Male Fertility

This article includes references about many of the known factors that affect sperm quality and quantity. Published in IVF Friends Newsletter in June 2005.

There have been many studies suggesting that human male sperm count and quality have been declining since the middle of last century1,2 and there has been a lot of research on the topic. Whilst some studies show no decline in certain groups3, most reveal a very concerning trend and a great need to discover more. It appears this decline is multifactorial and has lifestyle, environmental and nutritional aspects.

It is well known that cigarette smoking is a significant contributor to male infertility. Many studies have shown its effects on sperm, including decreased count, motility and density4,5. The implications of caffeine consumption were discussed in a previous article.

Some studies show that alcohol does not contribute to male infertility 5 but others suggest it is significant 6,7,8. One of these reported: “Alcohol can interfere with the function of each of these components, thereby causing impotence, infertility, and reduced male secondary sexual characteristics. In the testes, alcohol can adversely affect the Leydig cells, which produce and secrete the hormone testosterone. Studies found that heavy alcohol consumption results in reduced testosterone levels in the blood. Alcohol also impairs the function of the testicular Sertoli cells that play an important role in sperm maturation. In the pituitary gland, alcohol can decrease the production, release, and/or activity of two hormones with critical reproductive functions, luteinizing hormone and follicle-stimulating hormone. Finally, alcohol can interfere with hormone production in the hypothalamus.”7

Factors that are becoming more apparent in recent times are the many environmental factors affecting sperm quality. These include exposure to substances commonly found in our environment and household products8,9. There are many chemicals surrounding us that cause disruption to human hormones, some of which are the group of chemicals to which there is highest human exposure, the phthalates 8. Phthalates are used extensively in manufacturing, especially in cosmetics, perfumes and plastics. Others hormone disrupters include PCBs, DDT and DDE and lead8,9,10,11. There are a plethora of ways in which chemicals can interfere with the human hormones and this has a rippling or cascade effect of many functions of the body. It is becoming clear that some of the effects occur in utero, when the reproductive system is forming8,9.

There are several nutritional factors that impact on male fertility. The benefits of zinc, folic acid, antioxidant and omega 3 essential fatty acid supplementation have been shown to improve male subfertility12,13, as well as some herbal medicines14.

There is much more research needed before we fully understand the implications of environment, lifestyle and nutrition on male fertility. I always look at idiopathic male (and female) infertility as a jigsaw puzzle - whilst there is no single cause for the problem, if many small pieces that can be put into place, the whole picture becomes clearer. Apart from the obvious and well known ways of improving male fertility (such as not smoking, limiting alcohol intake, reducing scrotal heat exposure and taking certain nutritional supplements) there are some other treatments that may assist in the holistic management of male infertility.


1. Colburn, T., Dumanoski, D. and Myers, J. (1996). Our Stolen Future. London: Abacus.

2. Jensen TK, Carlsen E, Jorgensen N, Berthelsen JG, Keiding N, Christensen K, Petersen JH, Knudsen LB, Skakkebaek NE. (2002). ‘Poor semen quality may contribute to recent decline in fertility rates’. Hum Reprod. 17(6): 1437-40.

3. Costello MF, Sjoblom P, Haddad Y, Steigrad SJ, Bosch EG. (2002). ‘No decline in semen quality among potential sperm donors in Sydney, Australia, between 1983 and 2001’. J Assist Reprod Genet. 19(6): 284-90.

4. Kunzle R, Mueller MD, Hanggi W, Birkhauser MH, Drescher H, Bersinger NA. (2003). ‘Semen quality of male smokers and nonsmokers in infertile couples.’ Fertil Steril. 79(2): 287-91.

5. Curtis KM, Savitz DA and Arbuckle TE (1997). ‘Effects of cigarette smoking, caffeine consumption, and alcohol intake on fecundability’. American Journal of Epidemiology, 146 (1): 32-41.

6. Tsujimura A, Matsumiya K, Takahashi T, Yamanaka M, Koga M, Miura H, Nishimura K, Takeyama M, Fujioka H, Okamoto Y, Iwamoto T, Okuyama A. (2004). Effect of lifestyle factors on infertility in men. Arch Androl. 50(1): 15-7

7. Emanuele MA, Emanuele NV. (1998). Alcohol's effects on male reproduction. Alcohol Health Res World. 22(3): 195-201.

8. Sharpe RM & Franks S. (2002). ‘Environment, lifestyle and infertility — an inter-generational issue’. Nature Cell Biology 4 (S1), S33-S40

9. Fisher JS. (2004). Environmental anti-androgens and male reproductive health: focus on phthalates and testicular dysgenesis syndrome. Reproduction. 127(3): 305-15.

10. De Rosa M, Zarrilli S, Paesano L, Carbone U, Boggia B, Petretta M, Maisto A, Cimmino F, Puca G, Colao A, Lombardi G. (2003) ‘Traffic pollutants affect fertility in men’. Hum Reprod. 18(5): 1055-61.

11. Duty SM, Silva MJ, Barr DB, Brock JW, Ryan L, Chen Z, Herrick RF, Christiani DC, Hauser R. (2003). Phthalate exposure and human semen parameters. Epidemiology. 14(3): 269-77.

12. Comhaire FH, Mahmoud A. (2003). The role of food supplements in the treatment of the infertile man. Reprod Biomed Online. 7(4): 385-91.

13. Wong WY, Merkus HM, Thomas CM, Menkveld R, Zielhuis GA, Steegers-Theunissen RP. (2002). ‘Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial’. Fertil Steril. 77(3): 491-8.

14. Adimoelja A. (2000). ‘Phytochemicals and the breakthrough of traditional herbs in the management of sexual dysfunctions’. Int J Androl. 23 Suppl 2: 82-4.

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