Male Fertility Issues: Causes, Sperm Health and What You Can Do

Male factor plays a role in about 50% of fertility issues, but they're often overlooked in conversations about conception. Fertility is a shared process, and sperm health plays a role in whether a couple conceives, whether that's naturally or through fertility treatment.

Many of the factors that affect sperm health can be investigated, and in many cases supported, through a combination of diet, lifestyle changes, medical guidance and, where appropriate, targeted nutritional support. This guide explains what male fertility issues actually are, what can affect sperm health, when to consider testing, and what men can do before trying to conceive or starting fertility treatment such as IVF or ICSI.

What are male fertility issues?

"Male fertility issues" is a broad term. It can involve:

• How many sperm are produced
• How well sperm move
• Sperm shape and structure
• The quality of the DNA carried inside sperm
• The hormones involved in sperm production
• Ejaculation
• Physical blockages in the reproductive tract
• Testicular function
• Wider health factors, such as weight, sleep and stress

It's worth saying clearly: male fertility issues don't always mean a man cannot conceive. Some issues are mild, some are temporary and improve with lifestyle changes, and some need specialist investigation and treatment. A diagnosis is a starting point for a plan, not a verdict.

Understanding sperm health

Semen analysis typically looks at several distinct measures. Each tells you something slightly different.

Sperm count

Sperm count refers to the number of sperm present in a semen sample. A low sperm count can reduce the chances of sperm reaching and fertilising an egg, but the overall impact depends on the wider picture, including motility, morphology and the couple's individual circumstances.

Sperm motility

Motility refers to how well sperm move, and whether they can travel effectively towards the egg. Clinicians often look specifically at "progressive motility": sperm moving forward in a relatively straight line, rather than moving weakly or in circles.

Sperm morphology

Morphology refers to the size and shape of sperm. Having a higher proportion of unusually shaped sperm can be relevant to fertility, but morphology alone doesn't determine whether conception is possible, it's one piece of a larger picture.

Sperm DNA fragmentation

DNA fragmentation refers to damage within the genetic material carried by sperm. A standard semen analysis usually measures count, motility, morphology, semen volume and concentration, but DNA fragmentation typically requires an additional, separate test. This matters because sperm can look "normal" under a microscope while still carrying underlying DNA damage.

In short: healthy sperm need to be present in sufficient numbers, move well, be normally shaped, and carry intact genetic material, and testing is the only reliable way to know where things stand.

For a deeper explanation of these sperm parameters and the 72 to 90 day sperm development cycle, watch our Sperm Health Masterclass.

Common causes of male fertility problems

Lifestyle factors

• Smoking
• Alcohol
• Recreational drug use
• Poor sleep
• Chronic stress
• A sedentary lifestyle
• Very intense exercise or overtraining
• Anabolic steroid use

Heat exposure

Sperm production is temperature-sensitive, and repeated heat exposure has been studied in relation to reduced sperm quality. Common sources include:

• Hot baths
• Saunas and steam rooms
• Laptops used directly on the lap
• Tight underwear
• Occupations or habits involving prolonged testicular heat exposure

Diet and nutrient intake

A poor-quality diet may affect overall reproductive health and antioxidant status. Sperm cells are particularly vulnerable to oxidative stress, which is one reason diet quality is often discussed alongside sperm health.

Weight and metabolic health

Being significantly overweight, underweight, or having underlying metabolic issues may affect hormone levels and sperm quality.

Medical causes

• Varicocele
• Infections
• Hormonal imbalance
• Testicular injury
• Previous surgery
• Genetic factors
• Ejaculation issues
• Certain medications

Important: never stop or change a prescribed medication without speaking to your GP or specialist first, even if you're concerned it may be affecting your fertility. Raise it with the prescribing clinician rather than stopping treatment yourself.

Age-related factors

Men continue producing sperm throughout life, but sperm quality and DNA integrity may change with age. This doesn't mean older age rules out conception, it simply means age is one factor worth being aware of, alongside the others above.

When should men get a fertility test?

