Can You Improve Sperm Quality and Quantity?

Did you know that your sperm health is related to your overall health? Many men don’t realize the importance of sperm health until they are trying to start a family and getting pregnant doesn’t happen in the time frame expected or are diagnosed as infertile. In addition to problems with conceiving, unhealthy sperm quality and quantity is linked to increased risk of high blood pressure, cancer, and heart disease. Certain lifestyle habits, for example, can change hormones, such as reduced testosterone.  As a result, this may cause your sperm quality and quantity to be poor. (1).

Couples typically know that, when trying to get pregnant, the woman needs to stop drinking and taking certain medications, but it turns out that men should make those lifestyle changes as well. Male fertility not only can be directly impacted by lifestyle factors, it may even impact the development of your offspring. In today’s article, we examine lifestyle factors that may harm sperm health and how to ensure you are giving your future offspring the best start in life.

Before we dive in...

The great news is that if you start healthy lifestyle changes today, you may naturally improve sperm quality and quantity, which of course, in turns means improving your health. How long will it take to make a difference? Semen is continuously being produced in the male body and takes approximately 74 days to mature, meaning that positive lifestyle changes today can result in improvements in sperm quantity and/or quality in as little as 2 to 3 months.

Alcohol

Bad news for those who enjoy a good, stiff drink regularly --  alcohol is toxic to your cells and hormones. Consuming alcohol can lead to long-term and short-term blood pressure problems, erectile dysfunction, lower testosterone levels, and decreased sperm production. Liver disease caused by excessive drinking also may lead to fertility problems. A recent study explained that alcohol can have “profound deleterious effects on all levels of the male reproductive system.” Not only does it impact sperm but was also found to perhaps affect the development of the offspring (2).

“Having more than three drinks in one sitting temporarily increases your blood pressure, but repeated binge drinking can lead to long-term increases” (3), and a long term-increase in high blood pressure can actually lead to chronic erectile dysfunction. What is heavy drinking exactly? It is 14 or more drinks per week (4); this amount of drinking doesn’t allow your body to recover (5).

NOTE: heavy drinkers should slowly reduce alcohol intake rather than quit cold turkey which may temporarily but significantly increase blood pressure. Read more about how heavy drinking affects blood pressure here.

What to do:

The CDC recommends no more than 2 drinks a day or no more than 14 drinks a week for men. Keep in mind that having alcohol free days each week may give your liver the necessary time to recover (6).

Exercise

How and why exercise improves sperm health is still a mystery, but a recent study reports "that doing exercise can be a simple, cheap and effective strategy for improving sperm quality in sedentary men” (7). A couple reasons why exercise may help is by losing weight and improving hormonal balance. Testosterone, for example, is essential for sperm creation and exercise does have an impact on testerone. While different forms of exercise are up for debate on the impact on sperm health/testosterone, weight lifting and moderate cardio appear to consistently have positive impact. On the other hand too much High Intensity Interval Training (HIIT workouts and chronic endurance exercise may have a negative impact (8).

A new study published by Reproduction showed that sedentary men who start exercising between three and five times per week improve their sperm counts and other measures of sperm quality in just a few months. The researchers also found that men exercising moderately and continuously improved their sperm quality more than those following popular intensive exercise programs like HIIT.

Exercise may also benefit your future offspring. This has yet to be determined in humans, but in mice, mice that exercised had offspring that learned faster and retained more information longer (9).

The effect of exercise, however, only lasts as long as you continue to exercise. In other words, you must keep exercising to maintain the benefits. The study on sedentary men showed that only after stopping exercise for one week, the benefits to sperm count that had been achieved by exercise in the study started to decrease back to pre-training levels. Specifically, the benefits to sperm count, shape, and concentration started to drop towards pre-training levels after one week of stopping the exercise program, and sperm motility decreased 30 days afterwards (10).

In addition to lower sperm count, men suffering from low testosterone may experience fatigue and low libido. As a result, testosterone replacement therapy (TRT) has been on the rise, with men of all ages using testosterone supplements, but this can result in having NO SPERM in the ejaculate, or  azoospermia. The pituitary gland uses testosterone levels in the blood to determine how much FSH and LH to release for both testosterone and sperm production. When a man is given exogenous testosterone, it actually can work in similar ways as birth control does for women, in which taking the hormones causes the woman to not release eggs. When using TRT, the hypothalamus and pituitary glands believe the testes are already working, so FSH and LH secretion are suppressed, leading to less testosterone in the testes and reduced or failed sperm production (11).

What to do:

If sedentary, add 3-5 days a week of cardiovascular exercise for 30-60 minutes plus a weightlifting program 2-3 days a week. On the days off, stay active by walking or other relaxed physical activities. Talk to your doctor about an exercise program that works for your current fitness level.




Food/Weight

Being overweight is a problem for both male and female fertility and embryo health. There are multiple reasons for this which you can read more about here, but again, similar to too much alcohol and not enough exercise, testosterone is reduced, and there is an increased risk of health problems which can impact sperm DNA.

Being overweight or obese can reduce sperm count and even cause a man to have no sperm at all. It’s not clear whether the weight itself causes low sperm or if there are underlying diseases impacting sperm health, but regardless, losing weight helps restore sperm health (12)(13).

The good news is that research shows that simple diet and exercise changes can be used to reverse the damaging effects of obesity on sperm function (14). A study done in 2014 showed all kinds of interesting results when looking at diet and sperm. For example, they found that low-fat dairy intake, particularly low-fat milk, was related to higher sperm concentration and progressive motility, whereas cheese consumption was related to lower sperm concentrations, but only among past or current smokers (15).

Not surprisingly, they found processed meat and the ‘Western’ diet (high intake of red and processed meat, refined grains, pizza, snacks, high-energy drinks, and sugar) was not good for sperm health.

