How to improve male fertility and sperm quality

The notion that fertility is a woman's issue is not just incorrect, it's also unhelpful. Men are very much part of the equation, whether they are supporting a partner undergoing treatment, struggling with male infertility, involved in surrogacy journeys, or donating sperm to help someone else, to name a few.

Just because a woman tends to undergo the majority of medical treatment in fertility does not mean that men can or should be excluded. It's time to stop talking about fertility as if that were the case.

This article sheds light on various aspects of men's fertility by discussing causes of male infertility, exploring ways that male fertility can be improved and outlining the male fertility testing options that are available.

Causes of male infertility

In many cases, there is no clear reason why men have poor sperm or quality. However, in some cases there can be an explanation, such as:

• Genetic abnormalities

• Undescended testes in childhood

• Previous infections

• Varicoceles

• Sometimes the sperm may be functioning normally but men have difficulty with erection and/or ejaculation.

  
  

How to improve male fertility

When the issue is with the quality of the sperm itself, sperm quality can be improved to a degree. Lifestyle plays a role in the quality of sperm and can affect fertility, so some proactive changes can make a difference.

Stop smoking

Smoking can make it more difficult to get your partner pregnant as it can contribute to sexual impotence. It can also reduce fertility by lowering sperm quality and count and affecting your sperm’s ability to swim.

Further, second hand smoke can be detrimental to a female partner’s fertility. If your partner should fall pregnant, exposing them to cigarette smoke can also increase the likelihood of miscarriage, still birth and premature birth.

Regulate your temperature and environment

To produce high quality sperm, your testicles need to be slightly cooler than the rest of the body. This is why they are contained within the scrotum outside the body. Your lifestyle and environment can affect the temperature of your testicles but to help improve your fertility, you should aim to keep them cool.

• Take regular breaks if your job involves working in a hot environment

• Avoid hot baths and saunas

• Try not to sit for extended periods; get up and move around

•  Wear loose underwear and trousers

• Don’t sit with a warm laptop in your lap

Lower alcohol consumption

The NHS advises not to regularly drink more than 14 units a week as excessive alcohol consumption is detrimental to your health. This is also true when it comes to male fertility. High alcohol consumption can lead to fertility issues including:

• Sexual dysfunction

• Testicular atrophy

•  Decreased testosterone production

• Reduced sperm production

• Lower sperm quality

When trying to conceive, limiting your alcohol intake or avoiding drinking altogether can help improve your fertility.

Avoid recreational drugs

Certain recreational drugs (including cannabis, cocaine and anabolic steroids) are known to damage sperm quality, reduce testosterone and lower libido. The effects of recreational drugs can last for weeks even after you stop using them so if preparing to conceive, it is a good idea to avoid all recreational drugs for several months before trying.

Improve your diet and exercise

A healthy, balanced diet is also essential for keeping sperm in good condition. Feiby Nassan, a research fellow at Harvard's Department of Environmental Health, found that antioxidants and omega-3 fatty acids are key for good sperm production in a 2020 study. “I believe that it is not only, ‘You are what you eat,’ but it is also ‘Your sperm is what you eat,'” Nassan said.

Other tips for maintaining a healthy diet include:

• Reducing caffeine

• Eating 5 portions of fruit and veg per day

• Cutting down on saturated fat, sugar, salt and overly processed foods

•  Drinking at least 2 litres of water per day

• Increasing your fibre intake

In addition, being overly sedentary contributes to male infertility. Regular low or intermediate intensity exercise has been shown to improve semen parameters. This could be as simple as going for a short walk every day or engaging in social team sports.

Maintain a healthy weight

Men with a BMI over 30 are more likely to experience oligospermia (low sperm count) and azoospermia (no sperm) than men with a lower BMI. There is also evidence to suggest that overweight men have poorer outcomes from assisted reproductive technologies such as IUI and IVF. However, one study found that losing weight through diet improved semen quality and increased sperm counts by 40%.

Manage stress

Stress can reduce your sex drive which can make achieving pregnancy more difficult. In addition, severe and ongoing stress can impact sperm quality. Try to limit stress where you can and reach out to your support network and practice relaxation techniques to help you work through periods of stress.

Prevent sexually transmitted infections (STIs)

It’s a good idea to have an STI screening before you and your partner start trying to conceive. It is estimated that 15% of male infertility cases are a result of STIs. This is because some STIs can cause infection and damage to the testicular tubes while others can impact sperm production.

Male fertility testing

Male fertility tests help men understand their fertility status and their sperm quality. The results can also help inform treatment for male infertility and provide insight into the likelihood of success of different assisted reproductive technologies. For example, if sperm count and morphology are good but motility is poor, then IVF with ICSI may be recommended over traditional IVF as in this process, one sperm cell is injected into each individual egg.  

Semen analysis

A semen analysis is a standard fertility test conducted for men. The test assesses the quantity and quality of sperm, including the:

• Volume of semen

• pH

•  Sperm count

• Sperm motility (how they move)

• Sperm morphology (their shape)

• Liquefaction time (how long it takes semen to liquify after ejaculation)

Testicular ultrasound

A testicular ultrasound is an imaging test that looks at the testicles and surrounding structures to check for any abnormalities that may impact sperm production or delivery. For example, it will indicate if the testicles are receiving a normal blood flow or if any tumours or varicoceles are present. During female fertility tests, a similar ultrasound scan is conducted to check the health of the womb and ovaries.

