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Infertility can affect both the male and female, but very often the focus is on the female, which is understandable as they will grow and carry the baby. However, we must not forget that 50% of a child’s DNA comes from the male, so future dads to be need to prioritise optimising their health as well.
The statistics on the worldwide decline in sperm health are alarming and I am seeing more and more men book in to see me in clinic with low sperm count, poor motility and abnormal morphology, which is the form, shape and structure. They are often completely surprised when their doctor presents them with the results of their semen analysis.
“Sperm counts around the world have halved over the past 50 years, with the pace of decline more than doubling since 2000” (1). A 2019 journal also highlights that “sperm concentration, morphology and semen volume have all been shown to deteriorate drastically over the past decade” (2)
There are many factors that can affect the health of sperm. The most common ones are smoking, excessive alcohol, radiation, exposure to toxins, getting overheated, poor diet, inflammation, infections, nutritional deficiencies, hormone imbalances and a varicocele, which is an enlarged vein in the scrotum. Studies have showed that “smokers could increase DNA fragmentation by an average of 9.19 per cent compared to non-smokers. Also, air pollution, exposure to pesticides and insecticides increased sperm DNA fragmentation by an average of 9.68 per cent” (3)
Advancing age is also an overlooked factor in the male as “the decrease in sperm fertilisation rate starts between the ages of 45 and 50 years” (4)
Toxins are everywhere, pesticides and toxic chemicals are in our homes, in our gardens and in our food supply, which has contributed to a worldwide decline in sperm health. Yet despite the many known factors contributing to reduced sperm health, approximately 30–40 % of male infertility cases are unexplained.
DNA damage to sperm can not only cause infertility, but it can also increase the risk of miscarriage and could lead to birth defects. It is important to educate our dads-to-be on the diet, lifestyle, and environmental factors that can damage sperm. For example, how many men do you know that walk around with a mobile phone in their front pocket? or sit with an iPad on their lap for hours a day? This can be a direct source of radiation that can damage sperm.
Three months before you start trying to conceive is when your health should be at its most optimal. This is because it takes approximately 100 days for new sperm to be produced. This means that your sperm now reflects how healthy you have been over the last three months.
So, what can you do to optimise the health of your sperm in the three-month preconception period?
Nutrition
To improve sperm health nourishment is the key and therefore your diet needs to be nutrient dense and rich in antioxidants. You can achieve this by consuming at least five servings of vegetables a day and two servings of fruit.
Where possible and affordable, choose organic fruit and vegetables to reduce exposure to pesticides and herbicides, which can affect sperm health. Ensure you have at least one serving a day of leafy greens such as kale, mesclun, and spinach for active folate to support methylation and optimal cell health. When choosing vegetables, opt for a rainbow of bright colours for antioxidants.
Commit to eating a whole foods diet, with limited processed foods and refined sugar. Limit packet foods like biscuits, cakes, pies, and crackers. Choose food you can make at home from scratch.
A good general rule is to have a source of healthy fat and protein with each meal. Good examples of healthy fats are organic butter, coconut oil, eggs, avocado, bone broth, meat stock, fish, and nuts. Fats are the building blocks to make hormones, transports cholesterol, helps to reduce inflammation.
For protein, choose grass-fed meat, organic chicken, organic dairy products (e.g., kefir, yogurt, cheese, milk) organic eggs, fish, shellfish, nuts, seeds, beans, and legumes. Protein is the building block of body cells and tissues and provides amino acids essential for sperm production and healthy hormones.
Key nutrients that support sperm health
Nutritional deficiencies can also contribute to poor sperm health and can be a consequence of a diet lacking in nutrient-dense foods, soils lacking minerals, and poor gut health affecting absorption. Here are the key nutrients to optimise with diet and supplements where needed.
