Eugenia Grand is a specialist fertility and maternal weight management dietitian and a website coordinator for BDA Women's Health and Fertility Specialist Group. In this blog, she shares updates about what men can do to prevent infertility in the future or improve their current reproductive health.
The number of people with infertility is estimated to range between 42-180 million (WHO 2025). The prevalence of infertility has increased in the last decades. The male factor accounts for approximately 50% of the cases, emphasising the significance of this issue (Agarwal et al., 2021).
Notably, of all couples diagnosed with infertility, a male factor is identified as a primary or contributing cause in up to 50% of cases. Multiple factors may contribute to male infertility, including genetics, hormonal disorders, and testicular dysfunction, as well as injuries, infections or chronic conditions that impair normal sperm production (Agarwal et al., 2021). Unhealthy lifestyle choices have been linked to male infertility and are believed to be a factor in the annual decline in sperm counts in the Western world over the past 60 years (Levine et al., 2017). Environmental pollution, sedentary lifestyles, and unhealthy dietary patterns have been hypothesised as the main modifiable factors in the decline in human semen quality.
Follow a healthy, balanced diet Mediterranean diet
The latest evidence confirms that the mediterranean diet can have a protective effect on male fertility. According to a recent meta-analysis by Agarwal et al. 2025, the mediterranean diet protects semen quality parameters for participants from healthy populations and fertility clinics. However, more significant associations were obtained when evaluating healthy populations. The mediterranean diet provides numerous health benefits, including reducing the risk of chronic diseases and increasing life expectancy.
What is the mediterranean diet? It typically consists of a variety of fruits and vegetables, nuts, wholegrain breads and cereals, pulses, and seeds. It is low in saturated fat, usually from dairy and meat, and high in mono- and polyunsaturated fats from seafood and oily fish. Alcohol is consumed in moderation.
Eat your 5-a-day
This food group deserves a separate mention because fruit and vegetables contain a variety of vitamins (vitamins A, C, E) and phytochemicals (Carotenoids, Flavonoids, Anthocyanins, etc.) that act as dietary antioxidants and play a protective role in spermatogenesis. Plenty of scientific evidence confirms the benefits of fruit and vegetable intake for sperm quality. Folate, a naturally occurring form of Vitamin B9 found mainly in green leafy vegetables and fruits, plays an essential role in spermatogenesis by reducing the incidence of sperm genetic abnormalities, particularly aneuploidy (Young et al. 2008). Aneuploidy is a genetic abnormality involving an irregular number of chromosomes due to their duplication or loss.
Eat nuts daily
Nuts are a valuable source of vitamins (such as folate and vitamin E), minerals (like iron and Zinc), and healthy fats (including omega-3 fatty acids). Some of these nutrients may help reduce oxidative stress in developing sperm cells during spermatogenesis, which can lower sperm DNA fragmentation.
A recent meta-analysis found that consuming at least two servings of nuts daily as part of a Western-style diet improves sperm parameters, important indicators of male fertility (Cardoso B.R. and Fratezzi I., 2024). Other studies suggest that 60 - 75 grams of nuts can enhance sperm vitality, motility, and morphology.
Keep your weight in a healthy range
Obesity is a significant risk factor for chronic conditions like cardiovascular disease and diabetes. Studies have also shown a higher incidence of male factor infertility in men living with obesity. This has been attributed to hormonal imbalances, direct effects on reproductive organs, and disruptions in spermatogenesis. Even mild excess body weight is linked to poorer semen parameters like total sperm count and motility. As body weight increases (BMI of 30 kg/m² or greater), all sperm parameters decline significantly.
To enhance fertility, it is important to aim for weight loss if necessary and maintain a healthy BMI through a balanced diet and regular exercise.
Keep active
Numerous studies suggest that physical activity can benefit male fertility, but the ideal types of exercise remain unclear. Moderate activity is essential, and rigorous exercise is unnecessary for optimal fertility outcomes. Following NHS guidelines, aim for at least 150 minutes of moderate activity or 75 minutes of vigorous exercise weekly.
Limit your alcohol
Excessive alcohol consumption can decrease testosterone levels, negatively impacting libido and is linked to lower sperm quality and fertility.
For men trying to conceive, it's advisable to limit or avoid alcohol altogether. This supports their fertility and helps create a healthier environment for their partner during pregnancy.
A meta-analysis of 40 studies involving 23,258 men found that alcohol consumption negatively affected semen volume and hormone levels ( Nguyen-Thanh T, Hoang-Thi A.P., and Thi Anh Thu, 2023).
Limit alcohol intake to 14 units per week and include alcohol-free days. If there are male fertility issues, consider reducing or stopping alcohol while trying to conceive.
Key nutrients and food sources
- Zinc: Found in pumpkin seeds, beef, and lentils. Zinc is necessary for the normal function of the male reproductive system and spermatozoa
- Folate: Leafy greens like spinach help reduce sperm DNA fragmentation, and genetic errors
- Antioxidants: Berries, vegetables, nuts, and seeds protect sperm from oxidative damage
- Omega-3s: Oily fish like salmon and mackerel may help modify cell membrane composition and functionality
- Selenium: Brazil nuts, fish, meat, eggs may improve in sperm quality and reduction inoxidative stress
- Coenzyme Q10 (CoQ10): Meat, chicken, fish, and nuts has protective antioxidant properties
- Carnitine: Meat, poultry, fish, and dairy products. It is a nutrient related to sperm motility and has antioxidant properties.
If you believe your diet lacks essential nutrients, it's advisable to consult a fertility specialist dietitian for guidance on food sources or supplements.
Further thoughts
A recent study by Priskorn et al. 2025 investigated semen quality and lifespan in 78,284 men for up to 50 years. This study revealed that semen quality is a significant indicator of mortality. Men with high-quality semen can expect to live, on average, more than two years longer than those with severely impaired semen quality. However, before any preventive measures can be implemented, further studies are necessary to identify late-onset health issues related to semen quality.
References
- Agarwal et al. 2025 https://www.sciencedirect.com/science/article/pii/S2161831325000900?via%3Dihub
- Piera-Jordan et al. 2024 https://www.frontiersin.org/journals/nutrition/articles/10.3389/fnut.2024.1287864/full
- Salas-Huetos et al. 2018 https://www.sciencedirect.com/science/article/pii/S2161831322012728?via%3Dihub
- WHO 2025 https://platform.who.int/data/sexual-and-reproductive-health-and-rights/infertility-data
- Young et al. 2008 https://academic.oup.com/humrep/article-abstract/23/5/1014/646098?redirectedFrom=PDF&login=false
- Barbara R. C., Fratezzi I., Kellow N.J., 2024. https://www.sciencedirect.com/science/article/pii/S2161831323014370?via%3Dihub
- Priskorn et al. 2025 https://academic.oup.com/humrep/article/40/4/730/8051460?login=false
- Finelli R.,Mottola F., and Agarwal A., 2022 https://www.mdpi.com/1660-4601/19/1/328
- Nguyen-Thanh T., Hoang-Thi A.P., and Thi Anh Thu, 2023. https://www.sciencedirect.com/science/article/pii/S2405844023029304
- Levine H. et al. 2017. https://pubmed.ncbi.nlm.nih.gov/28981654/
