Male fertility: 10 tips for men trying to conceive

Are you and your partner figuring out how to get pregnant? Although a woman will be the one who technically gets pregnant, and carries and delivers the baby, a man also has a crucial role. For fertilization to occur, his sperm must be healthy and strong to reach and penetrate the woman's egg. 

To make fertilization happen, a man must be able to have and keep an erection, have enough sperm that are the right shape and move in the right way, and have enough semen to carry the sperm to the egg, according to the Mayo Clinic. A problem in any step in this process, including male fertility, can prevent pregnancy.  

A variety of factors, from genetics and lifestyle to environmental exposures and hormones, can affect a man's fertility, so it's difficult to isolate the exact cause for infertility, according to Dr. Jared Robins, chief of reproductive endocrinology and infertility at Northwestern Medicine's Fertility and Reproductive Medicine in Chicago.  Nonetheless, doctors identify the cause of problems in about 80 percent of infertile couples, Robins noted. When there is a known cause of infertility, problems in the male partner tend to account for about 40 percent of infertile couples, he said.  But there are many steps that men can take to enhance their health, lifestyle and relationship to increase a couple's chances of conceiving.  Here are 10 tips for men who want to improve their fertility.

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1. Lose extra pounds

Studies have suggested that couples in which the man is overweight or obese take longer to conceive than couples with no weight problems. Research has also indicated that being overweight or obese affects a man's sperm quality, reducing sperm counts and decreasing their ability to swim, as well as increasing damage to genetic material (DNA) in sperm, according to the American Society for Reproductive Medicine.  

A 2012 study found that overweight and obese men were more likely to have low sperm counts or a lack of viable sperm compared with normal-weight men, possibly making it harder for these men to father a child. The researchers suspected that too much body fat was linked with changes in testosterone and other reproductive hormone levels in men.

2. Get health conditions under control

Effectively managing chronic medical conditions, such as high blood pressure and diabetes, may improve a man's chances of getting his partner pregnant, suggests The World Journal of Men’s Health. Other medical conditions, such as cystic fibrosis or varicoceles (enlarged veins in the scrotum that cause overheating), may also affect male fertility, according to the Centers for Disease Control and Prevention. In addition, some medications used to treat high blood pressure (beta blockers), depression and anxiety (SSRIs), pain (long-term opiates), and an enlarged prostate (finasteride), could have a negative influence on fertility, according to the Cleveland Clinic. 

Supplemental testosterone can also decrease sperm production. Some chemotherapy drugs and radiation treatments for cancer can cause permanent infertility, according to the Mayo Clinic. A man should speak to his doctor about medication he is taking and whether it might interfere with his ability to father a child.

3. Eat healthy foods

"The role of diet in male fertility is unclear," Robins told Live Science. Even though the science may be inconclusive, it still makes sense for men to eat a variety of healthy foods, including plenty of fruits and vegetables, which are rich sources of antioxidants that may help to produce healthy sperm. Men should also consume fiber-rich foods, healthy monounsaturated fats, and moderate amounts of lean protein.  

Robins said men frequently ask him whether drinking soda can decrease their sperm counts. He tells them there's no good evidence that caffeine in soda affects men's fertility, and there's little evidence that caffeine in coffee, tea and energy drinks is linked with fertility problems in men.

4. Get regular physical activity

Robins said he encourages men to get regular exercise because it helps reduce stress, makes men feel better about themselves and benefits their long-term health.  While being physically active is beneficial, according to a 2014 study, published in the journal Wilderness and Environmental Medicine, those who have a strenuous training schedule and regularly participate in endurance events may impact their levels of luteinising hormone and testosterone, impacting fertility. 

Researchers have also looked at whether bike riding can affect sperm because the sport involves long periods of sitting in a position that increases scrotal temperatures as well as bouncing and vibrations that could cause trauma to the testicles. A few studies have suggested that long-distance truck drivers may also have more fertility problems for similar reasons as avid male cyclists. 

One study, published in the journal Fertility and Sterility, found that men who attended fertility clinics and who reported they cycled for at least five hours a week were more likely to have low sperm counts and poor sperm motility compared to men who did other forms of exercise.However, there's little data on whether or not cycling actually impacts sperm function, Robins said.