Zinc
The trace mineral zinc is essential for improving the quality, quantity, and motility of sperm. It is also a key mineral for immune health and increasing testosterone levels ( more on this later in this chapter). Experts recommend a daily supplement dose of at least 30mg zinc, preferably with a small dose of copper, to maintain a healthy balance of zinc and copper levels. This is because zinc and copper are antagonistic minerals, and excessive zinc intake can deplete copper levels. To increase zinc levels with food, add a tablespoon of pumpkin seeds to smoothies or breakfast cereals. Oysters, eggs, meat, poultry, nuts, seafood, and dairy are all excellent sources.
Selenium
A common deficiency in men is selenium, as it is a mineral that is lacking in our soils, especially in New Zealand. Selenium is vital for sperm count, morphology (shape and structure), and motility. Selenium is also an important antioxidant that is important in preventing DNA fragmentation. Aim for around 150–200mcg a day from all supplement sources. It is important to avoid exceeding 200mcg per day unless a qualified practitioner guides you, as higher amounts may be toxic when taken long term. Good food choices are Brazil nuts, fish, poultry, whole grains, and eggs.
Omega-3 Essential Fatty acids
Studies have shown that omega-3 essential fatty acids improve sperm quality, reduces inflammation, and decrease DNA damage. Aim to have oily fish such as tuna, salmon, sardines, and mackerel at least two to three times a week for an excellent source of omega-3 essential fatty acids. Also, flaxseed oil, hempseed oil, walnuts, and chia seeds are rich in omega-3. You may need to supplement with omega-3 if you do not feel you are getting enough in your diet. I recommend taking cod liver oil as it not only is rich in omega-3 but also has the extra benefit of naturally occurring Vitamin D and A, which helps to support hormone regulation and immune balance.
Coenzyme Q10
Using coenzyme Q10 in supplement form for at least three months leading up to IVF treatment has a lot of research supporting its effectiveness in optimising sperm health. It increases sperm count, motility, morphology, and its overall vitality. The other benefits of coenzyme Q10 are that it supports mitochondrial health and energy production and is an antioxidant that helps to combat oxidative stress by fighting free radical damage. The general recommendation is to take 200mg a day of coenzyme Q10 as ubiquinol, which is the better absorbed form. In severe cases of low sperm count, taking 400mg daily is even more beneficial. A 2019 study reported that “coenzyme Q10 improved sperm motility, concentration, and semen antioxidant status in infertile men, with a greater improvement observed in response to a dose of 400mg a day than a dose of 200mg a day” (5). You could just take 400mg a day for an enhanced response, but if cost is a factor, 200mg is still beneficial.
Vitamin C
The superstar nutrient vitamin C is also an important antioxidant for increasing sperm count, motility, and morphology. Vitamin C helps to prevent sperm from clumping together, therefore improving its ability to swim. Citrus fruits, berries, pepper, kiwi, broccoli, Brussel sprouts, potatoes, and tomatoes are all excellent sources of vitamin C. You may also want to consider supplementing with liposomal vitamin C ,which is gentle but well absorbed.
L-carnitine
The amino acid derivative and antioxidant l-carnitine has also shown in studies to be beneficial for improving sperm health. As an antioxidant, it helps to protect sperm against excessive production of free radicals that might lead to sperm damage. “research suggests that l-carnitine increases sperm motility, improved sperm concentration and morphology” (6).
According to a recent study in 2023, “overall evidence supports that l-carnitine can positively impact male fertility, even at relatively low doses of 2g per day. This supplement enhances sperm parameters, regulates hormone levels, reduces ROS (reactive oxygen species) levels and subsequently improves fertility rates” (7)
You can optimise l-carnitine levels by eating protein-rich foods such as red meat, poultry, fish, and dairy foods. Vegetables, fruit, and grains have small amounts. L-carnitine is also available as a supplement in most health shops and the recommended dose is 2g per day. Most supplements contain 500mg capsules, so this would be 4 capsules a day.
