Guide to Sperm Improvement

Sperm count is the total number of sperm in the entire semen sample (one ejaculation). Sperm concentration refers to the number of sperm per unit volume (milliliter) of semen. For example, a sample may include 3 milliliters of semen and a total sperm count of 45 million; that would be a concentration of 15 million sperm per mL.

Normal values: At least 15 million sperm/mL of semen.

Possible issues: Having too little sperm in your semen is known as oligospermia; having no sperm at all is known as azoospermia. These can both contribute to male-factor infertility.

Motility refers to the ability of the sperm to move or “swim” through the female reproductive system, which is essential to reach and fertilize the egg and is another crucial sperm quality parameter. Progressive motility means the sperm move forward in straight lines or in large circles, as opposed to in tight circles or along erratic paths.

Normal values: Motile sperm, at least 40%; progressively motile sperm, at least 32%.

Possible issues: Poor sperm motility, diagnosed when there’s a low percentage of motile sperm, is known as asthenospermia/asthenozoospermia. This is one of the most common male-factor infertility issues. However, sperm motility improvement can be accomplished with male fertility supplements and lifestyle changes.

Morphology means the sperm’s structure or shape, which is ideally a smooth oval head; a well-defined acrosome, or cap, that covers 40–70% of the head; and a long tail with no visible abnormalities. This shape is an important factor in sperm quality because it impacts a sperm’s ability to travel to and fertilize to the egg. Sperm morphology can be assessed using either the stricter Kruger criteria, or using the World Health Organization (WHO) criteria, which is more lenient.

Normal values: At least 4% normal forms

Possible issues: Poor sperm morphology, as evidenced by a low percentage of normal sperm, is another common male-factor infertility issue known as teratozoospermia. Lifestyle changes, such as quitting smoking and reducing drinking, can lead to overall sperm quality improvement and sperm morphology improvement.

DNA fragmentation refers to the degree of damage to the genetic material carried by sperm, such as separation or breaking of DNA strands into pieces. If the sperm contains a lot of DNA that’s broken or unstable, it may be more difficult for it to fertilize an egg, or it may increase the chances of miscarriage or birth defects. Research is still ongoing in order to fully understand the effects of DNA fragmentation of fertilization and fertility.

Normal values of DNA fragmentation index (DFI): Depends on testing; usually the “normal” cutoff is 30% using the SCSA test. DNA fragmentation is not usually tested as part of a typical semen analysis, but can outline the best next steps towards sperm improvement and sperm quality improvement.

Learn more about sperm DNA fragmentation.

Sperm are a key component of fertility in cisgender men and other people with sperm. Without at least some healthy sperm, you most likely won’t be able to achieve pregnancy, and you might need medical intervention and/or assisted reproductive techniques (ART) such as intrauterine insemination (IUI) or in vitro fertilization (IVF) to treat male-factor infertility.

Some emerging research is illuminating the relationship between sperm health, natural conception rates, risk of miscarriage, and the success of ARTs.

Male-factor infertility is solely responsible for 20–30% of infertility cases, and contributes to up to 50% of overall cases. Some studies have reported a drop of sperm counts by up to 50% in the past four decades. Researchers have proposed that pollution, diet, lifestyle, or exposure to chemicals that disrupt the endocrine system, among many other factors, could be to blame for decreased sperm quality.

The good news is that you are creating millions of sperm every single day; it takes about 74 days on average for the process of spermatogenesis to go from stem cell to final, mature sperm cell. So, if you make positive lifestyle changes, you could see sperm quality improvement within a few months.

Studying the impact of diet on male fertility is a complex process, and is still not fully elucidated. The difficulty of evaluating the exact composition of a person’s diet and accounting for all possible variables has resulted in a scarcity of strong evidence about how nutrition affects sperm health and sperm quality. However, the available data show that certain dietary patterns can be associated with worse or better semen parameters.

The common “Western” diet — high in fried foods, refined grains, added sugars, and red meat — is associated with lower sperm counts and concentration and reduced sperm motility and normal morphology. In general, diets high in processed meats, such as hot dogs and cold cuts, are associated with lower sperm morphology. The consumption of trans fats, found in partially hydrogenated vegetable oils like margarine as well as in animal products, has also been associated with lower sperm concentrations. Diets high in added sugars are also associated with lower progressive sperm motility.

