains, herbs and spices as you can (think about eating the rainbow – and I don’t mean Skittles!). These antioxidants are protective when it comes to sperm health.[3] Reducing processed meats, saturated fat and sugary drinks and snacks are also going to help support fertility.[4]
Not sure where to start? How about snacking? A 2023 study found that eating two handfuls of nuts a day improved sperm parameters, which are predictors of male fertility.[5] So replacing your daily packet of crisps and chocolate bar with nuts may be good for your swimmers!
Alcohol is a biggie, which evidence shows can significantly affect male reproduction and semen quality.[6] Swapping your evening beer for an alcohol free version might just make a difference to your fertility, as well as your energy levels and your mood.
Hydration is also a simple factor which can make a big difference in sperm volume, so making sure you’re drinking plenty of water is key, especially around the fertile window.
What about lifestyle?
Yes, this matters too!
Thinking about things like smoking, toxic exposure, exercise, stress and medications are also important when it comes to fertility.
Research suggests that toxic exposure through everyday chemicals like plastics and pesticides can impact fertility[7]. Air pollution also impacts semen quality[8], so if you’re running or cycling along a busy road, it might be time to change your route.
Heat exposure is also something to think about – hot baths, hot tubs, saunas, and even tight pants can damage sperm, so you may want to skip the sauna after your gym session.
And speaking of gym sessions, we already know that exercise is very important for many areas of health, and fertility is no exception. Evidence shows that obesity has a negative impact on various areas of male fertility, and that physical exercise appears to improve male fertility markers.[9] The type and intensity of exercise also matters though, as more extreme levels of physical activity have been associated with impaired semen quality.[10]
In summary…
- Unless you’re an individual or a couple using donor sperm, it is CRUCIAL that the male partner comes to the table and does the work too to optimise the couple’s chances of getting pregnant.
- It takes around 75 days for sperm to mature, which gives us a window of time to optimise sperm health before conception, thereby increasing the chances of conception and reducing the risk of miscarriage.
- Modifiable factors like diet and lifestyle CAN make a difference to sperm quality.
- When it comes to diet, reducing saturated fats and focusing more on healthy fats like oily fish, nuts and seeds, including plenty of colourful, antioxidant rich veg, reducing sugary food, drink and alcohol can improve sperm quality. The Mediterranean diet is well-researched for fertility, and is a good place to start.
- Smoking, a sedentary lifestyle, and environmental pollution are also linked to infertility. Check your BMI as being overweight is also detrimental to both male and female fertility.
- I know it might seem like a lot to take in – which is why I’d recommend working with someone you trust who can guide you through the different considerations and help focus on what’s important.
Wondering how I can help….
I am a nutritional therapist specialising in fertility. I work with clients – alongside their healthcare practitioners, if relevant – to address any nutritional or biochemical imbalances through achievable and sustainable changes to diet and lifestyle.
I offer a free 30-minute consultation where you can have a chat with me, tell me a little bit about you, and hear more about my services and ways of working. If this is of interest, please do get in touch here.
References
[1] Leslie, S. W., Soon-Sutton, T. L., & Khan, M. A. B. (2025). Male infertility. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Updated February 25, 2024. Available here
[2] Krausz, C. (2011). Male infertility: pathogenesis and clinical diagnosis. Best Practice & Research Clinical Endocrinology & Metabolism, 25(2), 271–285. https://doi.org/10.1016/j.beem.2010.08.006
[3] Hussain, T., Kandeel, M., Metwally, E., Murtaza, G., Kalhoro, D. H., Yin, Y., Tan, B., Chughtai, M. I., Yaseen, A., Afzal, A., & Kalhoro, M. S. (2023). Unraveling the harmful effect of oxidative stress on male fertility: A mechanistic insight. Frontiers in Endocrinology, 14, 1070692.
[4] Tully, C. A., Alesi, S., McPherson, N. O., Sharkey, D. J., Teong, X. T., Tay, C. T., Silva, T. R., Puglisi, C., Barsby, J. P., Moran, L. J., & Grieger, J. A. (2024). Assessing the influence of preconception diet on male fertility: A systematic scoping review. Human Reproduction Update, 30(3), 243–261.
[5] Cardoso, B. R., Fratezzi, I., & Kellow, N. J. (2024). Nut consumption and fertility: A systematic review and meta-analysis. Advances in Nutrition, 15(1), 100153.
[6] Finelli, R., Mottola, F., & Agarwal, A. (2021). Impact of alcohol consumption on male fertility potential: A narrative review. International Journal of Environmental Research and Public Health, 19(1), 328.
[7] Moreira, S., Pereira, S. C., Seco-Rovira, V., Oliveira, P. F., Alves, M. G., & Pereira, M. D. (2021). Pesticides and male fertility: A dangerous crosstalk. Metabolites, 11(12), 799.
[8] Checa Vizcaíno, M. A., González-Comadran, M., & Jacquemin, B. (2016). Outdoor air pollution and human infertility: A systematic review. Fertility and Sterility, 106(4), 897–904.e1. https://doi.org/10.1016/j.fertnstert.2016.07.1110
[9] Service, C. A., Puri, D., Al Azzawi, S., Hsieh, T. C., & Patel, D. P. (2023). The impact of obesity and metabolic health on male fertility: A systematic review. Fertility and Sterility, 120(6), 1098–1111.
[10] Belladelli, F., Basran, S., & Eisenberg, M. L. (2023). Male fertility and physical exercise. The World Journal of Men’s Health, 41(3), 482.
