Why Are Men Suddenly So Focused On Fertility?

For decades, fertility was treated as a woman's responsibility. Women tracked their cycles, changed their diets, took supplements, and attended appointments when they started trying to conceive. Men were often assumed to be fertile by default. But ongoing studies and data on sperm health have made that approach harder to justify.

Sperm make up half the fertility equation, yet many men still assume their fertility is a given. Part of that rising awareness has been driven by headlines about falling sperm counts. Some studies have reported declines over recent decades, potentially linked to a combination of environmental and lifestyle factors. More recent research has found stable sperm counts in some populations, suggesting the trend may not be as universal as earlier headlines implied. While there's no immediate cause for panic, experts agree sperm health deserves the same level of scrutiny many men already give other health markers.

At the same time, fertility is no longer a subject that only surfaces once a couple has struggled to conceive. Men are ordering at-home sperm tests, questioning the impact of testosterone therapy, and paying closer attention to biomarkers that previous generations may never have considered.

According to consultant in reproductive medicine and co-founder of Fitzrovia Fertility, Dimitrios Mavrelos MD(Res), MRCOG, several factors are driving this recent obsession on male fertility. "The data on falling sperm counts finally broke through into public awareness," he says. "At the same time couples are having children later, so more men are seeing fertility as a real obstacle rather than an abstraction."

Sperm are produced continuously, meaning today's sperm reflect how someone was living roughly three months ago. Your daily habits all leave their mark during that process. "There aren't many areas of medicine where the patient has this much leverage over the result," says Mavrelos. Fertility can’t always be changed through lifestyle alone, yet many men underestimate just how responsive sperm health can be when the conditions are right.

Why fertility is becoming part of the men's health discussion

The rising interest in fertility reflects a wider change in how men think about wellbeing as a whole. This time a decade ago, few healthy men in their twenties or thirties were asking about sperm quality. Today, fertility testing sits alongside blood glucose monitors, wearable devices, and hormone testing as another way of understanding what’s happening internally.

There’s also greater recognition that fertility is not solely determined by female health. "Fertility used to be filed under women's health, and the man's contribution was assumed to be fine unless proven otherwise," says Mavrelos. "That's now changing."

The accessibility of testing has accelerated that process. A semen analysis typically costs less than £200 through many private UK fertility clinics and can provide valuable information long before a couple has spent months trying to conceive. For clinicians working in reproductive medicine, earlier engagement is always welcome. A lot of men only investigate their fertility after a problem has emerged, even though some of the most important influences on sperm health are visible years before someone starts trying to conceive.

Male fertility is about more than just sperm count 

When people talk about fertility, there's a tendency to reduce it to a numbers game. Whilst sperm count is one important measure, it reveals surprisingly little on its own. Nutritionist and founder of Fertility Nutrition, Angela Heap, BANT, says one of the biggest mistakes men make is assuming a normal sperm count means everything is fine. "Count is one parameter but morphology, motility, DNA fragmentation and oxidative stress levels all matter,” she says. 

 A semen analysis typically looks at several different markers, each offering insight into a different aspect of reproductive health.

Sperm count

Sperm count refers to the number of sperm present in a semen sample. Lower counts can make conception more difficult, although a normal result does not guarantee fertility.

Sperm motility

Motility describes how effectively sperm move. To reach an egg, sperm must travel from the vagina, through the cervix and uterus, and into the fallopian tube where fertilisation typically occurs. Poor motility means fewer sperm are able to complete that journey. Reduced movement can occur for several reasons, including structural abnormalities in the sperm tail, damage caused by oxidative stress or problems with the energy production needed to power swimming.

Sperm morphology

Morphology refers to the shape and structure of sperm. Abnormalities in the head, midsection or tail can affect how well it functions and moves. For example, defects in the head may make it harder for sperm to penetrate and fertilise an egg, while tail abnormalities can impair swimming ability.

DNA integrity

This is an area that's received growing attention in recent years. DNA fragmentation occurs when genetic material within sperm becomes damaged. Fertility specialists are increasingly interested in it because some men experience fertility difficulties despite having normal sperm count, motility and morphology. Higher levels of DNA fragmentation have been associated with poorer fertility outcomes, even when traditional semen parameters appear normal.

What actually affects male fertility?

Some of the strongest influences on sperm health are surprisingly ordinary. Age, weight, sleep quality, alcohol consumption, smoking, diet, and physical activity all contribute to the environment in which sperm develop.

Age

For years, men have been sold a fairly reassuring story about fertility. Women have a biological clock dictating when and if they can conceive. Men, on the other hand, were told that age didn’t matter, and that they could take their time. Research suggests this is not actually the case, and that age can also impact sperm quality.

Mavrelos and colleagues examined almost 5,000 in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) cycles in a UK fertility centre, and found that outcomes worsened once the male partner was over 50, even after accounting for female age. The researchers also observed a decline in semen quality. Among men over 50, only around four in 10 met World Health Organization criteria across all semen parameters, compared with approximately six in 10 younger men. "The public health message is that men shouldn't assume they can leave fatherhood indefinitely without consequences," says Mavrelos.

