Male Fertility - It takes two to tango!
Introduction
Thousands of couples have trouble conceiving every year, but while there is plenty of support and practical advice available for women, male fertility issues can often be overlooked. As the saying goes, it takes two to tango, and infertility can affect both men and women equally.
Although not all cases of infertility are treatable, if you are looking for simple ways to increase your chances of having a baby or you are a woman trying to support your male partner in improving his fertility, whilst optimising your own diet and lifestyle, then this blog post is for you. We will look at the diet and lifestyle factors which can impact male fertility and provide easy ways to achieve them.
What Causes Male Infertility?
Male infertility is categorised by low sperm production and/or abnormal sperm function which can be caused by many things such as illness, injury, chronic health conditions and lifestyle choices.
Factors influencing male fertility contribute to around 50% of couples facing infertility issues. Most commonly, these issues are around sperm count and sperm motility (1).
While some cases are more complex, often sperm quality and quantity can both be improved with diet and lifestyle changes. Even if fertility treatment is needed down the line, making some small adjustments can often be a healthy and helpful first step towards conception.
How Your Lifestyle Can Optimise Your Fertility
Unlike women, who are born with all the eggs they will have in their lifetime, men create new sperm roughly every two months and so lifestyle and dietary changes can continue to improve sperm quality over time. The sooner you start implementing healthy behaviours the sooner you can reap the benefits.
When it comes to diet, it is often more helpful to focus on an overall healthy dietary pattern, and evidence shows that the Mediterranean diet is a great way of eating to optimise fertility; this being true for both men and women. Traditionally the Mediterranean diet is full of fruits and vegetables, nuts, legumes, beans, cereals, grains and fish, as well as healthy unsaturated fat sources like olive oil, and lower intakes of meat, dairy and alcohol.
One of the benefits of a Mediterranean style dietary pattern is that it has anti-inflammatory properties and inflammation can play a key (negative) role in male infertility. Inflammation can cause damage to cells which produce sperm which results in less sperm production and poor quality sperm produced (2, 3).
Which Nutrients Have A Positive Impact On Male Fertility?
In addition to a Mediterranean style dietary pattern, there are certain nutrients which have been found to have a positive impact on male fertility:
Zinc: has been shown to increase the production of testosterone, which impacts sperm quality, quantity and motility. Therefore, it is crucial to have enough of this key nutrient within your diet when trying to conceive. Good sources of zinc include quality red meat, eggs, seafoods, pulses, and milk if consumed regularly (4).
Selenium is an important mineral for male fertility as it can help with sperm development and motility (5). One of the easiest ways to incorporate selenium into your diet is by consuming a handful of mixed nuts each day but be sure to include a couple of brazil nuts as these are a particularly rich source. Other good sources include meat, fish and eggs.
Fibre: is a type of carbohydrate, and the UK recommendations are for adults to consume 30g each day. Fruits and vegetables can be a great source of fibre along with nuts, and wholegrains, such as oats, brown rice, whole wheat, pulses and millets. Consumption of these foods has been linked to positive impacts on sperm quality, perhaps because they are all rich in fibre as well as antioxidants like B vitamins and folic acid, and Vitamin E and selenium (5).
Vitamin C and Vitamin E: are antioxidants which protect the body from free radicals and oxidative stress. Too much oxidative stress within the body is linked to reduced fertility in men (and women) therefore including lots of dietary sources is important. Good food sources of vitamin C include citrus fruits, tomatoes and potatoes and vitamin E can be found in nuts and seeds (1).
Vitamin D: A nutrient with many functions, and a key role in reproductive health for both men and women. Low vitamin D levels in men are linked to low testosterone levels, and supplementation in those who are deficient increases both vitamin D levels and testosterone levels (6, 7). More recent studies have confirmed the link between vitamin D levels and semen quality and testosterone levels (8, 9), however, not all studies agree, so more work needs to be done in this area. Despite this inconsistency, it is important to include vitamin D rich foods for overall health, and potentially a positive impact on fertility, so be sure to include oily fish, eggs and dairy foods.
Omega-3 Fats: Fat is an essential nutrient for fertility, one which we often believe we need to exclude to be healthy. However the link between essential fatty acids like omega-3 fats, and fertility is very clear as they are involved in reproductive hormone production. They also have anti-inflammatory effects and so improve semen quality. Some great sources of omega-3 fats include oily fish like salmon, tuna, mackerel, sardines and trout, as well as plant based sources like walnuts and chia, hemp and flaxseeds (10).
Folate: This B vitamin (also known as vitamin B9), has an important role in sperm production and development. Folate also protects sperm DNA from damage and acts as a strong antioxidant. Foods high in folate include leafy greens, beans, nuts, and citrus fruits. It is also often added to fortified grains such as bread and cereal. Taking a daily folate supplement can also help ensure adequate intake for healthy sperm production (11).
