Women are so often the focus in conversations about infertility – which is defined as “a failure to establish a pregnancy after 12 months of regular, unprotected sexual intercourse”.
In reality, when you look at the causes of infertility, a third of the issues are with the woman, a third are due to the men and the remaining third are due to a combination of male and female factors, or unexplained.
One in seven couples in the UK have difficulty conceiving. Over the past 40 years, sperm counts worldwide have halved and sperm quality has reduced.
As we’re seeing male infertility increase at an alarming rate, it’s more important than ever to bring men into joint focus. Our fertility clinics need to be more inclusive, men need to be better educated about what lowers their sperm count and there needs to be more emotional support in place for them too.
What is good sperm health?
When we talk about sperm health, we’re talking about sperm quantity as well as quality. The structure of the sperm is important. It needs to be able to swim and survive in the female reproductive tract. A successful conception is most likely if the ejaculate contains at least 15 million sperm per millilitre. Too few sperm cells makes it more difficult as there are fewer candidates available to successfully fertilise the egg.
What lowers sperm count?
There are several factors that contribute to lower sperm count, although the cause of the problem on a global scale is yet to be determined. When addressing these issues on an individual level, some can’t be avoided. If you’re trying to improve chances of conception, focus on reducing the ones you can prevent.
Five of the common issues are:
1. Keeping your mobile phone in your pocket and other habits
Environmental toxins are potentially the biggest suspect for the recent decline in male fertility and increasing global pollution rates. Different environmental pollutants including tobacco smoke, plastics and traffic pollution have been shown in laboratory studies to reduce both sperm count and quality.
These chemicals are thought to cause problems with sperm cells’ DNA, causing them to reduce in number, or change in structure and ability to swim. Some chemicals, known as endocrine-disrupting chemicals (EDCs) can also impact your endocrine system and have an effect on the levels of hormones, such as testosterone, which affect sperm production. Examples of these EDCs include plastics, pesticides and other chemicals used in manufacturing.
Rising temperatures and global warming also have potentially detrimental effects. Sperm cells need to be kept cool, which is why the testicles are located outside of the body. For the same reason, keeping your mobile phone in your pocket can also reduce sperm count due to heat and electromagnetic activity released from the device.
2. What you eat, how often you exercise and how much sleep you get
Poor diet, a sedentary lifestyle, stress, alcohol, smoking (including vaping) and drug use can all have a negative impact on sperm health. So does lack of sleep. A study published in the Fertility and Sterility journal reported that men who consistently slept for less than six hours each night were 31 per cent less likely to conceive with their partners compared with those who achieved the recommended seven to nine hours of sleep each night.
3. Your age
Men have a biological body clock too. Whilst the rate of fertility decline is more pronounced in women as they age, and tends to happen earlier (fertility peaks at 20, with the most rapid decline from around age 35), men also see reduction in fertility with increasing age. Statistics show men over the age of 45 are about half as fertile as those under 25.
4. Sexually transmitted infections
If left untreated, common sexually transmitted infections (STIs) like chlamydia and gonorrhoea can cause something called epididymitis where the tube at the back of the testicles which stores and transports sperm becomes inflamed. The good news is, unlike a female who is born with all the eggs she will ever have, males constantly produce new sperm and so if the STI is treated with antibiotics, sperm count should return to normal.
5. Being overweight or obese
From a male fertility perspective, excess fat tissue can negatively impact male fertility both directly through damage to sperm cells, as well as indirectly, through changes to hormone levels. Excess fat tissue can disrupt normal endocrine processes and hormone production as it releases oestrogen and can cause testosterone to convert to oestrogen. Lower levels of testosterone and higher levels of oestrogen can impact how the testicles produce sperm, resulting in lowering sperm counts.
What should you do if you think you may have a low sperm count?
- See your GP if you and your partner have been having regular sex without using contraception for over one year (or six months if your partner is 36 or over) and have not been able to get pregnant. The main check for low sperm count is a semen analysis test, which can also look at the sperm quality such as how effectively it can swim.
- Improve your lifestyle whether you’re looking to conceive, or have been diagnosed with low sperm count. Reducing alcohol consumption, stopping smoking, including vaping, and losing weight (if you’re overweight) can all have a positive impact.
- Exercise regularly as studies have shown that men who regularly engage in exercise three to five times per week had higher sperm counts and improved sperm quality, compared with those who were more sedentary.
- Eat a balanced diet rich in nutrients and plenty of plants. Sperm is constantly being produced by the testicles, and so a continuous supply of nutrients is important to support sperm production. Irrespective of weight loss, diet changes can be helpful. For example, tomatoes containing a chemical called lycopene may boost sperm quality, which is just one example of the benefits of eating more fruit and veg.
- Have sex every two to three days without using contraception if you want to conceive. Whilst low sperm count can be a cause of infertility, it is still entirely possible to conceive naturally and couples aiming to do so should continue to have regular sex whilst seeking medical advice.