Guide to Sperm Improvement

When it comes to sperm improvement, there’s a lot you can do on your own—simple lifestyle changes that can have a big impact on your sperm health. This guide will explain the research behind sperm improvement, and provide some steps you can take to optimize your fertility.

Sperm basics
Components of sperm

Sperm is the male sex cell, also known as a gamete. Sperm cells are composed of a few distinct parts:

  • the tail, made of protein fibers, which helps it “swim” toward the egg
  • the midpiece, or body, which contains mitochondria to power the sperm’s movement
  • the head, which houses the nucleus where the sperm’s precious cargo—genetic information—is stored, as well as the acrosomal vesicle, a tiny structure at the tip of the sperm full of enzymes that helps the sperm penetrate the egg by digesting proteins and sugars on the surface of the egg.

Each sperm cell contains 23 chromosomes, which is half the number of chromosomes in a typical human cell; it’s known as a “haploid” cell. A chromosome is a molecule of DNA, the material that guides the growth and development of the entire human body. The egg contains the other half. Together, they create a fully realized cell of 46 chromosomes (known as a “diploid” cell), which then divides to become all of the other cells in the body. The fact that half of our DNA comes from the sperm and the other half from the egg is why we inherit some traits from each of our parents.

Sperm are produced in the testes (testicles) in a process called spermatogenesis, which takes about 74 days (1). Approximately 50–100 million viable sperm are produced by the testes each day (2). Spermatogenesis begins at puberty and continues, typically uninterrupted, until death. There is, however, changes in the health and quantity of the sperm with age.

Sperm parameters

There are several characteristics that can indicate the health of sperm and overall male fertility. Understanding which sperm improvements you may want to make will start with understanding these characteristics of male fertility.

Sperm count and concentration

Sperm count is the total number of sperm in a particular quantity of semen, the fluid that carries sperm out of the penis. Sperm concentration refers to how densely packed those sperm are within the 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.

Having too little sperm in your semen is known as oligospermia; having no sperm at all is known as azoospermia.

Sperm motility

Motility refers to the ability of the sperm to move or “swim,” which is essential for them to move through the female reproductive system and fertilize the egg. Progressive motility is the best type of movement that can be seen in sperm testing—that means the sperm move forward in straight lines or in large circles, as opposed to in small tight circles or along erratic paths.

Poor sperm motility, diagnosed when there’s a low percentage of motile sperm, is known as asthenospermia/asthenozoospermia.

Sperm morphology

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
  • a long tail with no visible abnormalities

This shape is important because it impacts a sperm’s ability to travel to and penetrate an egg. Poor sperm morphology, as evidenced by a low percentage of normal sperm, is known as teratozoospermia.

Sperm testing

The best way to test your sperm health, and understand any sperm improvements you may need to make, is to do a semen analysis. This test involves providing a semen sample, collected via masturbation, to a lab. There, it will be examined under a microscope to determine your sperm count/concentration, what percentage of your sperm are motile, and your ratio of properly formed sperm.

The test can be done in a fertility clinic or urologist’s office, or can be done from the comfort and privacy of home with a mail-in sperm testing kit, like we offer. The results of your semen analysis will tell you which of your sperm parameters are normal, and which (if any) are abnormal. The Legacy semen analysis report also includes personalized recommendations for sperm improvement, based on your lifestyle.

Why improve your sperm health?

Sperm are a key component of fertility in men. Without at least some healthy sperm, you won’t be able to create a healthy pregnancy without medical intervention. Male fertility issues contribute to at least 30% of diagnosed infertility cases, and in the past four decades, sperm counts have dropped about 50% (3). Researchers have proposed that pollution, diet, lifestyle, or exposure to chemicals that disrupt the endocrine system could be to blame.

Additionally, emerging research is illuminating the relationship between sperm health and miscarriage, suggesting that poor sperm motility and morphology may be a contributor to pregnancy loss (14).

The good news is that you are creating new sperm every single day; it takes about 74 days 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 improvements in sperm health within a few months.

What impacts male fertility—and what changes can I make to improve my sperm health?
Diet and sperm health

An extensive body of research tells us that a man’s diet has a significant impact on his sperm health. Unfortunately, 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 (4). In general, diets high in processed meats, such as hot dogs and cold cuts, are associated with lower sperm morphology (5). Diets high in added sugars are also associated with lower progressive sperm motility (6).

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 (7, 8) 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 improve sperm health (9, 10).

We know that fruits and vegetables are key for sperm health, as they’re an excellent source of many of the vitamins and nutrients required for the body to create healthy sperm, such as folic acid, vitamin C, and antioxidants.

