Fertility Facts for Men

Healthy sperm are essential to fathering a child. But they're not a given.

Medically Reviewed by Sheldon Marks, MD on March 24, 2016

Guys, don't take fertility for granted. If you want to father children, you need to pay attention to your own health, especially as you get older.

"Your age, the foods you eat, the medications you take, and any medical issues you may have: All can affect the way your sperm function," says Bruce Gilbert, MD, PhD, director of reproductive and sexual medicine at the Arthur Smith Institute for Urology.

While you can't control your age, be aware that it plays a big role in sperm health. Sperm quality starts to decline after 40.

"Men might have reduced fertility even if their semen quality looks good, because there may be some damage in their sperm," Gilbert says. And damaged sperm that can't penetrate an egg will make it harder to impregnate your partner.

Older guys are also more likely to father children with genetic diseases. A recent study found that men 50 and up pass on more genetic mutations via their sperm than younger men.

You can't slow the clock, but you can protect your fertility in other ways. Start by watching what you eat, Gilbert says. Pay attention to your cholesterol levels, too. Those can affect a sperm's membrane, making it harder for the sperm to fuse with an egg. Gilbert advises his patients to control their cholesterol through diet and exercise if possible. No one knows whether cholesterol-lowering meds affect fertility.

Other drugs do have a serious impact -- and "not just drugs like cocaine and marijuana, which are known to affect semen quality and erectile function," Gilbert says. "Chemotherapy and radiation for cancer or even surgery for malignant disease can be what we call gonadotoxic, or harmful to the sperm-producing testicles. Fortunately, you can store your sperm ahead of time." Ask your doctor about sperm banking before you begin treatment.

Testosterone replacement therapy can also be a concern. It drastically reduces or stops sperm production while you take it. And, Gilbert says, "15% of men on testosterone don't get sperm production back when they stop treatment."

A healthy weight helps you make healthy sperm, so keep fit. "Obesity influences hormones, particularly estrogen, which can impact whether you produce enough sperm and whether those sperm work properly," Gilbert says. "It also can cause the brain to send out fewer signals telling the testes to produce sperm."

Ask Your Doctor

1. Can lifestyle changes help preserve my fertility?

2. Will any of the medications I take affect my fertility?

3. Do I have medical conditions that might make it difficult to conceive? Should I treat them now?

4. How long should my partner and I try to conceive before getting tested for fertility issues?

5. Are there tests I should have to check if I am fertile?

Show Sources


Bruce Gilbert, MD, PhD, director, Reproductive and Sexual Medicine, Northwell Health’s Smith Institute for Urology, New Hyde Park, NY.

Guardian: “Overweight men may pass obesity risk to their children” December 3, 2015.

Maher, G. PNAS, February 8, 2016.

Schisterman, E. Andrology, May 2014.

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