It's worth considering a semen analysis or specialist advice if:

• You and your partner have been trying to conceive for 12 months without success
• Your partner is over 35 and you've been trying for 6 months without success
• You're preparing for IVF, ICSI or another assisted fertility treatment
• There's a history of testicular injury, surgery, infection or undescended testicles
• There are already known sperm issues from a previous test
• You've experienced recurrent miscarriage as a couple
• You have concerns about erectile function, ejaculation or hormone-related symptoms
• There has been anabolic steroid use, past or present

A semen analysis is a straightforward, non-invasive starting point, and can help identify whether sperm count, motility or morphology may be contributing to difficulty conceiving.

What does a semen analysis measure?

A standard semen analysis typically covers:

• Semen volume
• Sperm concentration
• Total sperm count
• Motility
• Progressive motility
• Morphology
• Sometimes signs of infection or inflammation

Sperm DNA fragmentation testing is a separate, additional test. It may be discussed where there have been recurrent miscarriages, repeated IVF failure, unexplained infertility, or a normal semen analysis alongside ongoing difficulty conceiving. It isn't something every man needs, it's a conversation to have with a specialist if one of these situations applies.

Can sperm health improve?

Sperm are produced and mature over roughly 72 to 90 days. This is a useful number to know, because it explains why:

• Men are often advised to start diet, lifestyle and nutritional changes at least three months before trying to conceive or starting fertility treatment
• Improvements are not guaranteed, but consistent changes may support the environment in which sperm develop
• A single good week is unlikely to make a lasting difference; it's the pattern over the full cycle that counts

Men with an abnormal semen analysis should seek personalised advice from a GP, fertility clinic or qualified fertility nutrition professional, rather than relying on lifestyle change alone.

Diet and lifestyle changes that may support sperm health

Diet

A Mediterranean-style eating pattern is the dietary approach most consistently associated with better sperm parameters in the research. In practice, this looks like:

• Good-quality protein with meals
• Colourful fruit and vegetables
• Wholegrains
• Nuts and seeds
• Oily fish or other omega-3 sources
• Zinc-rich foods (shellfish, meat, seeds)
• Selenium-rich foods (brazil nuts, fish, eggs)
• Antioxidant-rich foods generally
• Good hydration
• Less ultra-processed food
• Less added sugar

For more practical food ideas, see our guide to the best foods for male fertility, including zinc-rich foods, oily fish, walnuts, leafy greens and antioxidant-rich options.

Lifestyle

• Stop smoking
• Moderate alcohol intake
• Prioritise sleep
• Manage stress
• Stay physically active
• Avoid overtraining
• Maintain a healthy weight
• Reduce heat exposure around the testes

Environmental exposure

Some environmental exposures, including certain plastics, pesticides, solvents and other endocrine-disrupting chemicals, have been studied in relation to hormone function and sperm quality. This is an area of ongoing research rather than settled science, and there's no need for alarm; simple, practical steps (such as reducing use of certain plastics for food storage) are reasonable without being excessive.

For wider context on population-level sperm count decline, environmental exposures and lifestyle trends, read our guide to the decline in sperm quality.

Key nutrients involved in male fertility

This is an educational overview of nutrients that have been studied in relation to sperm health — not a product list, and not a claim that any of them treats or cures infertility.

• Zinc — contributes to normal fertility and reproduction, and contributes to the maintenance of normal testosterone levels.
• Selenium — contributes to normal spermatogenesis (sperm production).
• Vitamin C — contributes, along with vitamin E, to the protection of cells from oxidative stress.
• Vitamin E — also contributes to the protection of cells from oxidative stress.
• Folate — has a role in the process of cell division, relevant to sperm development.
• Vitamin B12 — contributes to normal energy-yielding metabolism.
• Vitamin D — vitamin D status has been studied in relation to reproductive health, though the evidence is still developing.
• Omega-3 (DHA) — present in sperm cell membranes and relevant to their structure.
• CoQ10 — involved in cellular energy production and has been studied in relation to sperm motility.
• L-carnitine — involved in energy metabolism within cells and has been studied in relation to sperm movement.
• Magnesium — involved in normal muscle function and energy metabolism, and has been explored in fertility-related research.

Do supplements help male fertility issues?

