Lifestyle Interventions

For men, excess weight creates an oxidative stress that can cause subtle damage to sperm and affect fertility as well as decreased pregnancy rates with IVF or ICSI.  Regardless of how you lose weight (GLP-1s, exercise, better diet) all appear to provide benefit.  In addition, having a diet richer in fruits and vegetables is recommended (avoiding meats and fats, that have oxidative effects.). Men with more fruits and vegetables in the diet tend to have better sperm production (and quality) than men with diets packed with meats/fats.

Exercise is better for sperm production than a sedentary lifestyle, but there are limits to the benefits of exercise.  Men who exercise more than 45 minutes a day (e.g., marathon-level training) is associated with decreased sperm production.  In addition, bicycle riding (including stationary bikes, such as Peloton) is associated with lower sperm production.  It is recommended to optimize fertility with regular exercise, at least three times a week, with up to 45 minutes per day.  Weight training vs. cardiovascular doesn’t seem to have different effects on fertility; both are beneficial.

Avoiding excess external heat (e.g., saunas, jacuzzis, hot tub) is important as testes are sensitive to heat (higher heat decreases sperm production and quality.). The clothes that you wear generally don’t have a significant effect on sperm production, but heat in the scrotum increases significantly if you keep your legs together (e.g., when holding a laptop computer on your legs) versus when legs are farther apart.  So, both boxers and briefs are reasonable, but it’s important that the testes can move and regulate their temperature regardless of the type of underwear worn.

There are no antioxidant treatments proven to enhance male fertility, but sperm are very sensitive to, and can be easily damaged by oxidative activity.  With this background, there are a wide variety of antioxidant supplements and vitamins offered to support sperm quality.  We recommend the Theralogix products of Conception XR motility formula and NeoQ10 since they are prepared with higher standards than at some nutraceutical firms and have the components best shown to protect sperm.  Nutrients that are helpful can also be obtained by eating a cup of walnuts, almonds, Brazil or hazelnuts, although these foods are fairly rich in calories.  Oysters provide zinc that is concentrated in semen, and fatty fish provides omega-3 oils that are helpful antioxidants as well.

Having regular sleep patterns, 7-9 hours per day, controlling stress in your life, and limiting caffeine to 1-2 drinks per day is also helpful to optimize sperm production.  Obviously, cigarette smoking, marijuana, and alcohol intake over 2 drinks per day have demonstrated adverse effects on sperm and male fertility.  Alcohol intake cannot be averaged over a week; more than 2 drinks per day can have direct adverse effects for several months.