Introduction
Male reproductive health is important aspect of men’s overall wellness. When pregnancy does not occur as desired, the reasons may be related to male partner, female partner or both.
The World Health Organization (WHO) defines infertility as a disease of the reproductive system of either males or females characterised by the failure to establish a clinical pregnancy after 12 or more months of regular, unprotected sexual intercourse. Male infertility can be caused by problems with sperm production, sperm function, semen delivery, hormonal regulation, reproductive anatomy, or other underlying causes.
Sperm health is an important aspect of the assessment of male reproductive function. Information from measurements such as sperm concentration, total sperm count, motility, morphology and semen characteristics can be useful, but no single measurement can determine fertility on its own.
Research also indicates that reproductive health can be affected by modifiable lifestyle factors. Diet, body weight, physical activity, smoking, alcohol intake, sleep, stress, heat and environmental exposures have been examined for possible association with semen quality.
By understanding these factors, men can make informed choices that support overall health and reproductive wellness, while acknowledging that persistent fertility concerns require professional medical evaluation.
What is Male Fertility?
Male fertility is the ability of a man to produce sperm capable of fertilising an egg and is influenced by many factors such as genetic abnormalities, diseases, environmental agents and lifestyle choices. Male fertility is often evaluated by a semen analysis, which considers a range of parameters such as sperm count, concentration and motility. [1]
Male fertility is broadly defined as the biological ability to contribute to conception. Successful reproduction requires several processes:
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Production of sperm in the testicles
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Sperm development and maturation
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Sperm normal motility
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Sperm structure normal
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Sperm transport through the female reproductive tract
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Semen collection
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Sperm–female reproductive tract interactions
WHO defines infertility as failure to conceive after 12 months or more of regular unprotected sexual intercourse. Importantly, infertility can be male, female, combined or unexplained.
So, difficulty to conceive should not automatically be blamed on the man or woman alone. If male factors are suspected, healthcare professionals may assess medical history, lifestyle factors and semen parameters, as well as other investigations when appropriate.
Understanding Sperm Health
Sperm health is not determined by a single number. Semen analysis is required that essentially used to check the fertility of a man, especially when couples are having difficulties conceiving. Studies concerning male fertility, testicular factors, and seminal characteristics have been under investigation for the last few decades. Various Parameters are included in semen analysis like:
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Sperm Concentration
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Total Sperm Count
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Sperm Motility
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Sperm Morphology
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Semen Volume
Healthy sperm will improve your chances of conceiving and your baby's health. [2]
Few Semen Nomenclatures According to WHO 2021 [3]
|
Nomenclature |
Definition |
|
Azoospermia |
Absence or complete lack of spermatozoa in the ejaculate |
|
Oligozoospermia |
Sperm count less than 15 million per ml |
|
Teratozoospermia |
having less than 4% of sperm with normal morphology |
|
Asthenoteratozoospermia |
having a count of total motile sperm less than 42%, or that of progressive motile sperm less than 30% |
|
Oligoasthenoteratozoospermia (OAT) |
less than 15 million sperm/mL, less than 42% total motility, and less than 4% of normal morphology |
|
Oligoasthenozoospermia |
Having less than 4% normal morphology of sperm and less than 15 million sperm per ml |
|
Oligoteratozoospermia |
Having less than 4% normal morphology and less than 15 million sperm per ml |
|
Asthenoteratozoospermia |
having less than 42% of all motile sperm and less than 4% of sperm with normal morphology |
|
Normozoospermia |
having semen parameters (≥15 million sperm/mL, ≥40% overall motility, and ≥4% normal morphology) |
|
Severe OAT |
Total no of sperm <5 million sperm/ml, with <4% morphology and <32% progressive motility |
|
Severe oligoteratozoospermia |
Total no of sperms <5% millions/ml |
Factors Affecting Sperm Health
Sperm is produced in the testes (testicles). They travel through the male reproductive system and mix with fluid (semen) made by the prostate gland and organs called the seminal vesicles. Sperm are ejaculated during orgasm. 
