6 Lifestyle Factors That Can Impact Male Fertility
Making changes to enhance fertility for men
Let’s talk about sperm. When it comes to fertility, there is SO much emphasis (and, may I say pressure) on women, that it is important to spend some time also talking about the other side of the coin, which is male fertility. Sperm health is 50% of the equation(!) for procreation and impacts trying to conceive.
This article will dive into the importance of the health of sperm, focusing on ways to enhance male lifestyle factors to improve male fertility:
- Smoking including cigarettes, vaping and marijuana and alcohol
- The impact of heat
- Food and nutrition
- Male vitamin supplements
- Sperm renewal
- Frequency of ejaculation
To learn about female lifestyle factors, read 6 lifestyle factors that contribute to female fertility.
Read about the semen analysis with guest specialist Dr. Jarvi, Urologist.
1. Smoking, vaping and alcohol
Cigarette smoking
First off, let’s go over the studies about cigarette smoking. According to the World Health Organization (WHO), 36% of all men who are 15 years or older are smoking regularly. And 46% of smokers are men of reproductive age. There was a very large meta analysis (when you combine the data from multiple studies on the same topic) that looked at 26 countries or different regions around the world and they looked at sperm parameters in men who were smokers and they noticed that they had about a 13 – 17% lower sperm concentration versus non-smokers.
Cigarette smoking has been associated with not only low sperm count, but also loss of motility and worse morphology. Cigarette smoking also causes DNA damage leading to abnormalities in the genetic material within the sperm, which can lead to infertility and potentially increased risk of miscarriage as well.
Fertility and Sterility, a highly esteemed journal in reproductive medicine, actually published a study where they looked at 300 couples undergoing a combination of IVF and ICSI (Intracytoplasmic Sperm Injection) – this is when you take one sperm and inject it directly inside the egg). These 300 couples participated in a total of 415 treatment cycles: 213 were IVF and 202 were ICSI cycles. The outcomes of the cycles were compared among women who smoked versus women who did not smoke, but their partners did smoke. And what the authors found is that the chances of failing fertility treatment with ICSI in cases where the male partner smokes was 3x times higher compared to the male partners that were not smokers. This is quite significant. And, it goes to show that even though such powerful technology exists, we’re still not that good at picking the right sperm or the best sperm, because there is still invisible DNA damage affecting the quality of the sperm and its ability to fertilize and drive embryo redevelopment, which is certainly affected by smoking. The mechanisms are not exactly clear. It could be due to the impact of nicotine on sperm DNA or the increase in reactive oxygen species, which is what happens when the capacity of the sperm to deal with oxidative stress is compromised.
It’s also important to know that ideally there is zero smoke intake, but we know that smoking is addictive and quitting smoking is really hard and it takes time (and, maybe several attempts).
There was a study showing that the effect of smoking is actually dose-related. This means that, if someone is smoking more than 10 to 20 cigarettes a day versus less than 10 cigarettes a day there is a difference in health outcomes. This is good news because if you cannot completely stop smoking, but you can at least decrease the amount of smoking to less than 10 cigarettes a day, that reduction alone can have a positive impact on health and fertility outcomes. And speaking of quitting smoking, another very interesting study that looked at for every year that a man had quit smoking, it reduces the risk of failing IVF by 4%. This is specifically about clinical pregnancy and live birth. So it’s not only fertilizing and making an embryo, but actually increases the odds of achieving a live birth.
Vaping
It’s important to know that while vaping may have less chemicals than traditional cigarettes, it still contains nicotine. Nicotine itself has been shown to have a serious impact on sperm parameters. So really vaping or smoking are both bad, regardless of what you might hear in the media and on social media.
Marijuana
Another topic that comes up a lot clinically is the consumption of marijuana and fertility and whether there’s an impact on sperm and pregnancy and embryo quality. Its important to note that with marijuana, there’s not nearly as much research out there as there is on cigarettes. Now with the legalization of marijuana in Canada, there’s a lot more research that’s starting to be published.
Marijuana and its active metabolite, tetrahydrocannabinol, or THC, can alter the signaling system within spermatozoa and sperm which can result in negative effects on the creation of sperm and male fertility.