Excess weight and metabolic health

Carrying extra weight around the middle doesn't just affect cardiovascular or metabolic health. It can also impact the hormonal conditions that sperm rely on, which may help explain why obesity is consistently associated with poorer fertility outcomes.

Smoking and vaping

Smoking remains one of the clearest lifestyle risk factors for fertility. Vaping still tends to fly under the radar, despite growing concerns around its impact on reproductive health. "People file vaping as harmless, but it's one of the habits that quietly works against fertility,” says Mavrelos. 

Alcohol

Alcohol is another factor fertility specialists frequently raise with patients. Heap says regular drinking can reduce testosterone, increase oxidative stress within testicular tissue, and negatively affect sperm morphology. Men trying to conceive may benefit from approaching alcohol differently than they would during other periods of life.

Sleep

Sleep often receives less attention than diet or exercise, despite its effect on hormones, recovery, and metabolic function. Poor sleep has been linked with lower testosterone levels and poorer semen quality in several studies. Heap describes sleep as one of the most commonly overlooked fertility factors she encounters in practice.

Heat exposure

The testicles sit outside the body for a biological reason. Sperm production functions best at temperatures slightly below core body temperature. Frequent hot baths, prolonged sauna use, laptops resting directly on the lap, and high-volume cycling may all increase heat exposure. On their own, these habits may seem insignificant, but over time, repeated exposure may create less favourable conditions for sperm development.

Can diet really Influence sperm health?

Among fertility specialists, the general consensus is a resounding yes. If nutrition shapes so many other aspects of health, fertility is unlikely to be an exception.

Research consistently finds that men eating diets rich in vegetables, wholegrains, oily fish, and other nutrient-dense foods tend to have better sperm concentration, motility, and morphology than those consuming poorer-quality diets.

What makes this encouraging is the timeframe involved. Unlike some health outcomes that may take years to improve, changes to diet can influence the next cycle of sperm production. "In my experience it takes a lot less time to correct things with men around poor sperm health than it can do for women," says Heap.

The message is not that one food or individual ingredient transforms fertility, but that sperm respond to patterns and trends.

The problem with ultra-processed foods

Few dietary trends have attracted as much scrutiny in recent years as ultra-processed foods. UPFs now account for a significant proportion of calorie intake in the UK, yet emerging evidence suggests they may be working against reproductive health.

These foods tend to be high in refined carbohydrates, industrial fats and additives while providing relatively little of the micronutrients sperm production depends on. They’re also associated with increased inflammation and oxidative stress, both of which can damage sperm DNA.

Heap points to one study which found that men with the highest intake of ultra-processed foods had significantly lower sperm concentration and total sperm count than those eating minimally processed diets. "This is one area where the evidence has moved quite quickly in the last five years," she says. "It's something I now raise with every male client from the very first consultation." 

Are there foods that support sperm health?

There’s no single superfood when it comes to fertility but research supports consistent diets rich in nutrient-dense foods. "It’s less about superfoods and more about the overall pattern," says Heap. The Mediterranean diet is often linked with better sperm parameters, although Heap is careful to point out that dietary advice should always account for cultural preferences and individual eating habits. The foods most consistently linked with healthier sperm include:

• Oily fish
• Nuts and seeds
• Colourful vegetables
• Legumes
• Wholegrains
• Extra virgin olive oil

Walnuts also deserve a special mention. Several studies have linked walnut consumption with improvements in sperm vitality and motility, likely due to their combination of omega-3 fatty acids and antioxidant compounds.

Which nutrients support male fertility?

Food is usually the best place to start. Yet nutrient gaps are not always obvious, which is why testing can sometimes be useful. A blood test may identify deficiencies such as low vitamin D, while a semen analysis can provide a broader picture of reproductive health.

According to Heap, supplements work best when they're supporting an already solid diet. The nutrients most often linked to sperm production and function include the following:

Zinc

Zinc is involved in sperm production, testosterone metabolism and DNA integrity.

Best sources include oysters, beef, lamb, pumpkin seeds, chickpeas, and lentils.

Selenium

Selenium helps protect sperm from damage during development, which can affect both sperm quality and DNA health.

Best sources include Brazil nuts, seafood, and eggs.

CoQ10

CoQ10 helps sperm produce the energy they need to swim efficiently and has been linked to improvements in motility.

Best sources include oily fish, beef, chicken, and organ meats such as liver.

Vitamin D

Vitamin D supports reproductive health and low levels have been associated with poorer sperm parameters in some studies.

Best sources include oily fish, egg yolks, fortified foods, and sunlight.

Omega-3 Fatty Acids

Omega-3 fats help maintain healthy sperm cell membranes and support normal sperm function.

Best sources include salmon, sardines, mackerel, herring, walnuts, chia seeds, and flaxseeds.

