How To Improve Sperm Health: Simple Steps For Male Fertility

Helloooooo my friends! This is the sequel to this post about what *I* did to optimize egg health and prepare for pregnancy and conception as a woman— but this post is through the lens of preparing for pregnancy from a male perspective! In this post, I’ll be outlining what Adam did to prepare as well as some info about male fertility.

Again, can people get pregnant without doing any “prep” at all? Absolutely!

But, from my perspective— if there is an opportunity to optimize and prepare for the best sperm and egg health, why wouldn’t I??? This is the raw material that will make your baby, and I want to set my pregnancy (and my future little one) up for success! To me, investing in the “prep” phase of conceiving felt empowering to know that I was (and that Adam was) doing the things within our control to help prepare for a healthy pregnancy.

Basically, my attitude when it comes to preparing for pregnancy is that it takes two to tango!

Since conception requires a sperm AND an egg, I’m going to find a way to optimize BOTH of those things if possible. As I mentioned in my previous post, I started my personal pre-pregnancy stuff about a year before I got pregnant, and thankfully Adam is a health-conscious individual, as well. So while he was already “walking the walk” in many regards with health and didn’t need to make many “changes”, there were a few things I asked him to be really diligent on in the three months out from conception to helpl optimize his end of the deal, sperm health, and chances of conceiving.

So, without further ado, here are the things he focused on!

who is this post for?

This post is for any couple or man looking to improve their sperm health from an “everyday” manner. This is post outlines first a FOUNDATIONAL approach to priming the male body for pregnancy, quality sperm health, and fertility— and then gives you some “extra” small steps that have been correlated with improved sperm health.

While there are highly specific, individualized, medicalized options out there (which can be AMAZING and a true godsend for many couples struggling with infertility), this post is moreso for the “everyday” scenario where you and your partner are trying to take an intentional approach to baby makin’ and get your body in a good place prior to conceiving.

In a nutshell: this is just a general guide of what we did in the months leading up to pregnancy to optimize both of our health, hormones, and chances of getting pregnant— but it is not medical advice. Definitely work with your provider to determine what’s best for you here!

(As always, I want to mention that fertility is a highly nuanced topic, and unfortunately there’s no one-size-fits-all answer. So if you’re someone who’s reading through this list thinking that you’ve done ALL these things and you’re still not getting the results you want, I just want to hold space for you and offer my empathy. I totally know that is a reality for many couples, and I want to acknowledge you.)

If anything, I hope this post inspires you (wherever you’re at in your fertility journey!) to find peace, empowerment, and hope in the things that ARE in your control as you prepare to make a baby. While many things with fertility feel uncontrollable and unpredictable, it can feel empowering to invest in your health, hormones, and chances of conceiving along the way.

There is never a guarantee, but it can feel empowering to “control the controllables” and do what you can to set yourself up for success.

sperm is half of the equation. 

Okay, here’s my mini rant. So often with fertility/infertility we focus SOLELY on the woman. What can SHE do? How is HER cycle? and if there are fertility problems it’s like, “what’s her issue???”

…but really a lot of times there can be issues on the male side—both parties matter in this equation!

If you’re going into pregnancy, I think it’s worth it that both parties do their part to prepare their bodies. From a physiologic standpoint, it takes about two months from the beginning of sperm production until sperm is ready to go, so you’ll want to give yourself about a 2+ month window in advance so that your positive changes have time to take hold and really optimize the health of the future sperm. 

do I really need to worry about this?

Fear not, my male friend, your sperm is probably juuuuust fine! This post is simply about being “ahead of the game” and doing the things in your power to optimize and increase your chances of healthy sperm.

And this is important because the data is showing some alarming trends that sperm health is on the decline for the general male population.

In fact, one meta-analysis examining 185 studies ( with over 45,000 healthy men) found that sperm counts have reduced by nearly 50% in the last 40 years (yes, really. that stat shocked me too.). It’s also shown that testosterone has decreased during this time, as well. This decline is largely contributed to diet, lifestyle, and exposure to environmental chemicals.

