Six natural ways to optimise male fertility

The NHS says that around one in seven couples will struggle to get pregnant. And while IVF is routinely offered to treat women, men are less likely to receive treatment for their own problems

According to the British Fertility Society, about 30% of conception problems are due to male infertility (with 30% due to female infertility and 40% due to unknown causes).[1] Yet reproductive healthcare remains distinctly feminised, putting an unnecessary burden on women and stigmatising infertility for men.

The good news is that men can future-proof their own fertility - and optimise their health and vitality at the same time. Leading nutrition and wellness expert Gideon Remfry explains how to increase sperm counts naturally, and gives us the lowdown on which male fertility supplements could help make sperm stronger for pregnancy.

A male fertility crisis?

The average sperm count among men in the West has more than halved in a generation and continues to fall each year, according to studies carried out on both sides of the Atlantic. 

A comprehensive and global review including 185 studies, counted semen samples from a total of 42,935 men between 1973–2011. The results showed a 50–60% decline in male reproductive health, concluding that “research on causes and implications were urgently needed.”[2] Although environmental pollutants, obesity and diet have all been proposed as a cause, no one has a definitive answer as to why.

Male infertility can have multiple causes, from viral infections such as Mumps during puberty to problems ejaculating during intercourse. Various medical, health and lifestyle issues can contribute to male fertility problems, including:

• A hormone imbalance such as hypogonadism, which causes an abnormally low level of testosterone.
• Poor quality semen - for example having a low sperm count, abnormally-shaped sperm or sperm with poor motility.
• A genetic problem such as Klinefelter syndrome (a rare condition involving an extra female chromosome.
• Having had undescended testicles as a baby.
• A structural problem – for example, the tubes that carry sperm being damaged and blocked by illness or injury, or being absent from birth.
• A genital infection such as chlamydia, gonorrhoea, or prostatitis (infection of the prostate gland).
• Varicoceles (enlarged veins in the testicles).
• Previous surgery to the testicles or hernia repairs.
• The testicles becoming overheated, for example through riding a motorbike, cycling or prolonged laptop use.
• Drinking too much alcohol, smoking or using drugs such as marijuana or cocaine.
• Certain medications, including testosterone replacement therapy, long-term anabolic steroid use, cancer medications, some antibiotics and some antidepressants.

Age can also play a role. Male fertility generally starts to reduce around age 40 to 45 years when sperm quality decreases. While there is no conclusive evidence, recent studies have found that some men in their 40s and 50s experience something similar to menopause,[3] a condition that has been dubbed the ‘manopause’ by the press.

What determines sperm health?

Problems with sperm health are a common cause of male infertility, affecting around one in three couples who are struggling to get pregnant, according to the NHS. [4] If you’re struggling to conceive or worried about your fertility, your GP can organise a semen analysis where your sperm will be looked at under a microscope. 

So what determines whether your sperm is healthy? Sperm health is determined by your sperm count (the number of sperm in a volume of semen), sperm motility (the percentage of sperm that are alive and swimming) and sperm morphology (the percentage of sperm with a healthy size and shape).

According to the NHS, a low sperm count is considered to be 15 million sperm per millilitre of semen. International guidelines produced by the World Health Organisation say that a normal semen analysis should show a motility of at least 30%, and at least 4% normally shaped sperm.[5]

What sperm counts can tell us about male fertility

While having a low sperm count may sound worrying, it’s worth remembering that sperm counts are hugely individual. The World Health Organisation’s suggested averages range between 40 million and 300 million sperm per ml - clearly a huge variation. 

Even more interestingly, the WHO also implies that having low or high sperm numbers does not necessarily correspond with the ability to conceive. What appears to be more important for fertility is the combined ‘quality’ of the sperm. [6][7]

Lifestyle factors that affect male fertility

Can you increase your sperm count naturally? From quitting smoking to losing weight, experts believe there are multiple, modifiable lifestyle factors that can improve a man’s fertility status. After all, your lifestyle can have a significant impact on your overall health. It stands to reason that it might affect your reproductive health, too. [8]

• Quit smoking 

Need a better reason to stub it out, once and for all? Smoking is associated with lower semen volume and total sperm count in fertile men, with improvements on semen quality noted once they had quit.[9]