Changing your diet for sperm improvement

The best diet for sperm improvement 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:

  • Processed meats
  • Red meat
  • Added sugars
Exercise and sperm health

Approximately a quarter of Americans live a sedentary lifestyle, meaning they don’t regularly engage in physical activity and have jobs that involve lots of sitting. We know that a sedentary lifestyle has a negative impact on fertility (in addition to many other elements of overall health), and that regular exercise is associated with improved sperm health.

In one study of sperm donors, those who spent more time engaging in physical activity had increased progressive motility (20). In another, physically active men were shown to have improved sperm motility and morphology as well as healthier hormone profiles for fertility (including higher levels of testosterone, the hormone which drives the male reproductive system) when compared to their more sedentary counterparts (17).

Some of the sperm improvements found with exercise may come from shedding excess weight. Being overweight or obese has been associated in research with lower sperm count/concentration and decreased motility.

Read more on the impact of exercise on sperm health.

Exercising for sperm improvement

Embarking on an exercise routine can have a remarkable improvement on sperm health. One study demonstrated that a 16-week aerobic training program, consisting of hour-long workouts on a treadmill three times a week, improved the sperm count, motility and normal morphology of obese patients (19). It’s been shown that exercise can improve sperm parameters significantly in as little as a few months.

What type of exercise is best for sperm improvement? In one study, men who practiced physical activities such as cycling, running, or swimming for more than 2 hours per occasion at least 3 times per week had better sperm motility and morphology, and lower levels of dead or dying sperm in their semen samples (16).

Another study measured the sperm improvement impact of several exercise regimens:

  • Moderate intensity continuous training (30–60 minutes of walking or jogging, 4–6 times per week)
  • High intensity continuous training (40–50 minutes of running, 3 times per week)
  • High intensity interval training (alternating sprinting and recovery for 20–40 minutes, 3 times per week)

The study found that, while all of the exercise regimens had positive effects on sperm health, the best exercise method for sperm improvement was moderate intensity continuous training (21). This suggests that sperm improvement can be seen by adopting the simple habit of walking or jogging most days of the week.

Smoking and sperm health

Cigarette smoking has long been considered one of the leading factors contributing to male infertility. A 2016 review examined 20 different studies of tobacco use and its effects on sperm health, and found that sperm count and motility were both significantly reduced by smoking—and that the more you smoke, the stronger these effects are (25). This was reinforced by a similar 2019 review that found a strong correlation between smoking and low sperm count/poor morphology (23).

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 damages the genetic health of sperm, those who smoke have a higher risk of parenting a pregnancy that ends in miscarriage or having a baby with birth defects (24).

If you quit smoking, there’s evidence that your sperm health can improve fairly quickly. In one follow-up study of men who quit smoking, sperm motility and morphology began to return to normal within six months. And research shows that former smokers who quit more than six months ago have similar semen parameters to non-smokers (25).

Alcohol and sperm health

The relationship between alcohol consumption and sperm health is a bit complex. We do know that high alcohol consumption is associated with decreased sperm health, 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 (26).

However, it’s not necessary to completely remove alcohol from your life in order to improve your sperm health. It’s actually possible, according to a few studies, that some alcohol consumption may actually improve fertility (researchers hypothesize that’s because some alcohol, like wine and whiskey, contains antioxidants) (28, 29). Additionally, it appears that occasional drinking has no significant impact on sperm health (30). If you’re looking to improve your sperm health, you can feel comfortable limiting your alcohol consumption to fewer than 5 drinks per week. 

Anabolic steroids and sperm health

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, so it signals the testes to stop producing the hormone.

Long-term use of steroids is associated with drastically lower percentages of motile and morphologically normal sperm (22). For many steroid users, sperm health improvement can be seen within 4–12 months of stopping the drugs. But some users experience steroid-induced “hypogonadism,” or a shutdown of the function of the testes, which produce testosterone and are responsible for creating sperm (22).

Sperm improvement medication

If you have low sperm count or poor motility/morphology and you’ve attempted sperm improvement on your own without any change, it may be time to see a specialist. Fertility specialists (reproductive endocrinologists) and urologists both treat fertility issues, and can help diagnose male infertility problems and treat them medically.

While fertility medication is often thought of as something women are prescribed, there are actually a few medications that are effective for male fertility and sperm health. These aren’t solutions you can undertake on your own. These medications are prescribed by a doctor for specific diagnosed causes of reduced fertility.

Three of the most common medications for sperm improvement:

Clomiphene citrate (or “Clomid”) is an estrogen blocking medication that, when used to treat male infertility, can increase levels of testosterone, luteinizing hormone, and follicle-stimulating hormone—all of which contribute to the production of sperm. Clomid has been shown to improve sperm count/concentration and motility in some men experiencing reduced fertility (31).