There is also a decrease in sperm quality being seen. “sperm health” is commonly measured in concentration (# of sperm in semen by density), vitality (percentage of sperm that are alive), motility (swimming ability of the sperm) and morphology (size and shape). On all these measures, the world seems to be in decline on average.

—now that may seem alarming. (and, in many ways, it is.), but I don’t share these stats to scare you, but moreso to show that sperm health is an area that may need to be addressed and optimized before pregnancy.

While there are some concerning stats out there, there ARE also things in our power that can help promote healthy sperm! And in this post we are going to outline the “foundational” aspects and the more nitty-gritty ideas for optimizing sperm health.

(PSSST: To all my fellow science-minded peeps, if you want to learn more about the topic of sperm health and declining fertility rates in the Western world, the book “Countdown” by researcher Shanna Swan was fascinating and so eye-opening. I also HIGHLY recommend “It Starts With The Egg” by Rebecca Fett which is where many of the points in this blog post were inspired by! A phenomenal resource.)

fertility basics— the “boring” things that you should not skip!

A lot of the things I outline here will be similar to the female pregnancy prep post, but that’s because a lot of them are just foundational and they TRULY. DO. MATTER. These are the things that your doctor or provider will likely tell you to start with, and it’s for good reason! The basics truly do make a difference.

You can click here to read the full post with more details, but for a super quick overview of “the basics” that both man and woman should focus on prior to conceiving:

• Avoid junk food and eat a veggie-filled, protein-rich diet

• Minimize stress

• Get quality sleep

• Limit your toxin exposure. (household cleaning products, occupational exposures, plastics, etc.)

• Exercise regularly

• If you smoke, begin the process of quitting.

• Limit excessive drinking.

This list may seem too basic and not at all #groundbreaking, but (as you know) I really don’t believe in “quick fixes”. Often times, it really can come down to TRULY committing to these “simple”, foundational aspects of health. The basics (food, hydration, stress management, etc.) and truuuuly approaching them with intention can have a huge impact.

…And, while just focusing on those basics will get you far, here are a few extra specifics if you want to REALLY dive in and do allllll the little things in your power.

take it to the next level

[more specific] ways to enhance sperm health

Okay, let’s get one thing clear— I TRULY recommend focusing on the “foundational”^^ list above first, and then using the below list as a supplemental opportunity. The below items are smaller, more specific and meant to be used as “add-ons” to an already healthy lifestyle.

You know me— I don’t share holistic health as an outlandish claim or “quick fix”, but moreso just small opportunities to optimize. I always recommend (and really committing) to the basics (food, sleep, hydration, etc.) FIRST, and then doing the little “extra” things that are in your power as the cherry on top. Sound good? great! Because this list below does have some powerful, evidence-supported ideas for supporting sperm health! Let’s dive in.

Wear boxers, not briefs. (seriously…) Okay, hear me out. Is this going to instantly solve everything? No. But, interestingly, a recent study done by Harvard faculty found correlation that men who wear tighter underwear exhibit lower sperm counts than those who wear looser underwear. In fact, analysis of semen samples showed that men who wore boxers had 25% higher sperm concentrations and 17% higher total sperm counts when compared with men who did not primarily wear boxers and instead wore briefs. While the cause isn’t exactly clear, it’s thought that maybe the tighter underwear holds the testes closer to the body where it’s warmer (harmful for sperm), could inhibit spermatogenesis, and alter FSH levels. So, just to be safe, in the few months leading up to us getting pregnant, Adam switched to boxers.

