7 Things Every Man Should Know About Fertility

From Avoiding Too Much Heat to Knowing When to Get Help

Patient and doctor
Advocate for yourself and your fertility. Don't be afraid to bring up your fertility related concerns with your doctor.. Helen Ashford/Stone/Getty Images

Most of the media and social attention on conception and pregnancy is focused on women. The pregnancy occurs in her body, so it makes sense that most people would assume conception is (almost) all about the woman. They would be wrong. It takes two to make a baby, and male fertility is just as important. Here are seven things every man should know about fertility.

#1. Your Diet, Health, and Work Environment Can Impact Your Fertility.

Your health habits matter when it comes to male fertility.

Some health habits to watch out for include the following:

  • Smoking: Smoking negatively affects sperm counts, sperm shape, and sperm movement, all important factors for conception. IVF treatment success has also been found to be poorer in male smokers, even when IVF with ICSI is used. (ICSI involves taking a single sperm and directly injecting it into an egg.) Smoking is also connected to erectile dysfunction, so dropping the habit may reverse some of the negative effects.

  • Toxic workplace chemicals: Does your job involve close contact with toxic chemicals? If so, you may be at greater risk for infertility and decreased sperm health. Farmers, painters, varnishers, metal workers, and welders have all been found to be at risk for decreased fertility. If your job involves toxic chemical contact or high heat conditions, speak to your doctor. There may be more steps you can take to protect yourself.

  • Sexually transmitted infections (or STDs/STIs): Sexually transmitted infections can lead to infertility if not treated promptly. Left untreated, an infection can lead to scar tissue within the male reproductive tract, making semen transfer ineffective or even impossible. If you have any symptoms of an STI, see your doctor right away, and if you're at risk of contracting an STI, get regular checks even if you are asymptomatic. You may unknowingly pass on an STI to your female partner, which can then damage her fertility.

  • Weight: Being over or underweight can have a negative effect on semen health. Men with a BMI below 20 have been found to have lower sperm concentration and sperm counts, while obese men have been found to have lower levels of testosterone and lower sperm counts.

  • Too many alcoholic drinks: Most studies have found that a few drinks a week won't cause any harm, but excessive drinking has been linked to lower sperm counts, poor sperm movements, and poor sperm shape. One study found that with every additional drink consumed per week, the IVF success rate decreased.

More on protecting or improving male fertility:

#2. Paying Attention to Age Is Important for Men, Too.

You may already know that female fertility declines with age. A 30-year-old woman has a 20% chance of conceiving in any one month, while a 40-year-old woman has only a 5% chance.

Male fertility is also affected by age, though not as drastically as in women. A 70-year-old woman cannot conceive naturally, but some 70-year-old men are still capable of fathering a child naturally. Still, age is something you should consider when planning your family.

Research has found that with increased age, male fertility and sperm health decreases, including an increase in DNA-damaged sperm. Male age has been linked to an increased risk of miscarriage, the passing on of genetic problems, and some birth defects. Increased male age has also been linked to increased rates of autism and schizophrenia.

IVF treatment is also impacted by male age. One study found that for each additional year of paternal age, there was an 11% increased odds of not achieving pregnancy, and a 12% increase in the odds of not having a live birth.

#3. Heat Is Bad for Sperm.

High temperatures are bad news for sperm. You've most likely heard of this in relation to the boxers vs. briefs argument. The thinking was that boxers, being less restrictive and having more air flow, would lead to cooler testicular temperatures and healthier levels of fertility. The research isn't really clear on whether boxers or briefs matter, although wearing extremely tight shorts or underwear, especially when made from a non-breathable fabric, may have an impact on sperm health.

More sources of sperm-troubling heat include:

  • Hot tubbing or long hot baths
  • Sitting for prolonged periods of time with your legs together (like at a desk job or while driving long distances)
  • Sitting with a laptop on your lap
  • Heated car seats

The heat damaging effects may have a longer lasting impact than you'd imagine, too. A very small study looked at men who attended a sauna twice a week, for 15 minutes, over a period of three months. When comparing to semen samples taken before the sauna visits, the researchers found decreases in sperm count and movement, as well as more DNA-damaged sperm. The men in the study were again evaluated three months and six months after they stopped attending the sauna. Sperm health wasn't completely regained until six months after the men stopped attending the sauna sessions.

#4. Male Infertility Is More Common Than You Think.

