Sperm Quality
When you and your partner decide it’s time to start a family, it’s natural to want to ensure your best chances of conceiving. Fertility isn't just about a woman's reproductive health—sperm quality is just as important. Knowing what can improve sperm health can help you on your path to parenthood.
Men can produce new sperm throughout their entire lives. Unlike women, who are born with a finite number of eggs that decline over time, men continuously produce sperm from puberty onward, thanks to a process called spermatogenesis. On average, men produce around 1,500 sperm per second, which adds up to over 100 million sperm per day.
What is sperm quality and why does it matter?
Sperm quality refers to how healthy and effective sperm are in starting and supporting a healthy pregnancy. It includes sperm count (the number in a sample), motility (how well they swim to reach the egg), and morphology (their shape and structure). Additionally, the DNA quality of sperm is key. Good sperm quality increases the chances of fertilizing an egg and supporting the growth of a healthy embryo.
Are we really seeing declining sperm count?
Research suggests that the whole spectrum of reproductive problems in men is increasing, including declining sperm counts, decreasing testosterone levels, and increasing rates of erectile dysfunction and testicular cancer.
In 2022, Hagai Levine, professor of epidemiology at the Hebrew University of Jerusalem and his collaborators published a review of global trends in sperm count. It showed that sperm counts fell on average by 1.2% per year between 1973 to 2018, from 104 to 49 million/ml. From the year 2000, this rate of decline accelerated to more than 2.6% per year. While a higher sperm count does not necessarily mean a higher probability of conception, below the 40 million/ml threshold the probability of conception drops off rapidly.
What can improve sperm count/quality?
Several factors can influence sperm quality. For example, age can slow down sperm production and motility. Studies demonstrate that even when controlling for the age of their partners (since older men tend to have older female partners), increasing male age is associated with male fertility decline, defined as increased time to pregnancy and decreased pregnancy rates. In one study of over 8,000 pregnancies, conception in one year was 30% less likely for men over age 40 compared with men under age 30.
There are many other factors, however, that are within your control. On average, sperm production takes 74 days from start to finish (may vary by individual), so it’s best to start making these changes a few months before trying to conceive.
Lifestyle Choices: Smoking, heavy drinking, drug use and being overweight can all negatively affect sperm health. Healthy lifestyle habits are key, and they also include protection from sexually transmitted infections such as chlamydia and gonorrhea, which can cause infertility.
Nutrition and Antioxidants: A diet rich in antioxidants, vitamins, and minerals supports healthy sperm. Ensuring a balanced intake of these nutrients can improve sperm health:
Zinc: Found in meats, nuts, and dairy, zinc is crucial for sperm development.
Folate: This B vitamin, in leafy greens, beans, and whole grains, can improve sperm count and motility.
Antioxidants: Vitamins C and E are in fruits, vegetables, and nuts. They reduce oxidative stress, which can damage sperm DNA.
Avoid Heat Exposure: Try to avoid activities that expose the testicles to high heat, such as hot baths, saunas, or wearing tight underwear for prolonged periods. Limit excessive training or activities that increase heat exposure to the groin area, such as cycling for extended periods.
Stress and Mental Health: Chronic stress and anxiety can impact sperm quality, but can be managed through exercise and meditation. Getting counseling to help cope with any mental health challenges can also benefit your fertility. Self-care is important, especially when trying to conceive can be a stressful endeavor.
Environmental and Occupational Exposures: If your work exposes you to toxic substances such as pesticides and heavy metals, be sure that you are taking protective measures.
Should you get tested?
For most men, a semen analysis is the first and most essential step in evaluating sperm quality. Depending on the results, additional tests like a DNA fragmentation test or hormone testing may be recommended. Testing provides valuable insights, helping men and their partners understand any underlying issues and informing decisions about fertility treatments such as IVF, IUI, or lifestyle changes to improve sperm health.
Semen Analysis
What it measures: The basic and most common test to evaluate sperm health, a semen analysis assesses multiple factors like sperm count, sperm motility, sperm morphology, semen volume (healthy volume is typically 1.5 to 5 milliliters), and pH levels.
Not ready to visit a clinic? There are some convenient options for at-home testing like bird & be’s At- Home Sperm Test and The Ovry Male Fertility Test.
Sperm DNA Fragmentation Test
What it measures: This test evaluates the integrity of the sperm’s DNA. Even if sperm appear normal under a microscope, high levels of DNA fragmentation can indicate underlying issues. Poor DNA integrity can lead to problems with fertilization, higher miscarriage rates, and lower success rates in treatments like IVF. This test is often recommended for men with unexplained infertility, recurrent miscarriages, or failed IVF attempts.
Hormone Testing
What it measures:
Testosterone: The primary male sex hormone, essential for sperm production.
Follicle-Stimulating Hormone (FSH): Elevated FSH levels may indicate issues with sperm production or testicular function.
Luteinizing Hormone (LH): Works with testosterone and is essential for normal reproductive function.
Prolactin and Estradiol: Imbalances in these hormones can affect sperm production and sexual health.
If you've been trying to conceive for 6-12 months without success, a semen analysis can check sperm health. To boost sperm quality, take care of your health. A fertility specialist can suggest lifestyle changes, supplements, or treatments to help.
Remember that sperm quality can fluctuate and can take around three months for new sperm to develop. Be patient as you work on lifestyle improvements. Remember, fertility challenges are common, and seeking support from a specialist can make all the difference.