5. Increase vitamin intake

Robins tends to recommend that men take a daily multivitamin. "There is little likelihood of harm and some potential benefits," he said.  Many multivitamin formulations for men might include antioxidants, such as vitamins C and E, and the minerals selenium and zinc. Some research has found that antioxidants may cause a slight increase in sperm count and movement, according to The American Society for Reproductive Medicine. It makes sense that antioxidants may improve sperm quality because they can protect against free radicals, which can cause damage to DNA within sperm cells, Robins said.

6. Be conscious of age-related fertility changes

Similarly to women, men have a ticking biological clock, but they experience fertility declines later in life than women do, according to a 2020 article by the BBC. Research shows that as a man gets older, both the volume and quality of his semen tend to diminish. As men get older, there is also a falloff in the number of healthy sperm and their movement, and they can also have more DNA damage in their sperm. 

These changes could mean it might take longer for a couple to conceive. With age, there is also a greater risk for genetic abnormalities in their sperm. Random mutations in a man's sperm can pile up as the years go by, making older fathers more likely to pass on more genetic mutations to a child. 

7. Stop smoking

Smoking is linked with reduced sperm quality: Male smokers are more likely to have low sperm counts and decreased sperm movement, and they have higher numbers of abnormally-shaped sperm, according to the American Society for Reproductive Medicine. 

Marijuana and other recreational drug use, including anabolic steroids for bodybuilding, should also be avoided because some studies suggest they may also negatively impact sperm production, Robins said.

8. Boxers or briefs?

"This is everyone's favorite question," Robins said. But there's not a lot of science to suggest that switching from briefs to boxers improves a couple's chances of getting pregnant. Although a man's underwear choice may affect his scrotal temperature and reduce sperm quality, most studies have demonstrated no real difference between boxers and briefs in terms of their impact on male fertility, Robins said.  

A 2016 study found that it really didn't make much difference whether men wore boxers or briefs or went commando on a couple's ability to conceive or on a man's semen quality, suggesting that it's best for men to wear whatever feels most comfortable to them when a couple wants to have a baby.

9. Beware of the heat

Frequent visits to and long stays in hot tubs, saunas and steam rooms could increase scrotal temperatures, which may decrease sperm counts and sperm quality.  But this heat exposure does not have a permanent impact on sperm, Robins said.  Reduced sperm counts may only be temporary and could return to normal in a few months once a man stops going into a hot tub or sauna.

A 2011 study about men using laptops received plenty of media coverage when it reported that men who placed the computers on their laps may be more likely to have damaged sperm and decreased sperm motility.  But these conclusions were "jumping the gun," Robins said. It's unclear how much time the men spent with the laptop in close proximity to their testicles, he explained, and it's also unclear whether the effects may have been caused by heat or if they resulted from radiation due to the use of a wireless connection.

10. Know when to get help

Infertility is defined as the inability of a sexually active couple who are not using birth control to get pregnant after one year of trying, according to The American Society for Reproductive Medicine. Robins said he tells couples that a woman who is under the age of 35 and her partner should try to become pregnant for one year without success before seeking an infertility evaluation. For women who are 35 or older, the time before seeing an infertility specialist shortens to 6 months in couples who are having sex regularly without using birth control, he noted.

Additional resources

For more information about how to improve male fertility and how to get help, head to the U.K. National Health Service website. You can read about male reproduction in more detail in the Encyclopedia of Reproduction.

Bibliography

"Hypertension and Male Fertility". The World Journal of Men's Health (2017). https://synapse.koreamed.org/articles/1088840

"The Impact of an Ultramarathon on Hormonal and Biochemical Parameters in Men". Wilderness & Environmental Medicine (2014). https://www.sciencedirect.com/science/article/pii/S1080603214001021

"Physical activity and semen quality among men attending an infertility clinic". Fertility and Sterility (2011). https://www.sciencedirect.com/science/article/abs/pii/S0015028210027767

"Smoking and Infertility". The American Society for Reproductive Medicine. https://www.reproductivefacts.org/globalassets/asrm/asrm-content/learning--resources/patient-resources/protect-your-fertility3/smoking_infertility.pdf

This article is for informational purposes only, and is not meant to offer medical advice.