Statistically, in two in every three couples that are having trouble conceiving a child—or ten percent of all couples—all or part of the problem is with the male partner. Male fertility is surprisingly sensitive. In healthy men, only 14 percent of sperm are properly motile and the right size and shape to function properly, and almost any illness anywhere in the body can reduce fertility from that baseline. Some kinds of lubricants can impede sperm movement, particularly if they aren’t labeled as sperm-safe. Smoking, drinking, and drugs—including prescription medications such as antibiotics and anti-hypertension drugs—can also have an effect. Other things that can harm male reproductive health include exposure to heat, obesity, poor diet, environmental contaminants such as lead or mercury, regular marijuana use, advanced age, and, counterintuitively, some genetic factors.
In addition to these general health and lifestyle factors, some specific issues affect the reproductive system in men directly. Certain sexually transmitted infections, such as gonorrhea and chlamydia, can cause damage, as can mumps when it leads to inflamed testicles, though this is rare because an effective long-term vaccine for mumps has been available since 1978. In rare cases, the body’s own immune system attacks the sperm as invaders.
Fortunately, there are treatments that can help. Even something as simple as dietary supplements can help. Folic acid, coenzyme Q10, and vitamin E are good for your overall health, and if you think you need a fertility boost, there’s no harm in trying that approach without having to talk to a doctor. Losing weight and transitioning to a primarily plant-based diet that’s low in fat will also improve your overall health even if it doesn’t help you with fatherhood, as can quitting smoking.
If a more aggressive approach is required, there are treatment options available. If the problem is caused by an infection, treating the infection usually restores fertility. If there’s an obstruction, surgery may be needed to remove it. Other conditions that reduce fertility can also be addressed with surgery. In-vitro fertilization can help overcome the luck factor exacerbated by low sperm count.