Food and lifestyle are the foundation of sperm health. That's worth repeating, because it's easy to skip past. Beyond that foundation:

• Some men may benefit from targeted nutritional support, particularly if their diet is inconsistent, they're preparing for IVF, they have signs of increased oxidative stress, or a semen analysis has flagged specific findings.
• Supplements should not be positioned as a cure for infertility, and results vary between individuals.
• Men with abnormal semen analysis results should seek personalised advice from a GP, fertility clinic or a qualified fertility nutrition professional before choosing a supplement routine.
• Supplements tend to be most relevant when used consistently over the sperm development window (roughly 12 weeks), rather than as a short-term fix.

For a practical guide to how Vitamen, Vitamen Boost, Menceive, Vitaseed Pro, Vital DHA and Kaneka Ubiquinol CoQ10 may fit together, read our male fertility supplement guide.

For a closer look at the research behind specific ingredients, see our dedicated guide: Do Men Really Need Fertility Supplements? What the Evidence Says.

Zita West Vitamen

A daily multivitamin for men providing zinc and selenium, taken as one capsule a day. Available in 30 capsule (1 month) and 90 capsule (3 month) sizes to cover a full 12-week preparation window.

Shop Zita West Vitamen

Zita West Vital DHA

A molecularly distilled omega-3 supplement delivering DHA and EPA, for men who feel their diet doesn't consistently include oily fish. Taken as two capsules a day, available in 60 capsule (1 month) and 180 capsule (3 month) sizes.

Shop Zita West Vital DHA

Zita West Vitamen Boost

An antioxidant complex designed to help the body's defences against oxidative stress, one of the factors linked to sperm quality above. Taken as two capsules a day, available in 60 capsule (1 month) and 180 capsule (3 month) sizes.

Shop Zita West Vitamen Boost

Zita West Kaneka Ubiquinol CoQ10

100mg of a highly absorbable form of CoQ10 per capsule, with a recommended serving of 2 capsules daily. Available in sizes from 60 to 360 capsules to suit a 1 to 6 month plan.

Shop Zita West Kaneka Ubiquinol CoQ10

Read more in our guide to CoQ10 and male fertility, including dosage and what the research says about sperm motility. For the broader research picture on this ingredient, including egg quality, sperm health and IVF preparation, see our full CoQ10 and fertility guide.

Zita West Vitaseed Pro

A premium antioxidant powder delivering N-Acetyl L-Carnitine and selenium, for men wanting more targeted support where sperm count, motility or morphology are a specific focus. One serving a day, available in 30 serving (1 month) and 90 serving (3 month) sizes.

Shop Zita West Vitaseed Pro

Male fertility issues and IVF or ICSI

Male fertility preparation matters before assisted conception, not only before natural conception.

• Sperm quality can influence fertilisation and embryo development.
• ICSI can help where sperm parameters are poor, but sperm health still matters to the process.
• Men should ideally begin preparation at least three months before treatment starts.
• Semen analysis and specialist advice can help guide next steps.
• Couples generally benefit from preparing together.

Individual outcomes vary, and preparation supports the process rather than guaranteeing a particular result, this is worth discussing directly with your fertility clinic.

Ultimate Male IVF Support Pack

Our full nutritional support pack for men preparing for IVF or ICSI, bringing together the multivitamin, antioxidant and omega-3 support covered in this guide into one routine.

Shop the Ultimate Male IVF Support Pack

12-week male fertility action plan

Week 1: understand your starting point

• Consider a semen analysis if appropriate
• Review current lifestyle habits
• Check sleep, alcohol, smoking, heat exposure and diet
• Speak to a GP or fertility clinic if there are medical concerns

Weeks 2 to 4: build the foundations

• Improve diet quality
• Add protein, vegetables, nuts, seeds and omega-3 sources
• Reduce smoking and alcohol
• Reduce heat exposure
• Improve your sleep routine

Weeks 5 to 8: support consistency

• Keep changes going daily
• Add regular, moderate exercise
• Manage stress
• Review nutrient intake
• Consider professional advice if choosing supplements

Weeks 9 to 12: review and plan next steps

• Continue habits through the full sperm development window
• Review semen analysis results if available
• Speak to a clinician if results are abnormal or conception is taking longer than expected
• Prepare for IVF or ICSI with specialist guidance if relevant

Not sure where to start?

