Fertility is a two-way process, and whether your partner has had fertility investigations or not, it is ALWAYS worth focusing on how you can improve the strength and quality of his sperm.
So many times the focus is solely placed on the female partner, especially if a semen analysis report looks 'normal'. However we now know that, along with sperm count, motility etc, the DNA (= the genetic material in the sperm head) may be negatively impacted by various lifestyle and environmental factors and this DOESN'T show up on a standard semen analysis (1). There are diagnostic tests (DNA Fragmentation Index) that can investigate if there is damage to the genetic material, but these are costly, and surely isn't prevention better??
So can I improve the concentration? motility? DNA?
Firstly, it's good to know that a fresh batch of sperm are made approximately every 3 months so there's always an opportunity to improve the next batch by making changes now. It takes them this long to make their way from the testes where they're made, through to the epididymis, where they're stored prior to ejaculation. They also need this time to fully mature and gain the ability to swim so that they can reach the egg.
So many factors within our daily lives can have a detrimental impact on (2):
sperm count (concentration)
motility (how well they move)
shape (morphology)
DNA integrity (that's the genetic material inside the sperm that helps to create the baby).
What's good to know, however, is that all of these areas can be improved upon.
So lets look at five different areas that you can focus on to improve the quality, and fertilising ability, of your sperm.
Diet
We all know that the typical 'Western diet' is not the healthiest of options when it comes to weight management, heart health, or blood pressure. It may not be so well known, however, that it may also impact the production, and quality, of sperm.
But how does what we eat actually help the tiny little swimmers anyhow?
There are substances called antioxidants found within our diet that can help to protect the DNA of the sperm from any potential damage, caused by free radicals.
Where can we find these antioxidants?
Some of the vitamins and minerals in our diet (Vitamin C, Vitamin E, selenium) act as antioxidants, but there are numerous other substances, found in colourful fruit and vegetables, that also have this amazing ability to clean up the free radicals and prevent damage to the sperm DNA. Therefore, including as many different coloured fruit and vegetables into the diet is a fantastic way to support the health of the sperm.
Is there a particular diet that's best?
This all depends on your own preferences, however, following a Mediterranean-style dietary pattern is a very good place to start. This includes incorporating plenty of extra virgin olive oil (another antioxidant), nuts, seeds, vegetables (think colourful), legumes, wholegrains, oily fish, and some dairy and meat (if not vegetarian / vegan). The healthy polyunsaturated fats found within this way of eating will also support the sperm by enhancing the flexibility of it's membrane (the outer edge of the sperm cell) which supports motility and fertilisation (3).
2. Smoking
Low sperm count, poor motility, and poor morphology have all been reported in individuals who are moderate to heavy smokers, with sperm count being cited as being 19% lower in heavy smokers compared to non-smokers (4). Smoking also increases the level of oxidative stress that is occurring in the body, using up the antioxidants, and leaving the sperm DNA open to an increased risk of damage. This may then impact the sperm's ability to fertilise the egg, or to develop on to a healthy pregnancy. Aside from the effects noted on the quality of a sperm sample, a further impact that has been reported is the increased risk of erectile dysfunction that comes with smoking (5).
Advice is therefore to stop smoking if you are trying to conceive.
What about e-cigarettes?
The jury is still out on e-cigarettes. It's early days, but initial studies are showing that smoking e-cigarettes may also lead to a decreased sperm count as well, so best to avoid (6).
3. Alcohol
Do a few pints at the local on a Friday night really have a negative impact on my sperm? Is it better to moderate throughout the week, or save it all up for the weekend?
Any consumption of alcohol has been shown to be detrimental to semen volume and sperm morphology, compared to no drinking. This effect was seen to be strongest in those that were having an alcoholic drink every day as compared to those having the occasional drink (7). So, having a daily drink is reported to be the most detrimental on semen quality.
The reasons behind this impact are not fully understood but are thought to be related to the effect that alcohol has on the sex hormones, impacting sperm production and development. It is also plausible that alcohol can have a negative impact on sperm DNA integrity as well.
Therefore, the occasional drink may not cause too many issues with sperm quality, but to be on the safe side, the advice would be to try and abstain from drinking, as much as possible.
4. Temperature of the 'crown jewels'
The testicles are meant to be kept at a slightly lower temperature (34 degrees) than body temperature (37 degrees). This is to optimise sperm production, and when things get too hot down there, sperm count and motility may be negatively affected (8).
