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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
If you’re trying to have a baby and it’s taking longer than you expected, you are far from alone. Millions of people worldwide struggle to conceive. In the U.S. alone, about 15% of couples face infertility or not being able to conceive naturally, despite having frequent, unprotected sex for a year (Leslie, 2021).
In the past, a woman’s fertility was usually the focus of fertility concerns. That’s changed, as research now shows that male infertility is the cause of about 20-30% of infertility cases and is a factor in about 50% of cases (Agarwal, 2015).
Because of this information, more male partners are undergoing fertility testing and may turn to supplements or foods to boost their fertility. Many supplements and foods are touted as ways to increase male fertility. While these are not going to cure specific medical conditions, they may help boost sperm quality and quantity.
Let’s take a look at what the research says about male fertility supplements, foods to increase male fertility, and what to expect when seeking answers to your fertility concerns.
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What is male infertility?
Male infertility means a man has a problem with his reproductive system which lowers the chances of his female partner getting pregnant. Male infertility is suspected if a man and a fertile female partner are not able to naturally start a pregnancy after a year of trying.
The common causes of male infertility include low semen quality, which is a measure of male fertility. Low semen quality can include low sperm count, sperm that aren’t moving well or have abnormalities, and blocked sperm ducts. Genetics, chronic health problems, age, injury, a lack of sleep, stress, and lifestyle choices such as smoking, drinking, diet, and exercise can all factor into male infertility (Leslie, 2021).
Male fertility and age
Like women, men do have a form of a biological clock. A male fertility age graph will show that as men age, fertility decreases. One study tracked sperm quality changes by age and found (Sharma, 2015):
- Age 34: Sperm count begins to decline.
- Age 43-45: Sperm motility (movement) and ejaculate volume decline.
Overall, research shows that it takes longer to get pregnant and the risk of birth defects slightly increases after the age of 40 (Sharma, 2015). That said, birth defects are rare and can happen at any age. If you’re trying to conceive with your partner, know that most men can be part of healthy pregnancies as they age (Fang, 2020).
Fertility tests for men
Waiting a year to see if you can achieve a pregnancy can be stressful and may not be practical. Reproductive health experts often suggest couples seek testing after six months of trying, especially if the female partner is over age 35 (ASRM, 2016).
Past or present medical conditions like an undescended testicle, a serious trauma to the testicles or problems with erectile dysfunction that’s limiting your ability to have sex are reasons to check in with a healthcare provider early on (Ferlin, 2020).
For men, initial fertility testing involves a conversation with a urologist, a physical exam, and a semen analysis. Here’s what to expect:
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This is usually a casual conversation about anything that may affect your fertility. It includes past injuries, surgeries, or sexually transmitted infections (STIs), which can damage testicles.
Overall health, exercise habits, diet, medications, and whether you smoke, use drugs, or drink a lot of alcohol are issues that can affect sperm quality. If you’re having problems with libido or erectile dysfunction, treatment can help increase the ability to have sex and conceive (Leslie, 2021).
A physical exam is used to identify conditions such as varicoceles (enlarged veins in the scrotum) or an undescended testicle. Both affect male fertility by warming the testicles, which can decrease sperm production (Leslie, 2021).
A semen analysis is the core male fertility test. If you’re having your semen quality checked, you’ll likely be asked to abstain from sex or masturbation for at least three days and provide a semen sample (during an office visit or quickly transported from home at room temperature within the hour). Sperm counts can vary, and a second sample is typically taken after at least a week if the first test showed abnormal results (Leslie, 2021).
Experts check the semen and the sperm and look at the following (Leslie, 2021):
- Semen volume
- Total sperm number
- Sperm concentration
- Vitality (percent of sperm alive)
- Movement of the sperm (motility)
- Shape of the sperm
At-home sperm tests
There are also a variety of home kits for testing sperm. An at-home male fertility test typically measures sperm count but does not look at overall sperm function. And a normal sperm count on its own doesn’t say a lot about male fertility. Some tests that involve mailing a semen sample to a lab show the shape and movement of sperm and may be able to flag more specific problems.