On the other hand, a diet high in fish, lean poultry, fruits and vegetables, legumes, and whole grains has been shown by multiple studies to be associated with improved sperm health, including better sperm motility. The “Mediterranean diet,” modeled on what’s traditionally eaten in Italy and Greece (primarily fruits and vegetables, seafood, healthy fats, and whole grains) is one example of a diet that has the potential to lead to sperm quality improvement, according to several studies.

We know that fruits and vegetables are key for sperm health and sperm quality, as they’re an excellent source of many of the vitamins, antioxidants, and nutrients required for the body to create healthy sperm, such as folic acid, vitamin C, vitamin E, and other antioxidants. Men who eat higher amounts of fruits and vegetables, particularly leafy greens, have a better chance of having higher sperm concentrations and improved motility.

The best potential sperm improvement diet is high in:

• Fruits and vegetables, specifically leafy greens and cruciferous vegetables like broccoli and Brussels sprouts
• Nuts and seeds such as walnuts, Brazil nuts, and pumpkin seeds
• Fatty fish such as salmon

And low in:

• Soy products
• Processed meats
• Red meat
• Added sugars
• Trans fats

Cigarette smoking has long been considered one of the leading risk factors in male-factor infertility. A 2016 review examined 20 different studies of tobacco use and its effects on sperm health, and found that smoking was associated with significantly reduced sperm count and motility — and that the more you smoke, the stronger these effects are. This was reinforced by a 2019 review that found a strong correlation between smoking and low sperm count/poor morphology.

According to the American Society for Reproductive Medicine (ASRM), infertility rates among smokers (both male and female) are twice as high as among non-smokers. Additionally, because smoking has the potential to damage the genetic health of sperm, those who smoke have a higher risk of having difficulty conceiving naturally, parenting a pregnancy that ends in miscarriage, or going through an unsuccessful IUI or IVF cycle.

If you quit smoking, there’s evidence that it can lead to sperm improvement. In one follow-up study of men who quit smoking, sperm motility improvement and morphology improvement was noted within an average of six months. Research shows that former smokers who quit more than six months ago have similar semen parameters to non-smokers.

Learn more about smoking and sperm health and how tobacco can impact sperm quality.

The relationship between alcohol consumption and sperm quality is a bit complex. We do know that high alcohol consumption is associated with decreased sperm health and sperm quality, with negative impacts on all sperm parameters. Habitual binge drinking is especially detrimental to sperm health — in one study, men who drank more than 40 drinks per week had a 33% reduction in sperm concentration compared to men who drank fewer than 5 drinks per week.

However, it may not be necessary to completely remove alcohol from your life in order to improve your sperm quality. It’s actually possible, according to some research, that some alcohol consumption may actually have fertility benefits (experts hypothesize that’s because some alcohol, like wine and whiskey, contains antioxidants).

Additionally, it appears that occasional and social drinking has no significant impact on sperm health and sperm quality. If you’re looking for sperm improvement, you should consider limiting alcohol consumption to fewer than 5 drinks per week.

Learn more about drinking and sperm health and how alcohol can impact sperm quality.

Anabolic steroids, also known as “performance-enhancing” drugs, are typically natural or synthetic forms of testosterone, often used to rapidly increase muscle mass. It might seem that — since testosterone is the hormone that controls the male reproductive system — adding testosterone to the body would improve fertility.

In fact, the opposite is true. Injecting additional testosterone actually causes the body to believe there’s enough testosterone. This signals the testes to stop the internal production of testosterone, which has long-term detrimental effects on spermatogenesis and sperm quality.

Long-term use of steroids is associated with drastically lower percentages of motile and morphologically normal sperm, reaching zero sperm count in many instances. For many steroid users, sperm improvement can be seen within 4–12 months of stopping the drugs; this recovery process can be assisted with certain medications.

However, a subgroup of men might have irreversible damage to their sperm production despite all medical interventions. Some users experience steroid-induced “hypogonadism,” or a shutdown of the function of the testes, which produce testosterone and are responsible for creating sperm.

Avoiding – or stopping – steroids can lead to male fertility improvement as well as sperm quality improvement.