Choose nourishing foods. I know I just listed on this in the “foundational” things to do, but I am posting it again because it really is so important. This goes for men, women, anyone! Focus on nourishment. The food we eat MATTERS. This is not the time for a ton of junk food and processed carbs—you want a lot of veggies, proteins, healthy fats, and complex carbs to keep yourself nourished. The foods we eat DO impact our health, our hormones, and subsequently our sperm. Do you have to be perfect? No! But nourishing your body supports overall health and wholeness in your body, which is so foundational as you prepare to conceive! 

Try antioxidant-rich supplements. We all know that antioxidants are good for us, but the data shows that they appear to be ESPECIALLY helpful for sperm health. In fact, this study estimates that a majority of male infertility is related to oxidative stress as a contributing factor. So, most of the supplements Adam took leading up to pregnancy were related to that aspect of male fertility and reducing oxidative damage of the sperm— one systematic review found that men who supplemented with antioxidants improves sperm quality and chances of conceiving. Quality nourishment and eating healthy foods is, of course, great for getting antioxidants as well! But here are a few supplements for an extra boost to fight oxidative damage to the sperm:

• CoQ10: A 2021 study demonstrated that men with lower CoQ10 levels tend to have lower sperm counts. After supplementation for 3 months with CoQ10, there was improved sperm concentration (p<0.05) and motility (p<0.01) of the sperm. Another study found that supplementing with coenzyme Q10 resulted in improved sperm quality and motility— during the treatment, 28.4% of the infertile men with oligoasthenozoospermia resulted in pregnancies after CoQ10 supplementation. While I recommend you check with your doctor for dosing, this study found that treatment with CoQ10 (200 mg/day or 400 mg/day) resulted in a significant increase in sperm concentration from baseline.

• Vitamin C: the ol’ standby— and for good reason! vitamin C is a powerful antioxidant and great supplement to consider. You may also want to consider Vitamin E. Both are direct antioxidants.

• fish oil: One 2018 study found that in men who took fish oil supplements improved sperm quality, with a particular improvement in DNA damage. In. a 2016 study, men who took fish oil with DHA supplements decreased the average percentage of sperm with DNA damage decreased from 22% to 9%. 

• ^^^Those are the three supplements Adam took every day for the 3 months before conception. You could also consider a multivitamin with methylfolate here as well. (As always, talk to YOUR doctor before starting any supplement. We all have unique health situations!)

orrrr just do this male-specific packet of supplements for fertility!: If having to buy a bunch of separate supplements isn’t your jam, I HIGHLY recommend the Perelel men’s supplements packets (save 20% with KATEESKURI20). Unfortunately, I hadn’t yet discovered this brand when Adam and I were getting ready to try or else I totally would’ve gone this route to help support Adam’s sperm health and fertility. You all know I loved and used this brand for my personal prenatal during pregnancy, but they also now have a packet of vitamins for the pre-conception period to help support male fertility and sperm health! SO COOL (and so important). Basically, it’s just one packet that has all^ of the supplements/nutrients I listed above, plus a really high-quality multivitamin (that is incredibly bioavailable and has a high-quality methylated folate and selenium added!). In my opinion, a lot of supplement packets out there are NOT trustworthy, but I personally love (and trust!) Perelel because they are evidence-backed, have no artificial fillers, and are created by team of doctors and reproductive endocrinologists to give you high-quality, bioavailable ingredients at research-backed doses— booooyah! Basically, it’s one simple packet per day that has everything your man needs for supporting his fertility :) You can find the packet here and save 20% with the code KATEESKURI20 :)

Cut back on alcohol. While heavy drinking has strong correlation with poor sperm quality, there is less data on how moderate drinking can impact it. However, one study found that increased alcohol consumption was correlated with decreased sperm count, motility, and fertilization rate. Again, no need to cut it out completely, but limiting it could be wise! Again, no need for “perfection” (adam definitely still had his craft beers during this time!), but just be mindful in your relationship to alcohol and consider limiting it closer to conception.