Sperm DNA fragmentation (SDF)

SDF is quite a grey area in the world of fertility care, and the subject of ongoing investigations and debates. Here's what we know (by one of our fertility doctors, Dr Sotirios Saravelos):

Sperm, like other cells within the human body, contains DNA, the genetic material that ultimately merges with that of the egg to create a healthy embryo. The sperm DNA itself can become damaged, leading to what is called DNA fragmentation.

Some DNA fragmentation is expected to be present, but it is thought that abnormally high DNA fragmentation may be associated with some cases of unexplained infertility, recurrent miscarriage, and failed IVF cycles.

Although abnormal sperm DNA fragmentation can predict poorer outcomes, it is not entirely understood what can be done to improve it. Lifestyle changes such as the ones mentioned above (stopping to smoke, improving diet and taking antioxidants) have been shown to help.

Is Sperm DNA fragmentation (SDF) part of routine examinations?

SDF is not generally a routine examination. The ESHRE guidelines on Recurrent Pregnancy Loss state that you can perform this test for exploratory reasons (i.e. to try to explain miscarriages) but it is not routinely recommended.

It is also not part of the routine parameters evaluated in semen analysis, which is performed under the microscope. This is because it examines a different aspect of the sperm, namely its DNA.

Would a poor result influence fertility treatment?

It may explain some poor results, in terms of infertility and miscarriage. Some interventions for the male partner may be considered to improve future outcomes, but these are being investigated and debated at the moment.

Does Apricity offer SDF?

Yes, Apricity can arrange for SDF to be performed in a partner clinic, and costs around £500.

Sperm DNA testing is not advised for everyone and the decision to test (alongside analysis of results) should be discussed with a fertility doctor. A consultation can be arranged by booking a free call with one of our fertility advisors.

Male infertility online and in the media

• HIMfertility is an initiative set up by comedian Rhod Gilbert (see more below) encouraging men to talk about fertility problems while offering resources and support. Their social media pages share the latest on their virtual meet ups, which men can join with their camera on or off.

• Stand Up to Infertility: Comedian Rhod Gilbert takes on the subject of male infertility in the BBC One Wales documentary Stand Up to Infertility, available on iPlayer. Rhod hopes to help men find voices, support and humour through the painful struggle of male infertility.

• In Me, My Brother, and Our Balls (available on BBC iPlayer), Love Island star Chris Hughes and brother Ben take on male infertility, a topic so many men struggle with but don't talk about. The program looks at the subject with intimacy, honesty and humour, for an insightful and meaningful watch.

• TEDx talk by marketing specialist and Swimming Aimlessly author Jon Waldman. Watch to hear Jon's experience of finding relief in one of life's most personal challenges.

• My Wife Let Everyone Assume She Was The One Dealing With Infertility, a beautifully-penned, honest piece by actor, writer and musician, Andrew Burlinson, on Romper. Infertility is so often deemed a woman's problem. It's not just incorrect, it's extremely alienating & unhelpful to men.

• In the Invisible Man, Fertility Podcast host Natalie Silverman chats to a range of men on their experiences with male infertility as part of Fertility Fest. The audio episode also features leading fertility specialists.

• Apricity have also had the chance to hear stories from some of the wonderful men who have been very open about their journeys with male infertility. These include: Toby Trice, It Takes Three and FortyYearOldDad, to name a few.

Fertility options for male gay couples

We are proud to offer fertility tests for same-sex male couples as well as variety of treatments for male gay couples. Our inclusive fertility care also extends to individuals, same-sex female couples and trans and non-binary partners:

Egg donation and surrogacy

Our surrogacy packages give male same-sex couples the chance to start a family and have a child from birth, with one parent also being biologically connected to the child. Full surrogacy involves using donor eggs and may also be suitable for solo transgender woman, a single cisgender man, and gay, cis and transgender couples.

Reciprocal IVF

For lesbian couples wanting to start a family, reciprocal IVF offers a way for both partners to be a part of the process. With our Shared Motherhood IVF package, one partner donates their eggs which are fertilised and then transferred to their partner to carry the pregnancy.

Solo parenthood

Many single women and those assigned female at birth do not have fertility challenges, meaning they have a good chance of a successful pregnancy with an IUI using donor sperm. If they do have fertility challenges, IVF may provide a viable treatment path. For single men and those assigned male at birth, solo parenthood can be achieved via surrogacy.

Fertility preservation

If you’re transitioning, your future fertility might not be at the forefront of your mind. However, fertility testing for trans and non-binary people can help you understand your fertility preservation options and how they can fit it within your transition.

Fertility preservation is also an option for those who aren’t ready to start a family yet, have a condition that affects fertility, such as endometriosis, or you are about to start treatment for cancer.

Male fertility assessments with Apricity

Apricity’s male fertility diagnostics package is designed to take a detailed look at your sperm parameters to give you a thorough understanding of your fertility and help inform treatment recommendations.

After a virtual consultation that takes place from the comfort of your own home, you can choose to attend a local clinic to provide a semen sample, or we can send an at-home sperm fertility test direct to your door. Once the fertility assessment is booked, you'll be given instructions on next steps. Usually, you'll be advised to abstain from sexual activity for 2-7 days.

The sample is then analysed under a microscope. The main parameters we test for are volume, concentration (number of sperm), motility (how sperm move) and morphology (sperm appearance). Your results are then explained in detail by a fertility doctor, who can answer questions and discuss any measures that can be taken to improve the sperm quality. If necessary, the doctor can recommend specific targeted treatment.

We also offer fertility tests for couples andfertility tests for females. Our services are supportive and inclusive no matter your circumstances or path to parenthood. If you’d like to take control of your reproductive health and take your first family planning steps, book a free consultation with an Apricity advisor.