Overall, the tests can be helpful as a guide. But if you are concerned about achieving a quick pregnancy and want a complete fertility assessment, it’s best to see a specialist, who can run a series of tests like the ones mentioned above. (Leslie, 2021).
Semen without sperm (azoospermia): causes and treatments
If your healthcare provider finds that there is a low sperm count, no sperm (azoospermia), or abnormalities in shape or sperm movement, or if your medical history raises a red flag, they may suggest additional tests which could include one or more of the following (Leslie, 2021):
- Hormone test: Abnormal levels of hormones such as testosterone and follicle-stimulating hormone (FSH) can cause male infertility. A blood test can measure levels. In some cases, hormone treatment can trigger sperm production and reverse infertility.
- Anti-sperm antibody test: While it’s fairly uncommon, sometimes a man’s antibodies attack sperm. This can happen after testicular surgery, prostatitis, or anytime sperm comes in contact with blood. The test involves giving a semen sample which is tested for antibodies.
- Post-ejaculation urinalysis: A condition called retrograde ejaculation can cause sperm to travel backward into the bladder rather than out through the penis. Finding sperm in a urine sample is used to diagnose retrograde ejaculation, which can be caused by medical conditions, surgery, or taking certain medications.
- DNA integrity test: This type of test, also known as sperm DNA fragmentation (SDF) testing, looks at the quality of sperm. SDF can be observed even in men with normal semen analysis results. DNA damage can make it harder to conceive, reduce the chances of a successful pregnancy, and increase the risk of genetic diseases passed down to a child (Kim, 2018).
- Genetic test: If a sperm count is very low, there could be a genetic cause. A blood test can show any Y chromosome changes or any inherited conditions that may affect sperm production.
- Testicular biopsy: Checking for sperm using a needle biopsy may show that sperm production is normal and that a blockage may cause low sperm counts.
- Imaging tests: Imaging tests vary depending on what’s being checked. Scrotal ultrasound uses sound waves to check for problems such as varicocele.
How to increase male fertility
If a medical condition is the cause of male infertility, there may be a procedure, such as a varicocele repair or sperm duct resection, that may improve the chances of conception. In other cases, hormone therapy may help start-up sperm production.
Whether medical treatment is advised or not, fertility specialists usually encourage lifestyle changes that can increase male fertility. These start with a healthy diet, exercise, and weight loss if needed. Some advise the use of various supplements to boost the nutrients known to improve sperm quality. Below, we’ll dive deeper into how food, supplements, and lifestyle changes can help boost fertility in males.
Foods to increase male fertility
Sperm is made from proteins, cholesterol, and a lot of other nutrients that your body gets from foods. Some men facing infertility have low levels of nutrients like zinc, magnesium, calcium, copper, and selenium; others have poor diets full of fatty acids. Avoiding some foods and eating more of others might improve sperm quantity, mobility, and decrease sperm DNA fragmentation (Skoracka, 2020).
If you’re trying to increase male fertility, try to avoid processed meats, red meat, high-fat dairy, sweet drinks, salty and sweet snacks (if unhealthy ingredients), and trans-fats, which are often found in fast-food and packaged products. Trans-fatty acids have been linked to poor sperm quality, inflammation, oxidative stress, and lower testosterone levels (Skoracka, 2020).
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Here are some of the top foods to increase male fertility:
Fruits and vegetables
Studies show men who eat the most fruits and vegetables, which are high in antioxidants, have higher sperm concentration, vitality (live sperm), and motility compared to men who have a low intake of fruits and vegetables.
Nuts, seeds, and whole grains
Snacking on walnuts is good for sperm. In a small study, the men who ate 18 walnuts a day for 12 weeks had improved sperm vitality compared to those who ate no nuts (Robbins, 2012). A separate study looking at adding mixed tree nuts into a Western-style diet found that adding nuts improved the number of sperm, vitality, motility, and morphology of the sperm.
Seeds and whole grains are also a part of a ‘sperm healthy diet’ (Skoracka, 2020).
Fish and shellfish
Studies have shown eating fish is linked to better sperm movement and improved fertility. The benefits may be due to high omega-3 fatty acid levels in fish (Ricci, 2017). Shellfish is an important source of omega-3’s and zinc, which help produce and activate sperm (Maldonato-Carceles, 2019).