Additional support
Alcohol
It would be worth reducing your alcohol intake as alcohol increases oxidative stress in the body and, several studies have found that regular alcohol consumption decrease sperm count, motility, and fertilisation rates. Stick to a couple of drinks at weekends. If you need a refreshing drink during the week, that is also good for your gut and therefore good for your health overall, choose kombucha, or sparkling water with lime, lemon or one or two tablespoons of apple cider vinegar, which I think tastes similar to cider.
Gut health
We now know that whatever is happening in your gut will be affecting the rest of your body, and sperm health is no exception. According to Dr Natasha McBride, author of Gut and Physiology Syndrome, “Our health very much depends on the health of our gut flora. No matter how far from the gut an organ of your body is, it is greatly affected by the gut flora’s composition, state, and function” (8)
Improving your gut health should be a priority. A properly functioning digestive system breaks down food, absorbs nutrients, and removes toxins that can affect fertility. A healthy digestive system ensures you are absorbing crucial nutrients for reproductive health. Even if you have a very healthy diet, if you are not absorbing the nutrients from your food properly, you will have nutritional deficiencies which can lead to mineral imbalances and hormone imbalances. For further information on how to support your gut health, check out my blog posts: Is Gut Health
Unlike studies on female fertility, there is limited research on the effects of gluten on sperm health. However, anything that is causing inflammation in your gut will be affecting your whole body and increasing oxidative stress. As it takes approximately 100 days for new sperm to be produced, it would be worth eliminating gluten for at least three months if you have been struggling with infertility for a while and your semen analysis is less than optimal. You can download my free E book to help you get started with a gluten-free diet.
Environmental factors
Reduce your exposure to environmental toxins by using natural skin care and cleaning products, drinking filtered water and avoid using plastic drink bottles and plastic containers and never use them in the microwave.
Keep your distance from your cell phones, as keeping a cell phone in your pocket can expose sperm to radiation, which can negatively affect sperm health. Also, avoid using an iPad or laptop on your lap.
Stay as cool as possible as elevated temperatures can impair sperm quality. try to avoid taking hot baths or showers and wearing tight fitted underwear. Staying cool is extremely important if you have a varicocele, which is a common condition that affects about 15% of men and causes the veins in the scrotum to enlarge. Fertility experts believe that the enlarged veins contribute to infertility by raising the temperature in the scrotum and decreasing sperm production.
Ensure you are hydrated as dehydration essentially dries up sperm, making motility difficult. Aim for 30mls of water for each kg of body weight. On a day when you do cardio exercise, especially in hot weather, aim for an additional 500mls–1 litre.
Low testosterone
Another factor to consider with male infertility is whether low testosterone levels, known as hypogonadism, may reduce sperm count and make it difficult to conceive.
Many men do not have optimal testosterone levels because of stress, inflammation, a poor diet, smoking, alcohol, and exposure to toxins. Here are some of the common symptoms of low testosterone in men. Could this be affecting you?
Reduced libido
Reduced erectile function
Low sperm count
Fatigue and exhaustio
Loss of body hair on face and body
Loss of lean muscle mass
Obesity
Depression
Insomnia
Here are some strategies which may help increase testosterone levels naturally.
Zinc
The fact that I am talking about zinc again shows how important it is for male fertility. Zinc is involved as a co-factor in over 300 enzyme functions in the body. It is also one of the trace minerals that is depleted by stress. As well as everything else going on in our lives, infertility is stress, chronic stress, so if our zinc stores get depleted, that is over 300 metabolic functions in the body that will be affected!
Zinc helps to regulate hormones and increase testosterone levels. Zinc-rich foods are oysters, beef, lamb, pumpkin seeds, lentils, mushrooms, spinach, and avocado. Supplementing with extra zinc may be beneficial if you are not getting enough dietary zinc, have an underactive thyroid or you are under a lot of stress.
Dietary fats
The body uses dietary cholesterol to produce testosterone. If you are not eating enough fat, or you do not absorb fat that well because of digestive issues, then the body may not have adequate cholesterol to make hormones. Aim to have a serving of healthy fats with each meal. This may include meat fat, butter, cheese, fermented dairy, sour cream, coconut oil, meat stock, avocado, salmon, nuts, seeds, and olive oil.