• Limit alcohol 

Studies on long-term alcohol use have reported reduced testosterone and sperm production, so reducing your alcohol intake may boost male fertility naturally.[10]

• Reduce stress 

Men who feel stressed are more likely to have lower concentrations of sperm in their semen, and the sperm they have are more likely to be misshapen or show impaired motility.[11]

• Prioritise sleep 

Men who went to bed before 10.30pm were four times more likely to have healthy sperm than night owls who stayed up past 11.30pm.[12]

• Lose weight if you’re overweight

Several studies have indicated that male fertility is affected by obesity, but why this should be is not yet clear. It has been proposed that obesity causes oxidative stress and inflammation, something which can cause fragmentation in sperm DNA.[13]

• Keep cool

Prolonged use of a warm laptop device, or anything which may cause the testicles to overheat such as excess sitting, cycling or restrictive clothing, is known to temporarily lower sperm count.[14]

Could your body’s own antioxidants help increase your fertility?

If you’re looking for ways to enhance male fertility naturally, a great place to start is with your diet. Most of us are aware that the natural antioxidants found in the foods we eat (such as the polyphenols in plants) are great for our health. What’s less well known is that antioxidants play an important role in the reproductive system. 

Our bodies have an in-built antioxidant system which produces powerful antioxidants like superoxide dismutase (SOD) and glutathione peroxidase (GPX). We can eat antioxidants and take steps that help us up-regulate our bodies’ own antioxidants, both of which create a cellular protective reserve known as our total antioxidant capacity, or TAC. Our TAC is our defence mechanism against the oxidative damage caused by mental and physical stress (oxidative stress).

This is important because oxidative stress plays a fundamental role in a lot of the causes of male infertility by negatively affecting sperm quality and function.

Six Ways to optimise male fertility

The good news is the power of this dual antioxidant protection can be supported with lifestyle, diet and exercise, all of which have been shown to positively impact on TAC, male health and fertility.[15]

Not sure how? Here are six ideas to get you started...

Get Moving (moderately!)

Forget go-hard or go-home. Taking moderate aerobic exercise for over 30 minutes three times per week shows excellent outcomes for heart, brain and semen health and has also been shown to up-regulate our bodies total antioxidant capacity and reduce oxidative stress.[16]

One study showed the impact of a four-month intervention of moderate aerobic exercise. In the study, inactive and overweight men who used a treadmill for 35-50 minutes three times per week showed improvements in both their semen quality and their reproductive hormone profile.

Eat the Rainbow

Diets rich in antioxidant foods like the Mediterranean diet have been shown to increase both TAC and semen quality. In addition they are associated with decreasing the risk of death from all-causes, including cancer and cardiovascular disease.

Polyphenols are plant compounds which have been shown to support numerous health benefits. Studies have suggested that TAC concentrations and carotenoids (a type of polyphenol found in broccoli, apricots, cabbage, and carrots) were “positively correlated with sperm motility, morphology, and concentration”, which confirms the positive relationship between blood antioxidants and sperm quality.

To highlight this further, blood samples taken from infertile men showed lower TAC and lower concentrations of plant polyphenols and vitamins such as carotenoids and vitamin E, especially when measured against fertile men.[17]

Put fish on the menu

Essential fatty acids are exactly that... essential! But even if you eat fish regularly, you may not be getting enough omega 3 to balance the high amounts of omega 6 in the modern western diet. Omega 6 is found in plentiful amounts in corn, canola and soya bean oil, margarine, peanut butter, chicken fat, fried food and hidden in a lot of healthy-sounding processed foods, such as granola and hummus. As omega 3 is found mainly in small oily fish, ratios inevitably tend to be lower.

The ratio of omega 6 to omega 3 fats we consume does seem to have an impact on general health, oxidative stress and inflammation. But it also has an effect on men’s semen profiles. One study compared omega 3 and 6 ratios between fertile and infertile men and concluded the infertile men had lower concentrations of omega 3 in their moving sperm cells than fertile men.