Are There Any Specific Foods To Be Mindful Of When It Comes To Improving Male Fertility?
Processed Meat: Replacing processed meats with good quality meat sources is a good idea, and keeping processed meats, such as bacon and sausages as an occasional treat. This is largely due to the nitrates and other preservatives found in these meats and better sperm quality is associated with diets rich in white meat and fish (1), so be sure to include these on your plate a few times a week.
Caffeine: Other things to consider when looking at optimising your diet to improve fertility is to be mindful of caffeine consumption. Caffeine is found in tea, coffee, and soft drinks and research now suggests that high intakes could have a negative impact on reproductive function (12). Aim for no more than 2-3 cups per day when actively trying to conceive.
Sugary Drinks: Drinking sugar sweetened beverages, or sodas, has been associated with negative impacts on sperm quality, however there are only a couple of studies looking at this so more work needs to be done to explore the impact on male fertility. If you do consume sugary drinks then it might be worth reducing your intake and replacing it with water or other non-caffeinated drinks (13,14).
Other Lifestyle Factors Which Impact Male Fertility
Maintaining a Healthy Weight: Maintaining a healthy BMI (between 18-30 kg/m²) can have a positive impact on fertility as being either under or overweight can affect hormone production, and having a BMI >30kg/m² is linked to reduced testosterone levels which in turn impacts reproductive function (15, 16).
Exercise: We all know that movement is good for overall health, but did you know that regular exercise can lead to increased testosterone levels in men compared to those who do not exercise regularly(17)? A recent review of the evidence on the impact of exercise on sperm quality concluded that although there is a mixture of findings from all the studies, in general being physically active is associated with improved semen quality. It is important to note though, that strenuous/intense exercise can have a negative impact on testosterone levels and semen parameters, and specifically intense cycling can reduce semen quality (18, 19).
Sleep: Getting enough sleep is not always easy, however the beneficial effects of good quality and quantity of sleep on both mental and physical health make prioritising sleep really important. When it comes to the impact of sleep on male fertility, again the amount of evidence isn’t huge, however a recent systematic review suggested that getting too little or too much sleep can worsen sperm quality, as well as a later bedtime (20). Therefore if you want to optimise your sleeping routine to improve fertility then aim to get to bed before 10pm and try to get around 7.5 hours sleep per night.
Alcohol : Alcohol intake can worsen oxidative stress and reduce sperm quality (21), so if you enjoy drinking alcohol then keeping to a moderate intake (for men this is no more than 14 units per week) is important for fertility.
Smoking: There is a clear negative link between smoking and infertility, with studies showing smoking can reduce sperm quality and damage DNA in sperm. In fact the more you smoke, the worse the sperm quality, so an obvious way to improve your fertility if you are a smoker is by not smoking or using recreational drugs (22).
Preventing Overheating: Making sure you do not overheat is also important for sperm, a few simple steps you can take are avoiding very hot baths and saunas, wearing loose fitting underwear, and walking around periodically if you sit down a lot at work (23).
Supplements: Although a healthy and balanced diet and lifestyle may be enough to optimise male fertility, for some people supplements may be useful in improving fertility. For a tailored and personalised approach to nutritional supplements speak to a fertility dietitian.
Take Home Message
Infertility can affect us all, whatever our gender, and making simple diet and lifestyle changes can have a positive impact on many fertility related factors.
When it comes to the right diet for male fertility then it seems that aiming for a Mediterranean style diet can only increase your chances of having a baby. And if you add in some simple lifestyle strategies like avoiding smoking, limiting alcohol and caffeine, getting some regular movement and plenty of sleep, as well as dietary goals like including lots of fruits and veggies, wholegrains, oily fish, lean meats, nuts and seeds and eggs then you will have covered all bases!
What’s even better is that if you are a couple trying to conceive then making these changes will be even easier if you do them together and have each other's support along the way.
References
Diet and Nutritional Factors in Male (In)fertility-Underestimated Factors.
Oxidative Stress, Testicular Inflammatory Pathways, and Male Reproduction.
Diet and sperm quality: Nutrients, foods and dietary patterns.
Association of vitamin D status with serum androgen levels in men.
Effect of vitamin D supplementation on testosterone levels in men.
Serum vitamin D content is associated with semen parameters and serum testosterone levels in men.
Is serum vitamin D level a risk factor for idiopathic male fertility?
Diet and Male Fertility: The Impact of Nutrients and Antioxidants on Sperm Energetic Metabolism
Coffee and caffeine intake and male infertility: a systematic review.
Intake of Sugar-sweetened Beverages and Fecundability in a North American Preconception Cohort.
Association between intake of soft drinks and testicular function in young men.
Physically active men show better semen parameters and hormone values than sedentary men.
The Impact of Intense Exercise on Semen Quality. Am J Mens Health.
Impact of sleep on female and male reproductive functions: a systematic review.