Anastrozole is a medication that has a similar effect, decreasing estrogen levels and increasing levels of testosterone, FSH, and LH to support sperm production. This medication may help improve sperm health for those who have low sperm count, and has been shown to improve sperm motility as well (32).

Finally, human chorionic-gonadotropin (hCG) and human menopausal gonadotropin (hMG) are two injectable hormone medications also used to treat hormone imbalances in testosterone and LH that lead to low sperm count and other fertility issues (33).

References:

  1. Kinetics of the germinal epithelium in man: https://eurekamag.com/research/024/923/024923058.php
  2. Fertility and the Aging Male: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3253726/
  3. Temporal trends in sperm count: a systematic review and meta-regression analysis: https://www.ncbi.nlm.nih.gov/pubmed/28981654
  4. Association of Dietary Patterns With Testicular Function in Young Danish Men: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2761546?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=022120#zoi190810r32
  5. Meat intake and semen parameters among men attending a fertility clinic: https://www.fertstert.org/article/S0015-0282%2813%2902544-2/fulltext
  6. Sugar-sweetened beverage intake in relation to semen quality and reproductive hormone levels in young men: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4168308/
  7. Dietary patterns and semen quality in young men: https://www.ncbi.nlm.nih.gov/pubmed/22888168/
  8. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies: https://www.ncbi.nlm.nih.gov/pubmed/28333357
  9. Association between adherence to the Mediterranean diet and semen quality parameters in male partners of couples attempting fertility: https://www.ncbi.nlm.nih.gov/pubmed/27994040
  10. Mediterranean and western dietary patterns are related to markers of testicular function among healthy men: https://www.ncbi.nlm.nih.gov/pubmed/26409012
  11. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies: https://www.ncbi.nlm.nih.gov/pubmed/28333357
  12. Diet and men’s fertility: does diet affect sperm quality?: https://www.fertstert.org/article/S0015-0282(18)30426-6/fulltext
  13. Nutritional modifications in male infertility: a systematic review covering 2 decades: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4892303/
  14. Assessment of sperm factors possibly involved in early recurrent pregnancy loss: https://www.ncbi.nlm.nih.gov/pubmed/19540481
  15. America’s Health Rankings, Physical Inactivity: https://www.americashealthrankings.org/explore/annual/measure/Sedentary/state/ALL
  16. Physically Active Men Show Better Semen Parameters than Their Sedentary Counterparts: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582143/
  17. Physically active men show better semen parameters and hormone values than sedentary men: https://www.ncbi.nlm.nih.gov/pubmed/22234399
  18. Body mass index effects sperm quality: a retrospective study in Northern China: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5312225/
  19. Exercise improved semen quality and reproductive hormone levels in sedentary obese adults: https://www.ncbi.nlm.nih.gov/pubmed/28627195
  20. Physical activity and sedentary time in relation to semen quality in healthy men screened as potential sperm donors: https://academic.oup.com/humrep/article-abstract/34/12/2330/5681530?redirectedFrom=fulltext
  21. The effects of three different exercise modalities on markers of male reproduction in healthy subjects: a randomized controlled trial: https://rep.bioscientifica.com/view/journals/rep/153/2/157.xml
  22. Anabolic steroids and semen parameters in bodybuilders: https://www.ncbi.nlm.nih.gov/pubmed/2512180
  23. Tobacco smoking and semen quality in infertile males: a systematic review and meta-analysis: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-018-6319-3
  24. Smoking and Infertility: https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/smoking-and-infertility/
  25. The impact of cigarette smoking on human semen parameters and hormones: https://www.ncbi.nlm.nih.gov/pubmed/12042277
  26. Habitual alcohol consumption associated with reduced semen quality and changes in reproductive hormones; a cross-sectional study among 1221 young Danish men: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185337/
  27. Association between socio-psycho-behavioral factors and male semen quality: systematic review and meta-analyses: https://www.fertstert.org/article/S0015-0282(10)00984-2/fulltext
  28. Mini-review of studies on the effect of smoking and drinking habits on semen parameters: https://www.ncbi.nlm.nih.gov/pubmed/15330386?dopt=Abstract
  29. Alcohol intake and semen variables: cross‐sectional analysis of a prospective cohort study of men referring to an Italian Fertility Clinic: https://onlinelibrary.wiley.com/doi/full/10.1111/andr.12521#andr12521-bib-0026
  30. Semen quality and alcohol intake: a systematic review and meta-analysis: https://www.ncbi.nlm.nih.gov/pubmed/28029592?dopt=Abstract
  31. Effect of clomiphene citrate on sperm density in male partners of infertile couples: https://www.ncbi.nlm.nih.gov/pubmed/18175667
  32. Aromatase inhibitors for male infertility: https://www.ncbi.nlm.nih.gov/pubmed/11792932
  33. Medical treatment of male infertility: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4708300/