Reduce exposure to environmental toxins: Obviously, this is something I talk a lot about on The Foundation Blog for women’s health, but it’s actually crucial for sperm health as well! Men, women, children, everyone— environmental toxins DO have an effect. High phthalate levels have been linked to lower levels of testosterone, and higher oxidative stress (which can really damange sperm health). While “clean products” often only get marketed to women, it’s actually equally as important for women and men! As we discussed in the women’s guide to preparing for conception, it’s TIME to ditch the toxic products in your house, your toiletries, etc.

• Even for men, make sure to take note of what’s in your toiletry, household products:

  • Adam uses Jack Henry for skincare/hair products (COUPON: KATE)

  • Primally Pure for deodorant. He likes tea tree or the charcoal scent. (COUPON: KATE10)

  • Dr. Bronner’s in the shower for body wash.

  • For cleaning the house, we use Branch Basics nontoxic cleaning supplies. (COUPON: THEFOUNDATIONBLOG)

  • Just limit toxins where you can— in a nutshell, this is NOT the time for axe body spray & toxic body washes & chlorox bleach. I highly recommend switching to clean products where you are able :) You don’t have to be crazy perfect, but it does make a difference. Environmental toxins are becoming increasingly evident as a source of damage to reproductive health.

Limit plastic exposure: Limit plastic as much as possible (and definitely avoid putting plastic in the microwave!). I’m kind of a crazy person about plastic, but Adam is a little more #chill than me generally speaking. However, in the months leading up to our conception, he was SUPER diligent about limiting plastics and ate off of glass, ceramic, etc. There are a lot of chemicals, microplastics, , BPA, and endrocrine disruptors in plastic— and especially if you’re heating it up, those toxins are much more likely to leech into the food and that can have an impact on the body. One study found that higher levels of BPA in males were linked with lower sperm counts, motility, morphology, and DNA damage. Basically, avoid plastic AS MUCH as you can before conceiving.

Keep your phone in a different pocket. Okay, I was hesitant to put this one because it seems a bit “out there”, but some early research is showing that there may be some truth to this. Although commonly dismissed, research has shown that keeping a cell phone in your front pocket could negatively impact sperm quality (again, I am not claiming this is the root of all evil, but perhaps just something to consider!). A study done by Cleveland Clinic showed that cell phone usage was correlated with decreased sperm count, motility, viability, and morphology. The same team found that when sperm samples were exposed to radiation from cell phone for 1 hour, they had a significant decrease in motility and viability and increased oxidation levels. Basically, you just want to keep your phone away from your privates— which means moving it from the front pocket. Whether it is firmly grounded in evidence is up for debate, but since it’s a relatively simple thing so we just decided to go for it! Adam is a big phone in the front pocket kind of guy (see photo below, ha!) so he just did his best keeping his phone off of his body altogether (sitting on the table, away from him, etc.) or just in his back pocket leading up to pregnancy. So yeah, just a small thing that could potentially have an impact!

Avoid hot tubs/saunas. Heat has been shown time and time again to impact sperm quality, count, and motility. So just be mindful in the time leading up to conception to avoid hot environments—hot tubs, saunas, steam rooms, that kind of thing. Adam personally avoided saunas, hot tubs, extra long hot baths, etc. for the 6 weeks leading up to conception.

commit to the basics & do the rest as you can

Honestly, much like what I did leading up to pregnancy, Adam also really focused on emphasizing the basics—good nutrition and a healthy lifestyle is HUGE, and will take you soooooo far in preparing your body to conceive! So, really, just COMMIT to the basics. Eat beautiful, nourishing foods. Go to bed at a reasonable time. Work on stress management. View it as a few months to really invest in your health, do the foundational things with intention, add in the “extra” things that you can— and really OPTIMIZE your body going into conception.

I hope you enjoyed these back-to-back posts on women’s conception prep and men’s conception prep! I know it can all seem so overwhelming, but my goal was to share the most important things Adam and I focused on to prepare for pregnancy…because it doesn’t have to feel overwhelming. You don’t have to “do it all”, but moreso just take the steps YOU can in your given situation.