For men who prefer a guided starting point, Zita West also offers male fertility support packs for earlier stages of preparation:

Male Foundation Fertility Support Pack

A baseline pack for men who have just started trying, bringing together our foundation multivitamin, probiotic and omega-3 support.

Shop the Male Foundation Fertility Support Pack

Zita West Menceive

A probiotic supplement supporting gut health as part of a wider male fertility nutrition plan. One capsule a day, taken as a 21 or 63 day course.

Shop Zita West Menceive

The right choice depends on your individual needs, diet, lifestyle, semen analysis results and whether you're trying naturally or preparing for fertility treatment. If you're unsure where to start, consider booking a free 1:1 consultation with a Zita West fertility nutrition expert, or speaking to your fertility clinic for personalised guidance.

Related male fertility guides

Male fertility is influenced by many overlapping factors. These guides explore specific areas in more depth.

• CoQ10 and male fertility
• Foods for male fertility
• Antioxidants for sperm health
• Magnesium and male fertility
• Vitamin C and sperm health
• Omega-3 and male fertility
• Probiotics and male fertility
• Caffeine and male fertility
• Male age and sperm health
• Male fertility supplements evidence
• Semen analysis and fertility test results
• Male Fertility Matters webinar resource

Browse the male fertility supplements collection if you are reviewing products as part of a wider preconception plan.

Frequently asked questions

What are the most common male fertility issues?

Low sperm count, poor motility, abnormal morphology, sperm DNA fragmentation, hormonal issues, varicocele, infections and ejaculation problems are among the most common.

How do I know if I have a male fertility problem?

Many men have no obvious symptoms. A semen analysis is usually the starting point for finding out whether sperm count, motility or morphology may be a factor.

Can sperm count improve naturally?

Sperm count may be influenced by lifestyle, diet, health conditions and medical factors. Some men see improvements after addressing underlying issues, but results vary and aren't guaranteed.

How long does sperm health take to improve?

Sperm develop over a cycle of roughly 72 to 90 days, so most changes need at least three months of consistency before their effect on sperm quality can be properly assessed.

What affects sperm motility?

Oxidative stress, heat exposure, smoking, alcohol, diet, age, infection, varicocele and certain medical factors have all been studied in relation to sperm motility.

What is sperm DNA fragmentation?

It refers to damage to the genetic material carried inside sperm. It may not show up on a standard semen analysis and can require a separate, specific test.

What foods support sperm health?

A Mediterranean-style diet with colourful fruit and vegetables, wholegrains, nuts, seeds, oily fish, and foods naturally rich in zinc and selenium.

Do men need supplements when trying to conceive?

Not always. Targeted supplements may help fill nutritional gaps as part of a wider diet and lifestyle plan, but they aren't a requirement for every man and shouldn't be seen as a treatment for infertility.

When should a man get a semen analysis?

If trying to conceive for 12 months (or 6 months where the female partner is over 35), before IVF or ICSI, if there are known sperm concerns, after recurrent miscarriage, or where there's relevant medical history.

Can male fertility issues affect IVF success?

Sperm quality can be relevant to fertilisation, embryo development and treatment planning, but individual outcomes vary and are best discussed directly with your fertility clinic.

Medical disclaimer

This article is for educational purposes only and is not a substitute for personalised medical advice. If you are concerned about fertility, semen analysis results, medication, symptoms or fertility treatment, speak to your GP, fertility clinic or a qualified healthcare professional.

References

1. World Health Organization. Infertility Fact Sheet (2023).
2. NHS. Infertility — diagnosis.
3. NHS. Trying to get pregnant.
4. Levine H, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis. Hum Reprod Update. 2022;28(3):365–391. PubMed
5. Showell MG, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2019;3:CD007807. PubMed
6. Jenkins TG, et al. Sperm epigenetics and male fertility. Epigenomics. 2017;9(3):267–275. PubMed
7. Jung A, Schuppe HC. Influence of genital heat stress on semen quality in humans. Andrologia. 2007;39(6):203–215. PubMed
8. European Commission. EU Register of nutrition and health claims made on foods (Regulation (EC) No 1924/2006) – authorised wording on zinc, selenium, vitamin C, vitamin E, folate and vitamin B12. EU Register