The health can be affected by:
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Age: If you are over 45 years, you are likely to have fewer healthy sperm than when you were younger. If you are older, you will also most likely produce less semen. Your sperm quality, sperm count and sperm motility (movement) might also be lower than when you were younger.
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Smoking: Smoking lowers your sperm count and the amount of semen you produce. The more you smoke, the lower the quality of your sperm. Even smoking fewer than 10 cigarettes a day affects your sperm health and increases the chance your baby will develop leukaemia (a type of blood cancer).
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Being Overweight: If you are overweight or obese, you are likely to have a lower sperm count and sperm that don't move as well. You are also likely to have more abnormal sperm. Being overweight can also affect the genes in the sperm that your baby will inherit.
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Alcohol: The occasional drink is unlikely to affect your fertility; however, heavy drinking can reduce sperm quality, lower testosterone production, and make it harder to achieve an erection.
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Sexually Transmitted Infections: Having a sexually transmitted disease such as gonorrhoea, chlamydia, syphilis, or genital warts can interfere with the normal function of your reproductive system. Most STIs are easy to treat, so speak with your doctor early to increase your chance of a successful pregnancy. Getting treatment for your STI will also reduce your chances of spreading it to your partner.
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Drugs: Medicines and illicit drugs can affect your ability to produce quality sperm. If you are receiving treatment for cancer, speak with your doctor about storing sperm for later use. Taking anabolic steroids may also cause permanent harm to your sperm production.
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Environmental and Occupational Hazards: Toxic products such as pesticides, chemicals, radiation and heavy metals can affect the quantity and quality of your sperm. It's best to avoid exposure before you try to conceive. If your work brings you into contact with toxic substances, make sure you follow all occupational health and safety regulations.
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Heat/Temperature: Testicles should be a few degrees cooler than your body temperature to keep producing good-quality sperm. Avoid hot baths and spas and wear loose-fitting underwear to keep your scrotum cool. [2]
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General Lifestyle Factors Affecting Sperm Health: Lifestyle factors such as diet, body weight, physical activity, sleep, stress, smoking, alcohol consumption and environmental exposure may affect sperm production and quality.
Factors to Keep Sperm Healthy
It’s never too soon to take care of your sperm. If you’re trying to conceive, the best way to help keep your sperm healthy is by leading a healthy lifestyle. This can include:
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Eating healthy
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Exercising regularly
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No smoking
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Getting to a healthy weight
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Moderate alcohol consumption
You can also protect your sperm by:
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Wear loose-fitting pants
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Avoid hot baths
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Not putting your computer or phone on your lap
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Wearing protective gear to avoid sports injuries to your groin
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Not taking anabolic steroids [2]
Role of Antioxidants in Male fertility
Oxidative stress plays a significant role in male infertility and there is growing evidence looking into the capacity of antioxidants to decrease the detrimental effects on sperm quality and function. Some antioxidants might enhance sperm parameters and improve fertility outcomes with supplementation, but outcomes vary based on dosage, duration, and individual health conditions. Antioxidant supplementation could be used as an adjuvant therapy for male infertility but should be used with caution and rationally by the selection of patients with deficiencies of the given antioxidants. [4]
Some of the endogenous and exogenous antioxidant systems and their mechanisms.
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Glutathione Peroxidase (GPx): Converts hydrogen peroxide and lipid peroxides to non-toxic forms in the presence of reduced glutathione. It is important to protect sperm mitochondria and nuclear material.
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Glutathione: A tripeptide with potent ROS-neutralizing capacity, glutathione protects sperm from oxidative damage and helps enzyme activity.
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Coenzyme Q10: CoQ10 is involved in mitochondrial respiration and is a lipid-soluble antioxidant that enhances sperm motility and reduces oxidative damage.
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Zinc and Selenium: Both are crucial for the structural and enzymatic integrity of sperm. Zinc stabilises the sperm membrane and its DNA. Selenium is a cofactor of glutathione peroxidase and sperm-specific selenoproteins.
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Vitamin C: A water-soluble antioxidant found in high concentration in seminal plasma, scavenges hydroxyl radicals and improves sperm viability.