A diet including fish, chicken, fruit, vegetables, legumes, and whole grains was significantly associated with higher progressive sperm motility, but not concentration (15) (16). Overall, men’s sperm is significantly more fertile when they have a diet high in vegetables, fiber, folate, lycopene, fruit, and a diet high in antioxidants also strongly correlates with improved semen quality.



Smoking, Chewing Tobacco, and Marijuana

Heavy smokers produce up to 20% fewer sperm than their non-smoking counters, and smoking may increase the number of abnormally shaped sperm, making it harder for sperm to fertilize the egg (17). Chewing tobacco also decreases sperm quality (sperm count, motility, morphology, and viability), as shown for the first time in a recent study of men undergoing infertility evaluation (18).

Not only does smoking impact your fertility, it may even decrease fertility in male children (19). In other words, if you smoke and have a baby boy, he may have 20% less sperm concentration than men who were conceived by a father who did not smoke when conceived.

While tobacco is clearly bad for fertility, marijuana is a bit more up for debate. Study results, however, are showing that chemical compounds in marijuana may impair sperms' ability to swim and also inhibit their ability to penetrate the egg. One study, for example, shows that  two main active cannabinoids of the marijuana plant, D9- and D8 -THC, damage sperm mitochondria and therefore make it more difficult for sperm to reach the egg (20). Another more recent study showed lower sperm concentrations in marijuana smokers (21).

What to do:

No amount of smoking is acceptable for sperm and fertility health. Quitting smoking can be incredibly difficult on your own. Check out this Quit Smoking Guide by Tobacco-Free Life for tips on quitting. If you smoke, talk to your doctor about programs to help quit for good. You may also want to talk to your doctor about marijuana use to see if it is impacting your ability to conceive.




Sleep

You probably would not surprised by the news that not getting enough sleep may impair sperm health, but you may be surprised to hear that too much sleep may also harm sperm health. Late bedtimes as well as short and long sleep durations were associated with impaired sperm health a study looking at semen.  

Too little and too much sleep are also associated with a higher prevalence of coronary heart disease, stroke, and diabetes, in addition to obesity and frequent mental distress, compared with people who have 7-8 hours of sleep a night (23). Long sleeping commonly is >9.0 h of sleep each night for adults (23), which may disrupt circadian rhythms, affecting the depth and length of sleep on subsequent nights, thereby impairing sperm health (22).



Environmental Factors

Toxins in everyday household products may impact hormonal health. Try switching to non-toxic cleaners, skin products, and avoid processed foods.

Occupational or other long-term exposure to certain types of toxins and chemicals, such as herbicides and pesticides, may reduce male reproductive health by either affecting testicular function or altering hormone systems. Chemicals in these products are known as endocrine disruptors and evidence points to negative impacts (27), but further research is needed (28). While trying to conceive and once pregnant, it is best to avoid toxins if possible. If it is not possible due to work, always wear appropriate personal protective equipment that will reduce the risk of exposure to that particular toxin.

Hot tubs, laptops, and a general increase in scrotal temperature can hamper sperm production. Although the benefits have not been fully proven, wearing loose-fitting underwear, reducing the time you spend sitting, avoiding saunas and hot tubs, and limiting scrotum exposure to warm objects, such as a laptop on your lap, might enhance sperm quality. Heat can also temporarily lower sperm count. Other things that impact sperm fertility are long bike rides and horseback riding (24). Biking for more than five hours per week has been found to decrease sperm motile sperm and count (25).



In a nutshell for healthy sperm (26)

  • If overweight, lose weight
  • Exercise regularly
  • Maintain a healthy diet with foods rich in antioxidants
  • Don’t smoke or use recreational drugs
  • Reduce your intake of alcohol to fewer than 5 drinks per week
  • Take a daily multivitamin
  • Don't overheat your sperm and avoid hot tubs and prolonged bike rides






Resources

  1. https://www.medicaldaily.com/low-sperm-count-could-mean-poor-health-not-just-indicate-infertility-423126
  2. https://pubs.niaaa.nih.gov/publications/arh22-3/195.pdf
  3. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058254
  4. https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking
  5. https://dontcookyourballs.com/alcohol-and-male-fertility/
  6. https://www.medicalnewstoday.com/articles/236476.php
  7. https://www.bbc.com/news/health-38206920
  8. https://www.piedmont.org/living-better/the-best-exercises-to-increase-testosterone
  9. https://www.nytimes.com/2018/05/09/well/move/do-fathers-who-exercise-have-smarter-babies.html
  10. https://www.eurekalert.org/pub_releases/2016-12/bl-jsm120216.php
  11. https://www.uranj.com/testosterone-effect-on-sperm/
  12. https://www.hsph.harvard.edu/news/hsph-in-the-news/excess-weight-sperm-fertility/
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177768/
  14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521747/
  15. Afeiche et al., (2014). Processed meat intake is unfavorably and fish intake favorably associated with semen quality indicators among men attending a fertility clinic. J Nutr. 144(7):1091-8.
  16. Gaskins et al., (2012). Dietary patterns and semen quality in young men. Human Reproduction. 27(10):2899-907.
  17. https://andrologyaustralia.org/your-sperm-health/
  18. https://www.fertstert.org/article/S0015-0282(05)01062-9/pdf
  19. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4639396/
  20. Fertil Steril 2009; 91:2471–6. 2009 by American Society for Reproductive Medicine.
  21. https://www.livescience.com/64350-marijuana-thc-sperm.html
  22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402839/
  23. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5402839/
  24. https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/fertility/art-20047584?pg=2
  25. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3717046/
  26. https://www.shadygrovefertility.com/blog/diagnosing-infertility/diagnosing-overcoming-male-factor-infertility
  27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043754/
  28. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046332/

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