Magnesium
Researchers have found a correlation between low magnesium levels and low testosterone levels, and that supplementing with magnesium can restore levels to within normal ranges. Magnesium is another mineral that is depleted by stress and is a cofactor in over 300 metabolic functions of the body. Magnesium-rich foods include almonds, cashews, seeds, bananas, avocados, brown rice, and leafy green vegetables.
It is challenging to get enough magnesium from food, so taking an additional magnesium supplement may help lower the stress hormone cortisol, which will have a knock-on effect of increasing DHEA and testosterone levels as stress and high cortisol levels deplete them.
Magnesium also inhibits testosterone from binding to sex hormone binding globulin (SHBG) which reduces the free testosterone available for use.
Weight bearing exercise
Try to do some resistance training with some weights at least three times a week, as this can help to increase testosterone levels naturally. This can also include exercises that use your own body weight, such as squats, lunges, planks, etc
Brief bursts of high-interval training like sprints, star jumps, etc. can also increase testosterone levels.
Summary
To sum up, if your sperm analysis is less than optimal, try not to despair. There are several steps you can take to boost the health and vitality of your sperm. Here are some actions you can take:
Eat a nutrient-dense diet rich in antioxidants. Aim for a rainbow a day of five brightly coloured vegetables a day and two fruits. At least one should be leafy green vegetables for a rich form of folate. Choose organic where possible and affordable.
Optimise the key nutrients that support sperm health and testosterone production through food choices and supplements: these are zinc, selenium, omega-3, coenzyme Q10, Vitamin C, magnesium, and l-carnitine.
Reduce or eliminate alcohol and smoking as excessive intake causes oxidative stress, which can increase the risk of DNA damage to sperm.
Reduce your exposure to environmental toxins by choosing natural skin care and cleaning products and avoid using plastic drink bottles and containers.
Keep your cell phone out of your pocket and use a laptop or iPad at a desk rather than on your lap. This is to reduce exposure to radiation.
Keep as cool as possible by avoiding hot baths, showers or hot tubs and wear loose fitted underwear. This is especially important if you have a varicocele.
If you need further assistance, feel to get in touch or take advantage of my FREE 15-minute discovery session. You can book this online by clicking here. This is an opportunity for us to have a chat about your situation and how I can help you.
For further information, check out my book Healing from Unexplained Secondary Infertility which is now available on Amazon.
References
Hurst L. Sperm counts are declining, scientist believe they have pinpointed the main causes why, 15/6/23, www.euronews.com.
Jurkowska K et al. The Impact of Metalloestrogens on the Physiology of Male Reproductive Health as a current problem of the XXI Century. J Physiol Pharmacol. 2019: 70 (3) 337-55.
DP et al. Food intake and social habits in male patients and its relationship to intracytoplasmic sperm injection outcome. Fertil Steril. 2003; 79: 53-9.
De Jonge C, Barratt CLR. The present crisis in male reproductive health: an urgent need for a political, social, and research roadmap. Andrology 2019; 7:762–8.
Ahahmar A T et al. The Impact of two doses of coenzyme Q10 on semem parameters and antioxidant status in men with idiopathic oligoasthenteratozoospermia. Clin Exp Reprod Med. 2019 Sept 46 (3) 112-118.
Salas–Huetus A et al. The effects of nutrients and dietary supplements on sperm quality parameters: A systematic review and meta anaylsis of randomised clinical trials. Advances in Nutrition, vol 9, issue 6 Nov 2018 883-848.
Mateus F G et al. L-carnitine and male fertility. Is supplementation beneficial? J clinic Med. 2023. Sep 6:12 (18): 5796.
Campbell-McBride Dr N, Gut and Physiology Syndrome. 2020. Medinform Publishing.
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