When you're trying to conceive, it's essential to recognize that fertility is a 50/50 partnership—sperm health is just as important as egg health. While much of the focus tends to be on female fertility, some studies show that 10-15% of men in the U.S. face infertility issues when trying to conceive. Understanding the signs of male fertility can empower you on your journey. In this post, we'll dive into the habits that affect sperm health, the signs of potential infertility, and when it might be time to seek medical advice.
What Does Healthy Sperm Look Like?
Before we dive into healthy sperm, we should understand the difference between semen and sperm. Semen is the thick, white substance released during ejaculation, while sperm are the microscopic cells within semen that carry the genetic material necessary for reproduction. When assessing the health of sperm, doctors look at three factors:
- Sperm Count: Refers to the number of sperm present in a given volume of semen.
- Sperm Motility: Measures the percentage of sperm alive and actively swimming.
- Sperm Morphology: Examines the size and shape of sperm, with a healthy sperm having an oval head and a long, smoothly moving tail.
According to the World Health Organization (WHO), a regular semen analysis shows a sperm concentration of at least 15 million sperm per millimeter of semen, with at least 30% motility and 4% normal morphology. While you cannot accurately judge sperm health by sight, if you notice any marked differences, such as changes in color, consistency, or traces of blood should prompt a discussion with your healthcare provider.
Signs That You’re Likely To Have Healthy Sperm
Healthy sperm is due to several factors and lifestyle habits, such as genetics, diet and daily water consumption. The only way to know the healthy sperm for sure is to have it tested by your healthcare provider. However, below are some signs of healthy sperm.
You Exercise Regularly
Research indicates that men who engage in moderate to vigorous exercise tend to have a higher concentration of sperm than those who don’t. Regular workouts may boost the body's production of antioxidants, which can help protect sperm cells from damage caused by free radicals. Additionally, staying active supports a healthy weight, reducing the risk of obesity and other chronic conditions known to impact sperm count negatively.
You have a Slim Waistline
Studies have found that a larger waist circumference in men is associated with lower sperm counts. Excess weight around the midsection can disrupt the release of sex hormones and hinder sperm production and development. Men with a smaller waist circumference might generally have better sperm quality than those with obesity or metabolic syndrome. However, it's essential to consider other factors that can also affect fertility.
You Steer Clear of Saunas and Hot Tubs
The scrotum naturally maintains a temperature a few degrees cooler than the rest of the body, which is essential for healthy sperm production. However, activities that raise the temperature of the testes, such as spending time in saunas and hot tubs or taking hot baths, could potentially reduce sperm count. A 2013 study involving healthy Finnish men with normal sperm counts found that regular sauna use—15 minutes a few times a week—led to a temporary decrease in sperm count. The men’s scrotal temperature dropped by 5.4 degrees Fahrenheit, and while their sperm counts returned to normal after six months, the study didn’t measure the impact on their overall fertility.
You Love to Eat Fish
Processed meats like bacon, luncheon, and sausage could negatively affect your sperm count. Studies have shown that men who consume the most processed meats have significantly fewer healthy, normally-shaped sperm than those who eat less. On the flip side, a diet rich in fish, particularly salmon and tuna, might boost your sperm count. Men who ate the most fish had a 65% higher sperm concentration than those who ate the least, thanks to the omega-3 fatty acids in fish, which play a crucial role in sperm production.
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You Avoid Tight-fitting Underwear
While Boxers or briefs is a personal preference, it can affect your sperm count. A 2018 study revealed that men who wore boxer shorts instead of tight-fitting underwear had 25% higher sperm concentrations and 17% higher sperm count than those who wore briefs. The study suggests that loose-fitting underwear helps keep the scrotum cooler, which may improve semen quality. Elevated testicular temperatures have been linked to reduced sperm production, so if you're aiming to optimize your fertility, it might be wise to stick with looser underwear.
You Have a Physical Job
A physical job can have several advantages, such as lower body weight and higher sperm count. A recent study discovered that men who engage in heavy lifting at work had a 46% higher sperm concentration and a 44% higher total sperm count compared to those with more sedentary jobs. If your job doesn’t involve physical labor, you can still reap similar benefits by incorporating weightlifting into your exercise routine, gradually increasing the weight you lift over time.
Your Voice Isn't Very Deep
Deep voices are often portrayed as the hallmark of masculinity, but they may not translate to healthier or more abundant swimmers. In one study, researchers found that while women usually find low-pitched voices more masculine and attractive, men with huskier voices tend to have lower sperm concentrations. The study suggests that testosterone might be a factor in this, as it's linked to more masculine facial features and deeper voices. However, excessive testosterone could potentially suppress sperm production, leading to lower sperm counts.