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Vitamin D: Vitamin D is increasingly being recognised for its roles in sperm function and motility.
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Lycopene: Neutralises ROS and helps preserve sperm DNA and membrane integrity.
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Carnitines (e.g., L-carnitine): Aid mitochondrial energy metabolism and sperm motility; their antioxidant effect also minimises oxidative damage.
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Omega-3 fatty acids (EPA, DHA): These are polyunsaturated fats that maintain the fluidity and integrity of membranes and have anti-inflammatory and antioxidant properties. [4]
Herbal Ingredients That Support Sperm Health
Herbal ingredients have been traditionally used in systems like Ayurveda for various aspects of men’s health. Plants can probably be useful in increasing fertility due to their antioxidant power and low side effects. Some of the ingredients are now being investigated in modern research by clinical and experimental methods.
The study result revealed that various herbs like Apium graveolens, Cinnamomum camphora, Cornus mas, Satureja khuzestanica, Withania somnifera, Fumaria parviflora, zingiber officinale, cinnamomum zeylanicum and Phoenix dactylifera are used in male reproductive system. [5]
Conclusion
A combination of biological, lifestyle and environmental factors influence male reproductive wellness. Sperm health is more than just a sperm count. Motility, morphology, concentration, and other semen parameters all play a role in the overall picture of reproductive function. Genetics, age and medical conditions are not always changeable, but many lifestyle factors are modifiable.
Male reproductive health starts with a healthy body composition, regular physical activity, adequate sleep, stress management, avoiding smoking, moderating alcohol, and sensible management of environmental exposures all backed up with a well-rounded diet.
Antioxidants and some nutritional or herbal ingredients have also been studied for their possible effects on semen parameters. However, the research is still mixed and the improvements noted in each individual study should not be taken as guaranteed results.
Ultimately, men’s reproductive health is part of overall health. While a sustainable lifestyle is the bedrock, if there are fertility concerns or ongoing reproductive health issues, it's still important to seek professional medical evaluation.
Frequently Asked Questions (FAQs)
1. What is male fertility?
Male fertility is a biological ability to participate in conception. Some of these processes include production, maturation, movement and delivery of sperm.
2. What determines sperm health?
Sperm health is evaluated by several parameters, such as sperm concentration, total count, motility, progressive motility and morphology. Other parameters, such as semen volume, may also be considered.
3. Does smoking impact on male fertility?
Yes, WHO recognises smoking as a lifestyle factor associated with higher chances of infertility, and it has been linked to negative reproductive outcomes.
4. How can exercise help with male reproductive health?
Being active on a regular basis helps the heart, lungs and metabolism and may improve some measures of reproductive health. However, training with excessive intensity without sufficient recovery may not bring further benefits.
5. Do antioxidants support sperm health?
Some antioxidants including selenium, zinc, CoQ10, omega-3 fatty acids, vitamins and carnitines have been investigated in relation to semen parameters.
6. When should someone see a professional about fertility?
If pregnancy has not been achieved after 12 months of regular unprotected intercourse, or earlier in cases with known reproductive-health concerns, professional assessment may be appropriate. Infertility may be due to male factors, female factors, both or may be unexplained.
References:
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Chawre S, Khatib MN, Rawekar A, Mahajan S, Jadhav R, More A. A Review of Semen Analysis: Updates from the WHO Sixth Edition Manual and Advances in Male Fertility Assessment. Cureus. 2024 Jun 29;16(6): e63485.
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Bouhadana D, Godin Pagé MH, Montjean D, Bélanger MC, Benkhalifa M, Miron P, Petrella F. The Role of Antioxidants in Male Fertility: A Comprehensive Review of Mechanisms and Clinical Applications. Antioxidants (Basel). 2025 Aug 19;14(8):1013.
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Boroujeni SN, Malamiri FA, Bossaghzadeh F, Esmaeili A, Moudi E. The most important medicinal plants affecting sperm and testosterone production: a systematic review. JBRA Assist Reprod. 2022 Aug 4;26(3):522-530.