How Men Can Protect Their Fertility

Simple ways men can protect their fertility, support healthy sperm, and know when it may be time to seek medical help.

When a couple is trying for a baby and pregnancy does not happen as quickly as expected, it is easy to assume that the problem lies with the woman. In reality, male factors contribute to about half of all cases where couples have difficulty conceiving.

The good news is that some factors affecting male fertility can be changed. A man's general health, lifestyle, medications, substance use and exposure to certain toxins can all influence sperm production and quality.

Of course, not every cause of male infertility can be prevented. Conditions such as varicocele, hormonal problems, infections, genetic conditions or previous cancer treatment may require medical evaluation and treatment.

What does male fertility depend on?

For pregnancy to occur, the testicles need to produce enough healthy sperm, and the sperm need to be able to move properly and reach the egg.

A semen analysis looks at several things, including:

Sperm count – how many sperm are present
Motility – how well the sperm move
Morphology – the size and shape of the sperm
Semen volume and other characteristics
Sometimes, other tests are needed to look for infection, hormonal problems or blockages.

But fertility is not just about the sperm. Sexual function and the ability to deposit semen in the vagina also matter. Timing and regularity of intercourse are important as well.

What can a man do to protect his fertility?

There is no guaranteed way to prevent infertility, but some everyday choices can help.

Stop smoking

Smoking is bad for sperm health. Studies have found lower sperm concentration and motility in men who smoke, and tobacco exposure may also cause damage to sperm DNA.

This includes being cautious about assuming that vaping is a harmless alternative. E-cigarettes are not considered a safe option for reproductive health either.

If you smoke, stopping is one of the most useful things you can do for your overall health and potentially for your fertility.

Keep alcohol moderate

Regular heavy drinking can interfere with male reproductive hormones and semen quality. If you are planning a pregnancy, keeping alcohol intake low is sensible.

Avoid anabolic steroids and unnecessary testosterone

This is particularly important.

Some men take anabolic steroids or testosterone because they want to build muscle or improve physical performance. Unfortunately, testosterone taken from outside the body can switch off the hormonal signals that the testicles need to make sperm.

The result can be a very low sperm count or even complete absence of sperm in the semen. The AUA/ASRM guideline specifically advises that testosterone monotherapy should not be prescribed to men who are interested in current or future fertility.

If you are taking testosterone and want to have children, talk to a doctor rather than stopping or changing the medication on your own.

Be careful with recreational drugs

Cannabis and other recreational drugs are best avoided when trying to conceive. The evidence regarding cannabis and male fertility is not completely consistent, but there are studies suggesting effects on sperm function and semen quality.

There is little reason to take the risk when pregnancy is the goal.

Look after your weight and general health

Being significantly overweight can affect male reproductive hormones, sexual function and, in some men, sperm count and movement.

Regular physical activity, a healthy weight, adequate sleep and a balanced diet are therefore good for both general health and reproductive health.

You do not need a special "fertility diet." Think of ordinary healthy food: vegetables and fruit, whole grains, pulses, nuts, adequate protein and less highly processed food.

Don't overheat the testicles

The testicles are outside the body for a reason: sperm production works best at a temperature slightly lower than normal body temperature.

Prolonged or repeated exposure to high temperatures may affect sperm production. This is why it is reasonable to avoid excessive heat exposure, particularly if you already have abnormal semen results.

However, there is not strong evidence that ordinary choices such as wearing normal underwear routinely cause infertility. So there is no need to become anxious about every pair of tight trousers or every warm bath.

Protect yourself from workplace chemicals

Some occupations involve exposure to pesticides, solvents, heavy metals, radiation and other chemicals that may affect reproductive health.

If your work involves these exposures:

Use the recommended protective equipment.
Follow workplace safety procedures carefully.
Avoid bringing contaminated clothing or chemicals home.
Tell your doctor about significant occupational exposure if you are having difficulty conceiving.

Eat well rather than relying on supplements

A balanced diet is more important than taking a collection of "fertility supplements."

Zinc, vitamin C, folate and other nutrients are important for normal health, but taking large doses of vitamins or antioxidants has not been clearly shown to improve fertility outcomes in otherwise infertile men. The AUA/ASRM guideline describes the clinical usefulness of such supplements as questionable.

So, rather than buying several expensive fertility supplements, it is better to first look at diet, exercise, smoking, alcohol, weight and other health issues.

Don't forget stress and sexual health

Trying to have a baby can itself become stressful. Work pressure, relationship difficulties, anxiety about performance and lack of sleep can all affect sexual wellbeing.

Stress does not automatically make a man infertile, but looking after your mental health is part of looking after your reproductive health.

Also remember that erectile or ejaculation problems are fertility problems too, even when sperm production is perfectly normal. They can often be treated.

When should you see a doctor?

Don't wait indefinitely if pregnancy is not happening.

For most couples, an infertility evaluation is recommended after 12 months of regular unprotected intercourse without pregnancy. Earlier assessment is appropriate when there is a known or suspected male fertility problem, sexual or ejaculation difficulties, previous testicular problems, certain medical treatments, or other reasons for concern.

And importantly, both partners should be evaluated. Male fertility is not something that should be investigated only after the woman has undergone numerous tests.

A simple semen analysis is often one of the first steps in evaluating the man.

In the end

You cannot prevent every cause of male infertility. But you can give your sperm the best possible environment by not smoking, avoiding anabolic steroids and recreational drugs, keeping alcohol moderate, maintaining a healthy weight, eating sensibly, exercising regularly and taking reasonable precautions against excessive heat and workplace toxins.

And if pregnancy is taking longer than expected, don't blame yourself or your partner. Fertility problems are common, and many causes can be identified and treated.