The Mediterranean diet: a “male fertility” diet
If you are looking to follow a specific diet to boost fertility, the Mediterranean diet may fit the bill. A 2019 study looking at eating a Mediterranean diet, which features large quantities of fruit and vegetables, whole grain products, olive oil, nuts, and fish, linked this diet to better sperm motility (Salas-Huetos-a, 2019).
A separate study of 225 men attending a fertility clinic with their partners showed that men eating a Mediterranean diet had a higher sperm count, higher number of normally shaped sperm, and increased sperm motility (Karayiannis, 2017).
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Male fertility supplements
A variety of dietary supplements have some evidence that they boost male fertility. Most are traditional vitamin or nutrient supplements that have antioxidant effects; others are herbal remedies that, in some cases, have antioxidants and also may boost the body’s testosterone production (Yao, 2016).
Because all are considered dietary supplements, they aren’t well-regulated by the FDA. So, the things they claim on their labeling are not proven (FDA, 2015). Finding well-researched supplements and talking to your healthcare provider is the best way to determine if a male fertility supplement will help you.
The following supplements are among the most researched for male fertility:
Vitamin & nutrient supplements
Vitamins, minerals, and amino acids show promise in boosting sperm quality and quantity. Many of these are antioxidants that may help protect against oxidative stress. Others appear to play roles in sperm production.
Since these supplements have few downsides, fertility specialists might suggest that men try them, since they may be helpful and are not considered harmful.
Herbal supplements for male fertility
For centuries men have used herbal remedies to treat infertility. And while the list of herbal supplements that may have fertility benefits is extensive, many of them do not have larger studies to back up their claims. What’s more, many supplements are linked to better sperm quality, but that doesn’t mean they can treat male infertility.
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Here are some of the herbal supplements with the most research behind them:
- Ashwagandha: A 2018 review of ashwagandha’s effect on male fertility found improvements in sperm counts and quality, along with increased hormone and antioxidant levels. But the researchers say the studies at hand are too small to draw conclusions about ashwagandha in the treatment of male infertility (Durg, 2018).
- Maca root: A number of studies have shown maca can help with libido, erectile dysfunction, and increase sperm concentration and mobility. It also has antioxidant properties (Zenico, 2009; Melnikova, 2015).
- Tribulus terrestris: Tribulus terrestris (TT) is a Mediterranean plant traditionally used to treat various ailments such as inflammation, swelling, cardiovascular disease, and male infertility. A 2019 review of studies showed it may improve sperm count, motility and morphology (Sanagoo, 2019).
While many herbal supplements have mild—if any—side effects, some can be dangerous for certain groups of people, like those with medical conditions. So, it’s best to talk about all supplements you plan on taking with your healthcare provider.
Lifestyle changes to boost fertility
Here are some other lifestyle changes that may give your fertility a boost:
Weight loss and male fertility
Increased adipose (fat) weight is linked to lower testosterone levels, poorer sperm quality, and reduced fertility compared to men of normal weight. One study shows the odds of infertility increase by 10% for every 20 pounds a man is overweight (Katib, 2015).
If healthy eating leads to weight loss, it may increase male fertility just by reducing body fat if there are no other medical problems. Excessive body weight also is linked to erectile dysfunction.
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Additional ways to increase male fertility
Increasing male fertility goes beyond a good diet and healthy weight. Here is a range of lifestyle factors that can help protect and enhance sperm production (Durairajanayagam, 2018; Leslie, 2021):
- Exercising regularly
- Getting enough sleep (poor sleep is linked to decreased sperm quality)
- Avoiding testicle injuries
- Avoiding anabolic steroids, which change hormone levels and can lead to low sperm count or no sperm
- Avoiding drugs and limiting alcohol (two drinks a day or less)
- Avoiding heating testicles (skip hot tubs, saunas, laptop computers on the lap)
- Reducing stress (psychological stress may decrease semen quality)
Many cases of infertility can be reversed and couples who don’t conceive naturally also have the option of assisted reproductive therapies such as in vitro fertilization.
If you’re a man who has not been able to conceive with your partner, reach out to your healthcare provider or a fertility specialist who can help you get to the bottom of your fertility problems.
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Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.