Start with the basics, REALLY commit to them, and then add in the “extra” things as you are able.

Cheers, friend!
-Kate

sources:

Agarwal, A., Deepinder, F., Sharma, R. K., Ranga, G., & Li, J. (2008). Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertility and sterility, 89(1), 124-128.

Agarwal, A., Desai, N. R., Makker, K., Varghese, A., Mouradi, R., Sabanegh, E., & Sharma, R. (2009). Effects of radiofrequency electromagnetic waves (RF-EMW) from cellular phones on human ejaculated semen: an in vitro pilot study. Fertility and sterility, 92(4), 1318-1325.

Auger, J., Eustache, F., Andersen, A. G., Irvine, D. S., Jørgensen, N., Skakkebaek, N. E., ... & Jouannet, P. (2001). Sperm morphological defects related to environment, lifestyle and medical history of 1001 male partners of pregnant women from four European cities. Human reproduction, 16(12), 2710-2717.

Braga, D. P. D. A. F., Halpern, G., Rita de Cássia, S. F., Setti, A. S., Iaconelli Jr, A., & Borges Jr, E. (2012). Food intake and social habits in male patients and its relationship to intracytoplasmic sperm injection outcomes. Fertility and sterility, 97(1), 53-59.

Kobori, Y., Ota, S., Sato, R., Yagi, H., Soh, S., Arai, G., & Okada, H. (2014). Antioxidant cosupplementation therapy with vitamin C, vitamin E, and coenzyme Q10 in patients with oligoasthenozoospermia. Archivio Italiano di Urologia e Andrologia, 86(1), 1-4.

Levine, H., Jørgensen, N., Martino-Andrade, A., Mendiola, J., Weksler-Derri, D., Mindlis, I., ... & Swan, S. H. (2017). Temporal trends in sperm count: a systematic review and meta-regression analysis. Human reproduction update, 23(6), 646-659.

Martínez-Soto, J. C., Domingo, J. C., Cordobilla, B., Nicolás, M., Fernández, L., Albero, P., ... & Landeras, J. (2016). Dietary supplementation with docosahexaenoic acid (DHA) improves seminal antioxidant status and decreases sperm DNA fragmentation. Systems biology in reproductive medicine, 62(6), 387-395.

Meeker, J. D., Ehrlich, S., Toth, T. L., Wright, D. L., Calafat, A. M., Trisini, A. T., ... & Hauser, R. (2010). Semen quality and sperm DNA damage in relation to urinary bisphenol A among men from an infertility clinic. Reproductive toxicology, 30(4), 532-539.

Mendiola, J., Meeker, J. D., Jørgensen, N., Andersson, A. M., Liu, F., Calafat, A. M., ... & Swan, S. H. (2012). Urinary concentrations of di (2‐ethylhexyl) phthalate metabolites and serum reproductive hormones: pooled analysis of fertile and infertile men. Journal of andrology, 33(3), 488-498.

Mínguez-Alarcón, L., Gaskins, A. J., Chiu, Y. H., Messerlian, C., Williams, P. L., Ford, J. B., ... & Chavarro, J. E. (2018). Type of underwear worn and markers of testicular function among men attending a fertility center. Human Reproduction, 33(9), 1749-1756.

Ross, C., Morriss, A., Khairy, M., Khalaf, Y., Braude, P., Coomarasamy, A., & El-Toukhy, T. (2010). A systematic review of the effect of oral antioxidants on male infertility. Reproductive biomedicine online, 20(6), 711-723.

Salas-Huetos, A., Rosique-Esteban, N., Becerra-Tomás, N., Vizmanos, B., Bulló, M., & Salas-Salvadó, J. (2018). The effect of nutrients and dietary supplements on sperm quality parameters: a systematic review and meta-analysis of randomized clinical trials. Advances in Nutrition, 9(6), 833-848.

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