There was a study on this topic published in Fertility and Sterility, which is one of our favorite journals, that was published in 2018. Looking at this study, they took a total of 409 men who were attending a fertility clinic and did their semen analysis and then completed a questionnaire looking at various lifestyle factors, including their marijuana use. They found that 43% of these men reported marijuana use. This may be a surprisingly high number to some, but I would say that’s in keeping with what we see clinically. Compared to non-users, semen quality was significantly decreased in volume, concentration, morphology, total motile count (TMC) and total progressive motile count (TPMC) compared to never users. This is a really, really significant piece of information.
Alcohol and caffeine
There was another study looking at the association between caffeine intake, alcohol consumption and IVFand ICSI outcomes in both men and women. This study was also a meta analysis and they combined 12 studies on caffeine consumption and 14 studies on alcohol consumption, looking at 26,992 couples that were going through IVF and ICSI. The results were very interesting. The good news of this study is that women’s and men’s caffeine consumption was not significantly associated with pregnancy rates or life birth rate.
Now again, this was a combination of studies. There have been some studies showing that you should be having less than 250 milligrams of caffeine a day. But at least in this study alone, they didn’t seem to have a significant impact at all. That is for caffeine and now for alcohol.
The bad news is that both maternal and paternal alcohol consumption was negatively associated with pregnancy rates and live birth rates after IVF/ICSI. As a matter of fact, compared with abstainers, the chance of the female partner achieving a live birth decreased by 9% for men who consumed 6 or more alcoholic drinks per week.
I think this is reassuring that the occasional glass of wine here and there when you’re celebrating is probably fine but limiting regular consumption for both partners is important.
2. The impact of heat
Another topic that comes up often when we’re talking about sperm and sperm health is heat, and specifically heat to the testicles or to the scrotum.
The temperature of the scrotum is really important for sperm health. Sperm are very sensitive to temperature and even slight temperature changes can actually have a big impact. This is why the testicles are hanging outside of the body, which protects them from being too hot. There is a condition called undescended testes, where if the testicles descend too late in life they are not functional anymore.
When it comes to heat, we worry when the testicles are being submerged or in a very high heat environment.
Some things to avoid frequent use of:
- taking hot baths
- saunas
- hot tubs
- seat warmers in the car
- Wearing tight-fitting underwear or pants
- Placing a laptop on your lap for a long period of time
Doing these things on a regular basis can increase the temperature of the testes and impair sperm production. For those trying to conceive, heat exposure should be limited.
3. Nutrition and sperm health
When it comes to supporting sperm health and trying to optimize sperm quality, a healthy diet makes a big difference. Certain foods nutrients can improve sperm quality and male fertiltiy.
Some foods to avoid:
- Red meat, processed meat
- Sugary drinks and snacks
- processed foods
Some foods to incorporate more of:
- Fish and seafood (salmon and shrimp)
- Omega-3 fatty acids (walnuts, fish, flax seed)
- Fruits and vegetables
- Whole grains
- Lean protein
- Olive oil
- Pumpkin seeds (great source of zinc)
4. Male vitamins and supplements
Obviously getting nutrients from your diet is best, but it can be hard sometimes. Sometimes we’ll use supplements to optimize intake. Some of the supplements that can improve sperm quality and male fertility:
- CoQ10: it’s a powerful antioxidant that can help protect the DNA from oxidative damage
- Zinc: is essential for the production of healthy sperm and can improve sperm count and motility
- L-carnitine: is an amino acid that plays a crucial role in energy metabolism
- Vitamin D
- Vitamin C
- Vitamin E
- Antioxidants
- Omega-3 fatty acids
- Selenium: is an important antioxidant and is also important for muscle and nerve function
- Magnesium: is involved in several processes in the body, like the energy production and muscle and nerve function
- Calcium
- Folic acid
5. Sperm renewal
How long does it going to take before you start seeing improvements in sperm quality? How long do you have to quit smoking or drinking or marijuana before doing an IVF cycle? As far as the sperm cycle, it takes about 74 days for sperm to fully mature. Temporary changes don’t work well; you want to commit to a lifestyle change. Any regimen that you do, it’s going to take at least three months before you see changes when it comes to sperm parameters.
