Why Men Should Prioritise Fertility Health

Written by: Jen Walpole

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Healf Journal

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.

The incredible thing about sperm production (spermatogenesis) is that it's a constantly regenerating process. Men create new sperm daily, meaning that diet and lifestyle adjustments can significantly impact sperm quality in just two and a half months (which is the time it takes to produce new sperm from start to finish). This underscores the importance of positive lifestyle changes, particularly nutrition, for both men and women who are trying to conceive. Ideally, couples should embark on optimising their health and well-being at least three months prior to attempting conception. This allows enough time for sperm to develop and mature fully, benefiting from the improved health choices. Remember that it’s not just about getting pregnant, but having a healthy baby too, which is determined from the quality of the sperm (and the eggs). 

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.

Supporting Testosterone Naturally

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. 

The Role of Nutrition in Male Fertility

Nutrition plays a crucial role in enhancing male fertility, with diet quality directly impacting sperm health and reproductive outcomes. The Mediterranean diet, renowned for its balance and nutritional completeness, is a particularly beneficial eating pattern to support male fertility. With this, we aren’t looking to overhaul your diet completely, but to consider adopting some of the principles of this diet. There is an emphasis on lower meat consumption in favour of fish, alongside a rich variety of vegetables, fruits, whole grains, and healthy fats such as olive oil, nuts, and seeds. These elements collectively contribute to improved sperm quality and fertility. For example, the Mediterranean diet is rich in omega-3 fatty acids, richest in oily fish, which are essential for male fertility. They are known to improve sperm cell membrane fluidity and function, which are vital for successful fertilisation. Research shows us that the intake of omega-3 fatty acids is positively associated with sperm morphology and motility, highlighting their importance in a fertility-supportive diet (7).


The Mediterranean diet is also rich in antioxidants which play a significant role in protecting sperm from oxidative stress that can damage sperm DNA and reduce fertility. Through the intake of a variety of colourful fruits and vegetables, we can obtain a wide array of antioxidants. However, obtaining these antioxidants from diet rather than from men's health supplements is advisable due to the potential pro-oxidant effect of high doses found in supplements (8). 


There are several nutrients in particular that are important for supporting male fertility and spermatogenesis. Firstly, zinc is essential for sperm formation and testosterone production. Studies have found that zinc supplementation can significantly improve sperm quality, especially in men with low baseline levels (9). Folate is considered crucial for women during pregnancy, but it is also important in male fertility also due to its role in DNA synthesis and repair inside the sperm cells. Research highlights that folate is critical for maintaining sperm DNA integrity, linking folate levels to overall sperm health (10). 


Another more commonly known male fertility nutrient is lycopene which is an antioxidant found in tomatoes (particularly cooked tomatoes) that has been associated with improved sperm quality (11). Meanwhile, L-Carnitine is involved in energy metabolism and sperm maturation. Studies support the positive effects of L-carnitine on sperm motility (movement) (12). Vitamin D status is another important factor in male fertility as it helps with the communication between the egg and sperm at fertilisation. 

"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" - Jen Walpole

Finally, N-acetyl cysteine (NAC) and coenzyme Q10 (CoQ10) both show promise in male fertility as well as female fertility. NAC is an antioxidant that improves oxidative stress markers and sperm parameters (13) whilst CoQ10 plays a role in energy production and antioxidant protection, improving sperm motility and density (14). Other natural remedies to support testosterone and male fertility include cordyceps supplements and ashwagandha supplements.


So, optimising nutrition through a Mediterranean diet and focusing on key nutrients such as omega-3 fatty acids, antioxidants (via colourful fruit and veg), zinc, folate, lycopene, L-carnitine, NAC, and CoQ10 can significantly support male fertility. These nutrients not only enhance sperm quality but also contribute to overall health, offering a holistic approach to improving reproductive outcomes.


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References

 

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

 

  1. National Institute for Health and Care Excellence (NICE). (2013). Fertility problems: assessment and treatment. Clinical guideline [CG156]. [Online] Available at: https://www.nice.org.uk/guidance/cg156

 

  1. Grande, G, et al. (2022). The Role of Testosterone in Spermatogenesis: Lessons From Proteome Profiling of Human Spermatozoa in Testosterone Deficiency. Frontiers in Endocrinology, 13.

 

  1. Corona G, Rastrelli G, Ricca V, Maggi M. (2010). Testosterone deficiency in the aging male and its relationship with sexual dysfunction and cardiovascular diseases. Horm Mol Biol Clin Investig. 4 (1), pp. 509-20.

 

  1. Yeap BB, Araujo AB, Wittert GA. (2012). Do low testosterone levels contribute to ill-health during male ageing? Crit Rev Clin Lab Sci. 49 (5-6), pp. 168-82.

 

  1. Leproult, R., & Van Cauter, E. (2011). Effect of 1 week of sleep restriction on testosterone levels in young healthy men. JAMA, 305(21), pp. 2173–2174.

 

  1. Safarinejad, M.R. et al. (2011). Effect of omega-3 polyunsaturated fatty acid supplementation on semen profile and enzymatic anti-oxidant capacity of seminal plasma in infertile men with idiopathic oligoasthenoteratospermia: a double-blind, placebo-controlled, randomised study. Andrologia. 43(1), pp. 38-47.

 

  1. Showell, M.G. et al. (2014). ‘Antioxidants for male subfertility’. Cochrane Database of Systematic Reviews, (12).

 

  1. Fallah, A. et al. (2018). ‘Zinc is an Essential Element for Male Fertility: A Review of Zn Roles in Men’s Health, Germination, Sperm Quality, and Fertilization’. Journal of Reproduction & Infertility, 19(2), pp. 69-81.

 

  1. Ebisch, I.M.W. et al. (2007). ‘The importance of folate, zinc and antioxidants in the pathogenesis and prevention of subfertility’. Human Reproductive Update, 13(2), pp. 163-174.

 

  1. Durairajanayagam, D. et al. (2014). ‘Lycopene and male infertility: evidence from laboratory studies to clinical trials’. Asian Journal of Andrology, 16(3), pp. 420–425.

 

  1. Balercia, G. et al. (2004). ‘Carnitine and male infertility’. Reproductive Biomedicine, 8(4), pp. 376-84.

 

  1. Ciftci, H. et al. (2009). ‘Effects of N-acetyl-cysteine on semen parameters and oxidative/antioxidant status’. Urology, 74(1), pp. 73-76.

 

  1. Safarinejad MR. (2009). Efficacy of coenzyme Q10 on semen parameters, sperm function and reproductive hormones in infertile men. J Urol. 182(1), pp. 237-48.