Around a fifth of men have a low sperm count. For couples experiencing difficulties in conceiving, male infertility is the main cause in about 20% of cases.
But research has found that lifestyle factors play a key role in semen quality and healthy sperm motility (this refers to the sperm’s ability to move forward or ‘swim’ to fertilise an egg during conception).
In fact, 3 months before you’re planning to start trying for a baby, it’s advisable to deal with pre-existing health problems with your doctor and to make healthy lifestyle changes such as those listed below. This will help to make sure that your sperm quality is the best it can be.
1. Lose excess weight
If you have a raised body mass index (BMI), then try to lose weight. Obesity has a massive influence on male fertility problems, and studies show that it can affect hormone levels causing reduced sperm production and concentration. Similarly, although the evidence is more conflicted here, there may also be a link between obesity and reduced sperm motility and morphology (this refers to the shape of a sperm). All of this can reduce the chances of the sperm fertilizing the egg.
It is also becoming clearer that male obesity can affect the molecular health of sperm and damage sperm DNA. Integrity of sperm DNA is essential for successful fertilization and normal development of a baby. Some research shows that paternal obesity can even affect the health of your future children, through increased susceptibility of offspring to chronic disease.
The best way to achieve an ideal weight is through healthy diet and exercise.
2. Stop smoking
Smoking can reduce ejaculate volume as well as sperm density and motility. Smokers might have a lower zinc content in their semen, which can reduce sperm production.
The tiny hairs that help semen move along the tubes of the epididymis (the tube that transports sperm produced in the testes) may be damaged in smokers, which can also negatively affect sperm function. Smoking can also harm erectile function.
Continuing to smoke also puts your partner at risk through passive smoking.
The good news is that these negative effects can be reversed if you give up smoking. Do ask your doctor if you need help stopping smoking, as there are NHS stop-smoking programmes that could improve your chances of stopping.
Want to give up smoking? Read our guide on the options available.
3. Cut back (or cut out) alcohol
Drinking alcohol excessively can affect the quality of sperm. It lowers levels of testosterone, follicle-stimulating hormone and luteinising hormone (LH), which is one of the main hormones that controls the reproductive system. Alcohol raises oestrogen, which can contribute to reduced sperm production: one study found that drinking as little as 5 units of alcohol a week could adversely affect sperm quality.
4. Avoid recreational drugs
Marijuana and cocaine are thought to affect male fertility, but large-scale studies are perceived as unethical, so it’s impossible to say for sure.
Anabolic steroids (sometimes taken by men to bulk up their bodies), amphetamines (speed), as well as heroin and methadone also damage sperm quality. If you’re using any of these drugs then talk to your doctor to work out a way to stop your habit.
5. Do regular exercise
It’s important to be active for good cardiovascular health and to be at an ideal weight for fertility.
But research has repeatedly shown that generally active men also have higher sperm counts than their sedentary counterparts. Aim for at least 30 minutes of moderate exercise, 5 times a week.
6. Manage your stress levels
Stress can reduce hormones such as LH and testosterone. In theory, this can affect sperm quality, although more studies are needed to make a definite connection.
‘Mental stress affects us in many ways. It affects our libido, potentially our reproductive abilities and probably also sperm quality,’ says Dr Rosen, Livi GP.
Learn a few simple breathing and meditation techniques that you can regularly turn to during stressful moments. The Headspace app is a great starting point.
7. Keep an eye on temperature
Increased temperature of the testicles might impair sperm quality. Try to avoid sitting for prolonged periods with a warm laptop on your groin area or carrying a warm phone in your pocket. Also, don’t take long hot baths, saunas and Jacuzzis.
Instead, wear loose-fitting trousers and undergarments (such as boxer shorts). If you work in a hot environment or sit down for hours at a time, it’s important to move around and get outside regularly.
8. Eat a healthy diet
Diets that are high in processed meat, caffeine, red meat, saturated fatty acids and trans fats are linked to low quality semen.
Fruit, vegetable, wholegrain and fish rich diets are linked to better sperm quality. In fact, a Mediterranean style diet for heart health will support fertility.
Make sure your diet is rich in antioxidants such as vitamin C, folate, zinc and B12. These are best obtained from your diet, so aim to eat at least 5 portions of fruit and vegetables each day. Talk to your doctor about your diet specifically, just in case you might need to take a food supplement - for example, because you’re vegan.
Foods rich in omega-3 fatty acids such as walnuts or oily fish (including salmon, sardines, mackerel and herring) help sperm production.
9. Talk to your GP
If you have existing medical conditions that might affect fertility, such as sickle cell or thalassaemia or other hereditary diseases, take the opportunity to see your doctor for a preconception chat.
Similarly, if you are a man who has had groin surgery or treatment for testicular cancer, then you might want to discuss fertility with a doctor sooner.
Remember to get STI excluded (or treated) by being tested as soon as possible, if that’s appropriate.
If you have not conceived as a couple after having unprotected sex for a year, then consult your doctor together; fertility treatment options such as IVF might be a consideration.
Reviewed by: Dr Rhianna McClymont, Lead GP, Livi