Folate

Folate is needed for DNA synthesis and healthy sperm development.

Best sources include spinach, kale, broccoli, lentils, chickpeas, and asparagus.

Vitamins C And E

These antioxidants help protect sperm from oxidative damage, one of the most common threats to sperm health.

Best sources include berries, kiwi fruit, citrus fruits, peppers, almonds, sunflower seeds, avocado, and extra virgin olive oil.

The testosterone misconception

Few topics create more confusion in male fertility than testosterone. Many men assume higher testosterone automatically means better fertility. Some even consider testosterone replacement therapy in the hope that boosting their levels will improve reproductive health. "This is where I do the most myth-busting," says Mavrelos. The reality is that the relationship is more complicated than we tend to give credit.

Taking testosterone externally sends a signal that the body already has enough hormone available. In response, the brain reduces the signals that stimulate sperm production.

What many men don't realise is that sperm production depends on extremely high concentrations of testosterone inside the testes themselves, far higher than the levels measured in a blood test. When that internal signalling is disrupted, sperm production can fall sharply. A man taking testosterone replacement therapy may feel stronger, have more energy, and experience a higher libido, all while his fertility declines. It's something Mavrelos says he sees regularly in clinic.

For men who may want children in the future, fertility plans should form part of the conversation before starting testosterone therapy, not afterwards.

The 90-day window 

One of the most useful things men can understand about fertility is that sperm are constantly being made. The process, known as spermatogenesis, takes roughly three months from start to finish. In practical terms, the sperm produced today reflect the environment they developed in over the previous twelve weeks. Poor sleep in January may influence sperm quality in April.

The same logic applies in reverse. Improvements to diet, sleep, exercise, and other lifestyle habits are unlikely to appear overnight. That's why fertility specialists encourage patience. Three months is generally considered the minimum timeframe for meaningful change.

Heap urges men to think even further ahead. "If there are underlying issues such as poor diet, high stress, significant alcohol intake, or a history of illness, six months gives you a much stronger foundation," she says.

The encouraging news is that sperm are very responsive. Unlike many health markers that can take years to change, improvements made today may begin to show up within a few months.

When should men think about fertility testing?

The standard advice is to seek fertility assessment after twelve months of unsuccessful attempts to conceive, or after six months if the female partner is over 35. Mavrelos believes there are situations where earlier testing makes sense. "A semen analysis is cheap, quick, and tells you a lot," he says.

Importantly, fertility assessment shouldn’t begin and end with the female partner. Male factors contribute to around half of fertility difficulties, yet men frequently remain untested until much later in the process.

Earlier testing may be particularly valuable for men with:

• A history of undescended testicles
• Previous chemotherapy
• Mumps during adulthood
• Prior reproductive surgery
• Known hormonal conditions
• Concerns around testosterone use

Even when results are reassuring, testing can provide clarity and establish a useful baseline.

The biggest mistakes men make

Both experts identify a similar pattern. Many men simply wait too long. Some assume fertility will take care of itself. Others rely on libido or sexual performance as evidence that everything is functioning normally. Neither assumption is reliable. "Libido, erections, and ejaculation tell you almost nothing about the sperm themselves," says Mavrelos.

Another common mistake is focusing on supplements before addressing the fundamentals. Sleep, nutrition, alcohol intake, smoking status, body composition, and physical activity consistently exert a greater influence on fertility than most of the products marketed to men online. The basics may be less exciting but they are where much of the evidence sits.

What men can do right now to support fertility

If fertility specialists tend to agree on one thing, it's that the unglamorous stuff often makes the biggest difference. Start by understanding your baseline. A semen analysis provides information that guesswork can't. From there, the priorities are pretty consistent across fertility clinics and nutrition practices:

• Stop smoking and vaping.
• Keep alcohol intake low, particularly in the three months before trying to conceive.
• Aim for seven to nine hours of sleep most nights.
• If you're carrying excess weight, focus on gradual, sustainable fat loss rather than crash diets.
• Build most meals around protein, vegetables, healthy fats, and minimally processed carbohydrates.
• Eat oily fish one to two times per week and include nuts, seeds, and legumes regularly.
• Stay physically active, aiming for a mix of strength training and cardiovascular exercise.
• Review any testosterone use with a specialist if future fertility is important.
• Give changes at least three months before expecting to see meaningful improvements.

If Heap had to focus on just three areas, she would start with diet quality, sleep, and alcohol intake.

That doesn't necessarily mean a complete lifestyle overhaul. It might be swapping a grab-and-go lunch for a meal built around protein and vegetables, adding an extra hour of sleep, or cutting back from several drinks a week to the occasional social occasion.

For men with known deficiencies, poor semen parameters or a limited diet, targeted supplementation may also be worth considering. Nutrients such as zinc, selenium, CoQ10 and vitamin D are among the most commonly used in fertility support.

None of these recommendations are revolutionary but that may be exactly why they work. Sperm health is often shaped by the small decisions repeated every day, and many of those sit firmly within our control.

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