Couples are advised to seek testing and treatment if they don't conceive after a year of unprotected sex (or six months, if the woman is age 35 or older). Usually, the female partner will see her gynecologist for an evaluation, but men need to be evaluated, too. Male-factor infertility is involved in up to half of all infertile couples. The break down is:

  • About one-third of infertile couples have female factor infertility
  • Another third have male factor infertility
  • The remaining third have both male and female factor infertility, or the cause remains unexplained

A semen analysis, which is a non-invasive test that evaluates semen and sperm health, should be done before any treatments (even clomid) are tried. If male factors are involved, and you try treatments before evaluating male fertility, your female partner will go through the physical stress -- and both of you will go through the emotional stress -- for no reason.

Speak to your partner's gynecologist about having the semen analysis done, even if she doesn't bring it up herself. You may need to see a urologist or fertility specialist for the semen analysis, or the gynecologist may be able to order the test for you.

#5. Male Infertility Is Usually -- But Not Always -- Symptomless.

Most of the time, male infertility shows no obvious outward signs. Being unable to conceive is usually the first sign of infertility in men. You can be in tip-top health and still have compromised fertility. (You can also, by the way, have a great sex life and have male infertility. Contrary to myth, fertility and sexual prowess are not related.)

There are, however, a few symptoms and risk factors to look out for. If any of these symptoms or risk factors apply to you, see a urologist before you start trying to conceive:

  • If you have an undescended testicle
  • If you have been treated for a sexually transmitted infection in the past
  • If you have trouble having or maintaining an erection
  • If you have low sex drive
  • If you have pain, swelling, or a lump in the testicular area

There are also a number of commonly taken medications that may impact your fertility. Speak to your primary care doctor to find out if any of your medications may be compromising your fertility. You may be able to switch to something else.

#6. Putting Off Testing and Treatment May Decrease Your Chances for Pregnancy Success.

Despite the recommendations to seek help after one year of trying, surveys have found that many couples don't. There are a number of reasons for this, including anxiety about fertility testing, concerns about the possible cost of treatments, and misunderstandings like thinking all infertility has obvious symptoms and causes, or thinking that once you've had a child, you can't be infertile. (You actually can have infertility after already having a child. This is called secondary infertility.)

Here's the thing: certain causes of infertility worsen with time. The sooner you get evaluated, the better your chances may be for pregnancy success. This applies to male testing as well as female testing. If only the woman is tested, time can be lost.

If you're worried about the costs, it may be helpful to know that the majority of infertile couples can be treated with low-tech, lower-cost treatments. IVF treatment, the most expensive fertility treatment, is not needed for the majority of couples.

#7. At-Home Sperm Analysis Tests Aren't Good Enough to Rule Out Male Infertility.

The semen analysis can make many men nervous, and many turn to the internet in hopes of taking a more anonymous test. These mail-based semen analysis tests are not as accurate as the testing done in a lab with fresh semen. In fact, to get the best test results, the sample should get to the testing lab within an hour of collection.

The at-home sperm tests are limited in what they can evaluate: most of them measure sperm count and semen volume, but they can't evaluate sperm movement and they rarely look at sperm shape. You can have great sperm counts, but if the sperm are not moving properly, or they're all poorly shaped, you may still be infertile.

If you're concerned about your fertility, see your doctor and get an accurate test done.

More things you need to know:


A Basic Guide to Male Infertility: How to Find Out What's Wrong. American Urological Association. http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/patient-guides/whatswrongpg.pdf Accessed April 16th, 2013.

Crosnoe LE, Kim ED. "Impact of age on male fertility." Curr Opin Obstet Gynecol. 2013 Mar 13. [Epub ahead of print]

Eskenazi B, Wyrobek AJ, Sloter E, Kidd SA, Moore L, Young S, Moore D. "The association of age and semen quality in healthy men." Hum Reprod. 2003 Feb;18(2):447-54.

Garolla A, Torino M, Sartini B, Cosci I, Patassini C, Carraro U, Foresta C. "Seminal and molecular evidence that sauna exposure affects human spermatogenesis." Hum Reprod. 2013 Apr;28(4):877-85. doi: 10.1093/humrep/det020. Epub 2013 Feb 14.

Klonoff-Cohen HS, Natarajan L. "The effect of advancing paternal age on pregnancy and live birth rates in couples undergoing in vitro fertilization or gamete intrafallopian transfer." Am J Obstet Gynecol. 2004 Aug;191(2):507-14.

Male infertility: Symptoms. MayoClinic.com. Accessed April 16th, 2013.

Male Infertility. Urology Care Foundation. Accessed April 16th, 2013. 

Pourmand G, Alidaee MR, Rasuli S, Maleki A, Mehrsai A. "Do cigarette smokers with erectile dysfunction benefit from stopping?: a prospective study." BJU Int. 2004 Dec;94(9):1310-3.

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