Male Infertility: Causes, Sperm Health & What You Need to Know
Written by Jess Kasriel, Fertility Nutritional Therapist / Practitioner
If you're trying to conceive, how much of the fertility journey feels like it has landed on your shoulders?
You're tracking your cycle, checking ovulation, changing your diet, taking supplements, booking appointments and Googling fertility at 11pm.
And perhaps your partner has had a semen analysis — or perhaps his fertility hasn't really been investigated yet.
If this sounds familiar, I want you to know that fertility isn't just a woman's health issue.
It takes two people to create a pregnancy, and male factors can contribute to infertility either on their own or alongside female factors. The World Health Organization recognises male, female, combined and unexplained factors as possible contributors to infertility.
So if you're struggling to conceive, male fertility deserves to be part of the conversation from the beginning.
How common is male infertility?
Male factors are a significant part of the fertility picture.
Depending on the population and how infertility is defined, estimates vary, but male factors are involved in a substantial proportion of couples experiencing infertility.
And importantly, this isn't about finding someone to blame.
Infertility is a couple's health issue, not a woman's fault or a man's fault.
The current approach to fertility assessment is to consider both partners rather than putting the majority of the investigation and responsibility onto the woman.
This matters because the female partner can sometimes go through blood tests, scans and other investigations while male fertility hasn't yet been properly assessed.
A semen analysis is a relatively straightforward first step that can provide useful information about sperm concentration, movement and morphology.
What can cause male infertility?
There are lots of possible causes, and sometimes no single cause is identified.
Male infertility can be associated with:
Low sperm concentration or absent sperm
Reduced sperm motility — meaning sperm don't move as effectively
Abnormal sperm morphology — differences in sperm shape and structure
Problems with ejaculation or sexual function
Varicocele — enlarged veins around the testicle
Previous infections or damage affecting the testicles
Hormonal conditions affecting sperm production
Genetic factors
Some medications and medical treatments
Use of anabolic steroids or testosterone
Smoking, excessive alcohol intake and some other lifestyle factors
Obesity and metabolic health
Certain environmental exposures
The WHO identifies problems with semen production, sperm number, movement and morphology among the common causes of male infertility, alongside hormonal, anatomical, genetic and other factors.
Some causes are treatable, while others may require fertility treatment or assisted reproductive technology.
That's why getting an appropriate medical assessment is so important.
What about lifestyle and sperm health?
This is where things get really interesting.
Sperm are continuously being produced, and the process of sperm production takes approximately two to three months.
That means the lifestyle your partner is living today isn't necessarily reflected immediately in a semen analysis.
It also means that if there are areas of lifestyle or nutrition that could be improved, consistency matters.
There is evidence linking factors such as smoking, excessive alcohol intake and obesity with fertility problems, while environmental pollutants and toxins are also being investigated as potential contributors.
However, it's important not to turn this into another fertility checklist.
Your partner doesn't need to suddenly eat perfectly, take 15 supplements and become completely obsessed with sperm health.
Instead, it's about looking at the bigger picture.
What can support male fertility?
Depending on the individual, it may be useful to look at areas such as:
Nutrition
Is he eating enough of a varied, nutrient-dense diet? Are there any obvious nutritional gaps?
Fruit and vegetables
A varied diet rich in plant foods provides a broad range of vitamins, minerals and other compounds important for overall health.
Healthy fats and protein
Including a variety of protein sources and sources of unsaturated fats can form part of a balanced diet.
Alcohol
Reviewing alcohol intake may be worthwhile, particularly if consumption is high.
Smoking
Smoking is associated with adverse reproductive outcomes, and stopping smoking has benefits far beyond fertility too.
Movement and metabolic health
Regular physical activity and maintaining a healthy weight can support overall health and may be relevant to reproductive health.
Medications and supplements
It's important to review medications and supplements with an appropriate healthcare professional. In particular, testosterone therapy and anabolic steroids can suppress sperm production and are important to discuss if you're trying to conceive.
Sleep and recovery
Good-quality sleep and adequate recovery are part of looking after overall health — something that can easily get overlooked when life is busy.
And remember: more isn't always better.
When it comes to fertility supplements, I don't believe in simply throwing everything at the problem. It's much more useful to understand what is actually relevant to the individual.
What about sperm count?
If your partner has been told that his sperm count is low, it can feel frightening.
But one semen analysis isn't necessarily the whole story.
Semen parameters can vary, and the results need to be interpreted in the context of the individual and the couple's wider fertility picture.
A semen analysis can look at things such as:
Sperm concentration
Total sperm number
Sperm motility
Sperm morphology
Semen volume
If a result is abnormal, your GP, fertility clinic or appropriate specialist can advise on whether repeat testing or further investigation is needed.
And importantly, a semen analysis isn't a measure of a man's worth, masculinity or sexual ability. It's simply a piece of information that can help you understand what might be happening.
Don't put all the pressure on yourself
If you're the woman trying to conceive, it can be very easy to feel like everything is your responsibility — your diet, hormones, cycle, supplements, stress, sleep, age and overall health.
But conception involves two people, so if you're struggling to conceive, it's important that both partners are considered and supported.
If your partner hasn't had a fertility assessment yet, it may be worth discussing this with your GP or fertility clinic rather than assuming the problem must be with you.
Male fertility and the bigger picture
Supporting male fertility isn't about finding one miracle food or supplement. It's about looking at the individual and understanding the wider picture — his diet and lifestyle, general health, medications or supplements, alcohol and smoking, any use of anabolic steroids or testosterone, medical conditions, and what his semen analysis shows.
These are much more useful questions than simply asking, “What's the best supplement for sperm?” because, just like female fertility, male fertility is individual and there isn't a one-size-fits-all approach.
Supporting your fertility journey
As a Fertility Nutritional Therapist / Practitioner based in Finchley, North London, I work with women who want to understand their fertility and feel more supported through the process.
My approach combines personalised fertility nutrition and lifestyle guidance with fertility education, healing, Reiki and mind-body support.
And while much of my 1:1 work is with women, I always believe in looking at the whole fertility picture, including male factors where relevant.
If you're feeling overwhelmed by all the things you could be doing, my Fertility Clarity Session gives you 60 minutes of focused, personalised support to step back, look at your individual situation and work out what may be worth focusing on next.
Fertility Clarity Session — 60 minutes | £222
I also offer:
Fertility Reset £1,111 (payment plan available) — a 6-week personalised 1:1 programme to help you understand your body, uncover your fertility foundations and create a clear path forward.
Fertility Rebalance £2,250 (payment plan available)— a 3-month deeply personalised 1:1 programme for women who want ongoing support, accountability and deeper work throughout their fertility journey.
Touch base soon!
Jess x
References
World Health Organization (WHO) — Infertility. Information on male, female, combined and unexplained factors, and causes of male infertility.
American Society for Reproductive Medicine (ASRM) — Diagnosis and treatment of infertility in men: AUA/ASRM guideline. Guidance on male fertility assessment and evaluation.
American Society for Reproductive Medicine (ASRM) — Diagnosis and treatment of infertility in men: AUA/ASRM guideline Part II. Guidance on evaluating male and female partners in parallel.
World Health Organization (WHO) — WHO Laboratory Manual for the Examination and Processing of Human Semen, 6th edition.
American Society for Reproductive Medicine (ASRM) — Tobacco or marijuana use and infertility.