There are a number of ways that the scrotal temperature may be increased, and therefore there are also a number of recommendations to help to prevent any negative impact on the sperm quality:
avoid wearing tight underwear,
avoid regular saunas and really long soaks in a hot bath / jacuzzi,
avoid sitting for prolonged periods of time - try and get up and move around regularly to avoid the testicles getting too hot,
avoid resting your laptop on your lap as the temperature from the computer may have a detrimental effect.
5. Stress
Research has shown that stress (psychological, physical, emotional) can negatively impact sperm count and motility (9). A full understanding of the mechanisms behind this effect are not yet known, however, stress has also been shown to affect the balance of reproductive hormones, such as testosterone, that are involved in the production of sperm - a potential contributor.
Infertility, on its own, is a major cause of stress, making it very difficult to avoid. Finding ways to limit other stressors in your life, either physical (over-exercising) or psychological (work / financial) is advised.
We need a little stress in our lives for our bodies to function normally, but it's all about finding the BALANCE.
As well as limiting other stressors, how can you manage the unavoidable ones? Ask yourself the following questions.
What do you enjoy doing?
How can you incorporate it into your daily / weekly routine?
This will look very different for everybody, so it's important to understand what works for you. Maybe it's a lunchtime walk to break up the day in the office? Maybe it's having 20 minutes in the morning to complete Wordle and Globle (a usual past-time in my house!)? Or it could even be putting your headphones on and listening to your favourite playlist on your commute back home?
Find what works for you.
So, although we live in a world that sometimes feels like it is seemingly working against our fertility, there are definite areas that you can focus on to hopefully improve the quality of sperm.
Focus on eating a colourful Mediterranean-style diet
Stop smoking / e-cigarettes
Reduce / abstain from alcohol
Keep the temperature around your testicles nice and cool
Look at how you can implement stress management techniques / actions
Making changes now could have positive effects in a short space of time, and also not only on your sperm. I bet you'll notice a myriad of energy giving, clear thinking, and restful sleeping benefits.
If you have any questions about anything you have read here, please don't hesitate to get in touch at sarah@theembryologistnutritionist.co.uk. You can also book in for a free chat to discuss your situation if you feel you may benefit from some extra support.
References
1. Agarwal A, Majzoub A, Baskaran S, Selvam MKP, Cho CL, Henkel R, et al. Sperm DNA fragmentation: A new guideline for clinicians. World J Mens Health. 2020;38(4):412–71.
2. Leisegang K, Dutta S. Do lifestyle practices impede male fertility? Andrologia. 2021;53(1):1–13.
3. Collodel G, Castellini C, Lee JCY, Signorini C. Relevance of Fatty Acids to Sperm Maturation and Quality. Oxid Med Cell Longev. 2020;2020.
4. Harlev A, Agarwal A, Gunes SO, Shetty A, du Plessis SS. Smoking and Male Infertility: An Evidence-Based Review. World J Mens Health. 2015;33(3):143.
5. Cao S, Yin X, Wang Y, Zhou H, Song F, Lu Z. Smoking and Risk of Erectile Dysfunction: Systematic Review of Observational Studies with Meta-Analysis. PLoS One. 2013;8(4).
6. Bjurlin MA, Kamecki H, Gordon T, Krajewski W, Matulewicz RS, Małkiewicz B, et al. Alternative tobacco products use and its impact on urologic health – will the lesser evil still be evil? A commentary and review of literature. Cent Eur J Urol. 2021;74(2):152–60.
7. Ricci E, Al Beitawi S, Cipriani S, Candiani M, Chiaffarino F, Viganò P, et al. Semen quality and alcohol intake: a systematic review and meta-analysis. Reprod Biomed Online [Internet]. 2017;34(1):38–47. Available from: http://dx.doi.org/10.1016/j.rbmo.2016.09.012
8. Durairajanayagam D, Agarwal A, Ong C. Causes, effects and molecular mechanisms of testicular heat stress. Reprod Biomed Online [Internet]. 2015;30(1):14–27. Available from: http://dx.doi.org/10.1016/j.rbmo.2014.09.018
9. Nordkap L, Priskorn L, Bräuner E V., Marie Hansen Å, Kirstine Bang A, Holmboe SA, et al. Impact of psychological stress measured in three different scales on testis function: A cross-sectional study of 1362 young men. Andrology. 2020;8(6):1674–86.
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