The results suggest the potential benefits of improving omega 3 ratios through diet or through Omega 3 supplements, such as our Inessa Advanced Omega 3 Fish Oil, as a viable therapeutic approach in infertile men when the cause is unclear.[18][19]

Consider taking an antioxidant supplement

N-acetyl-cysteine or NAC is an antioxidant and although further research is required, early studies using NAC suggest it may boost glutathione levels (part of your total antioxidant status) and reduce oxidative stress.

One study showed that a three-month treatment using 600mg of NAC per day orally, saw sperm counts and motility increase significantly. Interestingly the men’s hormonal profile and TAC levels also improved.[20]

Think Zinc

Zinc is an essential mineral present in every one of our cells. It’s responsible for numerous functions from metabolism to immunity and is associated with our growth and development. Zinc is found in meat, seafood, legumes and fortified cereals, amongst other foods and multivitamin supplements. We do not create zinc in our bodies and can only get it from our diets.

But does zinc have a role to play in male health and fertility too? Research suggests it may support improving sperm count and quality. One study looked at 108 fertile and 103 infertile men and examined the effects of zinc supplements (and folic acid) on improving their semen variables. After 26 weeks the sub-fertile men demonstrated a 74% increase in total normal sperm count and a slight improvement in motility.

Another study highlighted that poor zinc nutrition may be an important risk factor for low quality of sperm in unknown causes of male infertility.[21][22]

Try a herbal remedy

Ashwagandha may be an ancient herbal remedy, but it has a lot of modern research behind it. It’s regarded as an adaptogenic herb, meaning it may help your body and brain adapt to managing stress more effectively.

Ashwagandha also shows promise as a herbal remedy for infertility by improving both blood circulation throughout the body (something that’s known to be good for maintaining erections) and naturally enhancing sperm quality.

Advances In Nutrition published a large systematic herbal review examining specific herbs and their effects on testosterone concentrations in Men. Ashwagandha was one of only two evidence-based herbs shown to work and the outcomes suggested ashwagandha herb, root and leaf extracts, may have a positive-effects on testosterone concentrations in men and treating male infertility.[23]

How to improve male fertility naturally

Sperm are known to be particularly vulnerable to environmental factors, such as exposure to toxic chemicals. PFAS (found in everything from plastic containers to soaps and electronics) are known as ‘forever chemicals’ as they don’t break down in the human body. They’ve been found to disrupt the male hormone testosterone and are correlated with a reduction of semen quality.[24]

Here’s how you can limit your exposure to toxins and increase your sperm count naturally.

Protect yourself

Take steps to limit your exposure to environmental toxins where possible. Use protective clothing if working with chemicals, replace nonstick pans with stainless steel alternatives, and don’t heat up food in plastic containers.

Avoid lubricants during sex

• Some commercially available lubricants can be damaging to fertility, reducing the ability of sperm to move spontaneously and actively toward the egg. If necessary, consider using a fertility-friendly lubricant, or search for a lubricant that is hydroxyethylcellulose-based as this is the most similar in consistency and viscosity to natural vaginal mucus.

Talk to your GP about medications

• Along with recreational drugs, certain prescribed medications are known to contribute to fertility issues too. These include calcium channel blockers, some antidepressants, anti-androgens, opioids, anabolic steroids and anti-epilepsy drugs.[25] Always talk to your GP before discontinuing any medication.

Moving Forward with Male Fertility Optimisation

Our ability to improve our total antioxidant capacity shows that lifestyle changes can buffer and balance the impact of mental and physical stress on our bodies. In fact, far from being beyond our control, simple lifestyle changes present an opportunity to improve both our fertility outcomes and our overall wellness.

Staying active, losing weight and making changes to your diet and lifestyle can help support male fertility, while certain male fertility supplements may also be beneficial for optimising sperm count and testosterone.

If a restricted diet means you’re struggling to get all the nutrients you need to enhance your own sperm health, taking good-quality supplements can help. Inessa Advanced Multivitamin contains 25 ingredients (including clinical doses of zinc and antioxidants), while Inessa Advanced Omega 3 gives you all the testosterone-boosting benefits of the essential fatty acids EPA and DHA.

Clinician-made, at Inessa we only make products that we believe to be of real benefit to your health. Made of all-premium ingredients at clinical doses, they’re free of fillers or additives and based on sound science. Click here to find out more.