You Avoid Smoking, Alcohol and Caffeine
While it may sound like conventional knowledge, habits like drug use, smoking, excessive alcohol, and high caffeine consumption can all negatively impact sperm quality. Reducing or eliminating these behaviors could lead to significant improvements in sperm health. Since you produce millions of new sperm every day, and it takes about three months for sperm to mature fully, a man who quits smoking after a poor semen analysis might see noticeable improvements in sperm quality within four months.
You Avoid Single-Use Plastics
Microplastics are fast becoming a hot topic in the health & wellness space. Some studies have linked microplastics to lower sperm counts. A 2024 study detected significant levels of 12 different microplastics in both human and canine testes, leading experts to suspect a link to declining sperm counts. Another study found that men with the highest levels of BPA (bisphenol A, a chemical commonly found in plastics) in their urine had a significantly lower percentage of motile sperm. While scientists are still unraveling the exact cause, they suspect that BPA might disrupt estrogen and androgen activity in the epididymis, a part of the testicles, potentially hindering the normal development of sperm.
Common Signs of Infertility in Men
Changes in Sexual Desire
Like women, a man's fertility is closely tied to his hormonal health. Fluctuations in virility, which are often regulated by hormones, might be a sign of underlying fertility issues.
Testicle Pain and/or Swelling
Testicular pain or swelling can happen for several reasons, including injury, inflammation, or a sexually transmitted infection. Some of these can impact fertility, and if you have swollen or painful testes, you should see a healthcare provider.
Problems Maintaining an Erection or Ejaculating
Erectile dysfunction (ED) is more frequently affecting younger men than ever before. Large, multinational studies have estimated that as much as 30% of men under 40 have ED. One reason may be hormonal health, linked to the male reproductive system. Reduced or imbalanced hormones may result in a diminished ability to conceive. Similarly, issues ejaculating can also be an issue. If you are dealing with either, seek the counsel of a healthcare provider.
Small, Firm Testicles
Testicle size varies, and while smaller testicles generally do not pose any issues, sometimes small, firm testes can indicate a health problem. If the size of your testes has changed over time or one is smaller than the other, it’s time to see a healthcare provider to rule out anything serious.
Can You Fix Male Infertility?
The short answer is yes, you can “fix” male infertility or at least improve sperm count, motility and morphology in most cases. Depending on the cause, there are multiple treatment options that you can discuss with your healthcare provider.
Lifestyle changes
Some habits, like diet, smoking, excessive drinking and lack of physical exercise, may be the reason behind diminished male fertility. You may be able to increase the production of healthy sperm by:
- Switching out some of your daily meals for more fruits and vegetables, including fish
- Maintain a healthy weight and engage in regular physical activity at least a few times a week
- Stop smoking, drinking and using recreational drugs (if necessary, do not be afraid to ask for medical support)
- Avoid using lubricants during sex, which can decrease sperm motility
- Try a men’s fertility supplement that includes nutrients like Omega-3 and CoQ10
Medications
Hormonal imbalances can cause male infertility. Several medications address these imbalances with the aim of improving healthy sperm production. Some of the common medications include estrogen receptor blockers or human chorionic gonadotropin, which addresses low testosterone.
Surgery
Surgical treatments for male infertility include several options depending on the underlying issue.
- A vasectomy reversal reconnects the vas deferens, allowing sperm to enter the semen again, making pregnancy possible;
- Vasoepididymostomy is another surgical option that removes blockages in the epididymis, the tube where sperm mature, restoring the flow of sperm into the semen;
- Sperm retrieval involves a biopsy to extract sperm directly from the testicles or epididymis;
- A varicocelectomy removes varicose veins in the scrotum that can negatively impact sperm quality, potentially improving the chances of conception.
Assisted Reproductive Technology
Assisted reproductive technologies (ART) offer options for couples facing fertility challenges.
- Intracytoplasmic sperm injection (ICSI) involves a healthcare provider injecting a single sperm cell directly into an egg to facilitate fertilization.
- In vitro fertilization (IVF) is another approach where your female partner receives fertility medications to stimulate the maturation of multiple eggs in the ovaries. Once the eggs are ready, a provider collects them and exposes them to sperm in a lab. If fertilization occurs, the resulting embryo is placed inside a uterus to initiate pregnancy.
ARTs can be expensive and not always covered by health insurance, so many couples opt to try IVF and other ART methods last in their fertility journey.
When Should You See a Fertility Specialist?
If you and your partner have been trying to conceive through unprotected sexual intercourse for 12 months without success, both of you need to undergo an infertility evaluation. If your partner is over 35, seeking an assessment sooner may be advisable. Health experts often recommend assessments for both partners, as this can help avoid costly procedures like IVF that are frequently focused on female fertility when the issue may actually lie with the male. Taking this comprehensive approach ensures that both partners' fertility is addressed, improving the chances of a successful pregnancy.