6. Frequency of ejaculation
Ejaculation actually matters. Men tend to come into the clinic for their semen analysis and we will see that they will have abstained from ejaculation for like, 15 days. And what we notice is that the concentration or count is ok but the motility is very, vey low.
Long periods of abstinence from ejaculation, which can be via intercourse or masturbation, can lead to decreased motility of the sperm. I find in speaking with many couples, that the men purposely may try NOT to ejaculate until it is that “fertile window” of trying to conceive because they may think saving up sperm may help. Well, it doesn’t and it is actually the exact opposite.
The healthiest sperm is fresh sperm. The testicle is meant to be emptied. The best ejaculatory frequency is between two to five days. Post five days, we start seeing the decrease in motility of sperm. From the point of view of fertility treatment, for example for IVF and IUI, we want the freshest and best sperm. If it’s less than two days of abstinence, then we might not get the right concentration.
Best Supplements for Male Fertility
Create a comparison table.
| Supplement | Potential Benefit |
|---|---|
| CoQ10 | Supports motility |
| Zinc | Testosterone production |
| Selenium | Antioxidant protection |
| Vitamin C | Reduces oxidative stress |
| Vitamin E | Improves sperm membrane health |
| Vitamin D | Hormonal support |
| Omega-3 | Membrane integrity |
| Folate | DNA synthesis |
| L-Carnitine | Motility support |
Add a note stating supplements should only be taken under medical guidance after appropriate evaluation.
Nicotine, ZYN and Male Fertility
Nicotine may affect male reproductive health, including sperm quality and fertility. This applies not only to cigarettes and vaping but also to nicotine pouches such as ZYN. While nicotine pouches do not involve smoking or inhaling tobacco smoke, they still deliver nicotine, so they should not automatically be considered fertility-friendly.
If you are trying to conceive, reducing or avoiding nicotine may be a worthwhile step alongside other lifestyle changes. Speak with a healthcare professional if you need support with stopping nicotine use.
When Should You See a Fertility Specialist?
Consider speaking with a fertility specialist if you have been trying to conceive without success, particularly if:
- You have been trying for 12 months without pregnancy when your partner is under 35.
- You have been trying for 6 months when your partner is 35 or older.
- You have a history of testicular injury, surgery, infection or other reproductive health concerns.
- You have experienced problems with ejaculation or erections.
- You have previously had fertility problems or abnormal semen analysis results.
- You have used testosterone replacement therapy or anabolic steroids, which can affect sperm production.
A fertility specialist can assess both partners and may recommend tests such as a semen analysis to identify potential factors affecting fertility.
Closing thoughts on lifestyle factors to improve male fertility
Modifying lifestyle factors is hard! Although lifestyle is important, it’s also not the be all and end all of fertility.
It’s not as if you just get enough exercise or if you just eat enough zinc that your fertility problems are going to be fixed. This is just one factor in a massive puzzle that we don’t even necessarily know what all the pieces are and how everything fits together. Even if you go on vacation and you have a few drinks every night, that one week trip is not going to completely ruin your odds of fertility or set you back or ruin everything. Life is all about balance. It’s important to understand the principles and how the treatments have to fit into your life.
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FAQs
What is the fastest way to improve sperm health?
The most effective steps include stopping smoking, maintaining a healthy weight, eating a nutrient-rich diet, limiting alcohol, getting adequate sleep, and treating any underlying medical conditions. Since sperm take about three months to develop, improvements may not be immediate.
How long does it take to improve sperm quality?
Sperm production takes approximately 74 days, so lifestyle changes or medical treatments typically take around two to three months before improvements are reflected in a semen analysis.
Which vitamins are good for male fertility?
Nutrients commonly associated with sperm health include zinc, selenium, vitamins C, D and E, folate, CoQ10, omega-3 fatty acids, and L-carnitine. A healthcare provider can advise which supplements are appropriate based on individual needs.
Can being overweight affect male fertility?
Yes. Excess weight may disrupt hormone levels, lower testosterone, reduce sperm quality, and increase oxidative stress, all of which can affect fertility.
When should a man see a fertility specialist?
Men should consider a fertility assessment if they have been trying to conceive for 12 months (or 6 months if the female partner is over 35), have abnormal semen analysis results, a history of testicular problems, previous cancer treatment, recurrent pregnancy loss with a partner, or other known fertility risk factors.