If you liked this article, you might like An Interview with Melanie Brown Leading Specialist in Fertility, IVF & Pregnancy.

References

1. https://www.britishfertilitysociety.org.uk/fei/what-is-infertility/
2. Hagai Levine, Niels Jørgensen, Anderson Martino-Andrade, Jaime Mendiola, Dan Weksler-Derri, Irina Mindlis, Rachel Pinotti, Shanna H Swan, Temporal trends in sperm count: a systematic review and meta-regression analysis, Human Reproduction Update, Volume 23, Issue 6, November-December 2017, Pages 646–659, https://doi.org/10.1093/humupd/dmx022
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253726/
4. https://www.nhs.uk/conditions/low-sperm-count/#
5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8706130/
6. https://www.who.int/publications/i/item/9789241547789
7. https://www.nhs.uk/conditions/low-sperm-count/
8. Barazani, Y., Katz, B. F., Nagler, H. M., & Stember, D. S. (2014). Lifestyle, environment, and male reproductive health. The Urologic clinics of North America, 41(1), 55–66. https://doi.org/10.1016/j.ucl.2013.08.017
9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6693933/
10. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5504800/
11. https://www.fertstert.org/article/S0015-0282%2814%2900381-1/pdf
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7181488/
13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7473997/
14. https://pubmed.ncbi.nlm.nih.gov/12128094/
15. Benedetti, S., Tagliamonte, M. C., Catalani, S., Primiterra, M., Canestrari, F., De Stefani, S., Palini, S., & Bulletti, C. (2012). Differences in blood and semen oxidative status in fertile and infertile men, and their relationship with sperm quality. Reproductive biomedicine online, 25(3), 300–306. https://doi.org/10.1016/j.rbmo.2012.05.011
16. Rosety, M. Á., Díaz, A. J., Rosety, J. M., Pery, M. T., Brenes-Martín, F., Bernardi, M., García, N., Rosety-Rodríguez, M., Ordoñez, F. J., & Rosety, I. (2017). Exercise improved semen quality and reproductive hormone levels in sedentary obese adults. Nutricion hospitalaria, 34(3), 603–607. https://doi.org/10.20960/nh.549
17. Parohan, M., Anjom-Shoae, J., Nasiri, M., Khodadost, M., Khatibi, S. R., & Sadeghi, O. (2019). Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies. European journal of nutrition, 58(6), 2175–2189. https://doi.org/10.1007/s00394-019-01922-9
18. Innes, J. K., & Calder, P. C. (2018). Omega-6 fatty acids and inflammation. Prostaglandins, leukotrienes, and essential fatty acids, 132, 41–48. https://doi.org/10.1016/j.plefa.2018.03.004
19. Safarinejad, M. R., Hosseini, S. Y., Dadkhah, F., & Asgari, M. A. (2010). Relationship of omega-3 and omega-6 fatty acids with semen characteristics, and anti-oxidant status of seminal plasma: a comparison between fertile and infertile men. Clinical nutrition (Edinburgh, Scotland), 29(1), 100–105. https://doi.org/10.1016/j.clnu.2009.07.008
20. Jannatifar, R., Parivar, K., Roodbari, N. H., & Nasr-Esfahani, M. H. (2019). Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men. Reproductive biology and endocrinology : RB&E, 17(1), 24. https://doi.org/10.1186/s12958-019-0468-9
21. Lim, K. H., Riddell, L. J., Nowson, C. A., Booth, A. O., & Szymlek-Gay, E. A. (2013). Iron and zinc nutrition in the economically-developed world: a review. Nutrients, 5(8), 3184–3211. https://doi.org/10.3390/nu5083184
22. Colagar, A. H., Marzony, E. T., & Chaichi, M. J. (2009). Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men. Nutrition research (New York, N.Y.), 29(2), 82–88. https://doi.org/10.1016/j.nutres.2008.11.007
23. Smith, S. J., Lopresti, A. L., Teo, S., & Fairchild, T. J. (2020). Examining the Effects of Herbs on Testosterone Concentrations in Men: A Systematic Review. Advances in nutrition (Bethesda, Md.), nmaa134. Advance online publication. https://doi.org/10.1093/advances/nmaa134
24. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9986484/
25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3719368/