Why Men Should Prioritise Fertility Health

For too long, fertility has been viewed primarily as a female-centric concern. However, the tide is finally turning, and more men are taking charge of their fertility health. If you're in a relationship, it's crucial to remember that conception is a team effort, and fertility should be a couple's focus. After all, it takes two to tango, and a healthy baby needs healthy inputs from both sides. Fertility expert Jen Walpole shares with us her insights into why men should prioritise their fertility health.

Contrary to popular belief, male fertility does decline with age. While women experience a more dramatic decline between the ages of 35-40, sperm quality and quantity can also decrease in men around the same age range, albeit not as dramatically. Modern lifestyles have had an impact here with studies showing a significant decline in male semen parameters over the past few decades, including sperm count, motility (movement), and morphology (shape) (1).

These factors can all impact conception and statistics around infertility point to a near-balanced 50:50 split regarding contributing factors, with roughly 50% of infertility cases involving male factor infertility in the UK (2). This highlights the vital role men's health plays in achieving a successful pregnancy. Thankfully, a growing awareness of male factor infertility is empowering more men to address their fertility proactively.

Contrary to popular belief, male fertility does decline with age. While women experience a more dramatic decline between the ages of 35-40, sperm quality and quantity can also decrease in men around the same age range, albeit not as dramatically. Modern lifestyles have had an impact here with studies showing a significant decline in male semen parameters over the past few decades, including sperm count, motility (movement), and morphology (shape) (1).

These factors can all impact conception and statistics around infertility point to a near-balanced 50:50 split regarding contributing factors, with roughly 50% of infertility cases involving male factor infertility in the UK (2). This highlights the vital role men's health plays in achieving a successful pregnancy. Thankfully, a growing awareness of male factor infertility is empowering more men to address their fertility proactively.

Testosterone plays a vital role in sperm production and male fertility. It is critical for spermatogenesis, the process of sperm creation, stimulating Sertoli cells within the testes, which nurture developing sperm cells (3). Testosterone also contributes to libido, which is essential for conception and low levels can negatively impact fertility (4). Finally, in terms of general health, testosterone impacts bone density, muscle mass, and mood. Optimal levels are linked to reduced risks of various chronic diseases (5). To optimise testosterone levels, men can support them naturally through a variety of lifestyle factors. For example:

Reduce exposure to endocrine disruptors – Endocrine disruptors such as plastics, polycyclic aromatic hydrocarbons (PAHs), phthalates, and heavy metals interfere with the body's hormone systems, including testosterone production and regulation in men. These chemicals mimic or block hormones and disrupt the body's normal functions. Exposure to them can lead to decreased testosterone levels, reduced sperm quality, and overall reduced fertility. Reducing exposure to these endocrine disruptors can positively impact male fertility by mitigating their adverse effects on testosterone levels and sperm health. Avoiding plastic containers for food and drinks, choosing organic foods to reduce PAH exposure, avoiding products with phthalates (often found in personal care products), and minimising exposure to heavy metals can help maintain healthier testosterone levels and improve fertility outcomes. Alcohol and caffeine should be considered within this and limited during the preconception period too.

Regular weight-bearing exercise - Weight-bearing exercises, such as strength training and resistance workouts, naturally enhance testosterone production in men. These activities stimulate muscle growth and repair, triggering the body's hormonal response system. Consequently, regular engagement in weight-bearing exercises can significantly boost testosterone levels, supporting overall male health and vitality. Aim for at least 30 minutes of moderate intensity exercise most days of the week.

Managing stress – Chronic stress triggers the release of cortisol, known as the "stress hormone" which can directly suppress testosterone production in the testes. Cortisol can also interfere with the signalling pathways that regulate testosterone synthesis, which further reduces its levels. This stress-induced hormonal imbalance may lead to decreased libido, fertility issues, and other health problems associated with low testosterone. Practicing relaxation techniques like yoga, meditation, or deep breathing will help manage cortisol levels, which can have a negative impact on sleep, which brings us nicely onto the next point.

Quality sleep - Studies highlight that men who obtain just 5-6 hours sleep per night have been shown to have reduced fertility due to lower testosterone levels. The researchers noted that their testosterone levels were that of someone ten years older with only 6 hours sleep per night (6). So, prioritise 7-8 hours of quality sleep each night by limiting screen use (phones, laptops, tv) at least one hour before bed. Introduce a wind down routine, lower the evening lighting in the home, ensure the bedroom is cool and consider getting natural daylight first thing to support the natural sleep/wake cycle (circadian rhythm).

Maintaining a healthy weight – Being overweight or obese can negatively impact testosterone levels since adipose (fat) tissue can behave like endocrine (hormone) glands, producing excess oestrogen, which can disrupt hormonal balance and make conceiving more challenging. Men can consider fasting 14-16 hours overnight to help with weight loss, increase movement and ensure they balance blood sugar levels with protein at every meal (and snacks). By considering nutrition in their fertility picture and increasing antioxidants, men may find that if they carry excess weight, they start to lose this as they adopt healthier eating habits.