The Male Fertility Factor: What Every Couple Should Know Before They Start Trying
Here is a question I cannot stop asking: infertility affects men and women in almost equal measure, so why do we, as women, so often set about trying to "fix" ourselves first?
Because there is a hyper-focus on female fertility, and I have lived it. Cycle mapping, injecting hormones, invasive ultrasounds, endless specialist visits, that is just the tip of the iceberg. It can leave you worried, riding a hormonal rollercoaster, or simply burnt out. Our reproductive systems even have their own dedicated specialty. But are our male counterparts offered the same education, support and resources? Because it takes two to tango. Fertility is a team sport. So why does the conversation feel so relentlessly female?
What is male factor infertility?
On average, 40 to 50% of all infertility cases involve a "male factor" reproductive issue. To put that another way: the male partner is solely responsible in around 20% of cases, and a contributing factor in another 30 to 40%. This is not a small corner of the picture. It is roughly half of it.
Male factor infertility is usually down to one of three things:
- Low sperm count (not enough swimmers)
- Blockages (hurdles for the swimmers)
- Abnormal sperm function (swimmers who never took swimming lessons)
Here is the catch. Because the most common sign of male infertility is simply the inability to conceive, with no other obvious symptoms, many men are not prompted to look at their reproductive health until they are already trying for a baby and struggling. With far fewer cultural cues, conversations or check-ups encouraging men to understand their own fertility, many never go through the rigmarole of testing and treatment that women so readily volunteer for. For a lot of couples, the male factor is not even explored until the woman's reproductive health has been exhaustively investigated first. That order of operations is worth questioning.
What can affect male fertility?
Male reproductive health issues tend to fall into a few categories:
Difficulty conceiving
This can stem from an inherent disorder, a hormonal imbalance, dilated veins in the testes (a varicocele), or blockages in the reproductive tract.
Sexual function issues
Difficulty ejaculating, low ejaculate volume, low libido, and erectile dysfunction are all common examples.
Swelling in the testes
A lump, or other swelling or fluid in the testes, may interfere with the flow and delivery of sperm, and always warrants a check with a doctor.
Gynaecomastia
This swelling of breast tissue in men can be linked to reduced testosterone or increased oestrogen, and can be a visible signal worth investigating.
None of these are things to feel ashamed of, and most are far more common than men are led to believe. The first step is almost always a simple semen analysis, a straightforward test that tells you a great deal.
How can men improve their fertility?
The encouraging part is that male fertility is not fixed in place. Just as it is for women, much of it responds to the same everyday levers: what you eat, how you sleep, how you manage stress, and getting the right checks early. Sperm are produced continuously over roughly a three-month cycle, which means changes made today can show up in sperm health a few months down the track. Here is where to start.
What foods are good for sperm?
Just as it does for women, nutrition plays a role in male reproductive health, and several nutrients have been studied for their association with sperm health. It is worth saying clearly: these are nutrients research has linked to aspects of fertility, not magic fixes, and a man with fertility concerns should see a doctor rather than self-prescribing. With that framing, the nutrients most often studied include:
- Arginine and carnitine (amino acids), studied in relation to sperm count
- Selenium, which is involved in testosterone production
- Vitamins B5, C and E, which support healthy sperm development
- CoQ10 (an antioxidant), which has been studied in relation to pregnancy rates
- Zinc, which plays a role in sperm motility and the ability to fertilise
In food terms, that points to a diet rich in oily fish, eggs, leafy greens, nuts, seeds, shellfish and colourful vegetables, the same kind of whole-food eating that supports general health. A targeted supplement, chosen with professional guidance, can help where there is a genuine gap, but it is the overall pattern that matters, not any single "fertility pill."
Does stress affect sperm count?
It can. Oxidative stress has been shown to negatively affect the DNA within sperm, which can make fertilisation more difficult. Reducing oxidative stress, through the everyday levers of sleep, nutrition, movement and cutting back on smoking and excess alcohol, can support sperm health. Mental and physical health are not separate from fertility. They are part of it.
How long does it take to improve sperm health?
Because sperm regenerate over a roughly three-month cycle, most specialists suggest giving lifestyle changes at least three months before expecting to see a difference in a semen analysis. It is the same preconception window we talk about for women, which is rather the point: this is a three-month project couples can take on together, not a last-minute fix.
Why male fertility is still underdiagnosed and undertested
This, for me, is the heart of it. A UK study of 22 men who were experiencing infertility and going through IVF found that all of them had delayed seeking help. As the researchers put it: take into account that men are notoriously slow to seek medical help for ordinary complaints, then add the cultural baggage that ties fertility to male identity, and it is no surprise men are reluctant to take the first step.
That reluctance has a cost, and too often, women absorb it. Birth control management falls largely on our shoulders. Egg freezing is on the rise, while plenty of men quietly assume they will be able to procreate until they are 90. No wonder so many of us end up feeling solely responsible for fertility.
So here is my ask: can we share the load? Fertility is a team sport. It is time the conversation, and the care, reflected that.
moode answers your questions about male fertility
How common is male factor infertility?
Very. A male factor is involved in 40 to 50% of all infertility cases, with the male partner solely responsible in around 20% and a contributing factor in another 30 to 40%. It is roughly half the picture, which is exactly why both partners should be investigated, ideally at the same time.
What are the main causes of male infertility?
The three most common are low sperm count, blockages that prevent sperm being delivered, and abnormal sperm function (problems with how sperm move or are shaped). Underlying causes can include hormonal imbalances, a varicocele (dilated veins in the testes), infection, or lifestyle factors. A semen analysis is the usual starting point for identifying which is at play.
How can a man increase his sperm count naturally?
In many cases, lifestyle changes can support sperm health, since sperm are continually produced over roughly a three-month cycle. Better sleep, a nutrient-rich diet, regular movement, maintaining a healthy weight, and reducing smoking, excess alcohol and oxidative stress can all help. Where there is a specific medical cause, a GP or fertility specialist can advise on treatment.
When should a man get a fertility test?
Ideally, at the same time as his partner, rather than after every female avenue has been exhausted. If a couple has been trying to conceive for 12 months without success (or 6 months if the woman is over 35), both partners should be assessed. A semen analysis is simple, quick and genuinely informative.
Does age affect male fertility?
Yes, though more gradually than for women. Sperm quality, count and DNA integrity tend to decline with age, and older paternal age has been associated with longer time to conception and some health considerations. Men do not have a hard cut-off the way women approach menopause, but the "I have got until 90" assumption is not accurate either.
Jess Rosenberg is the founder of moode and a trained nutritionist and naturopath. She created The Prenatal after her own experience of pregnancy left her questioning the quality of what was available on the Australian market. Learn more about moode.
At moode, we talk a lot about preparing the body for pregnancy, and our prenatal is made for women. But preparation was never meant to be a solo project. If you are the one doing the cycle tracking, the appointments and the supplements, it is more than fair to ask your partner to get a simple semen analysis and look at their own health too. Fertility is a team sport, and sharing the load is good for both of you, and for the baby you are hoping to make.
Fertility is a team sport. It is time the conversation, and the care, reflected that.
