Male fertility health is too often relegated to the sidelines in reproductive wellness conversations, despite accounting for roughly half of all infertility cases. When a couple struggles to conceive, the default assumption tends to fall on female factors, leaving men unaware of the impact everyday choices and biological changes can have on their reproductive potential.
This article will examine the five key factors affecting male fertility health. It will cover how ageing can harm sperm quality and the essential roles that nutrition, stress management, and environmental factors play. Understanding these aspects can help improve male reproductive health. By spotlighting these often-overlooked factors, we empower men to take control of their fertility timeline and make informed decisions on the path to fatherhood.
1. Male Infertility Accounts for Half of All Infertility Cases
When couples struggle to conceive, the focus frequently falls on female fertility issues. However, male factors are responsible for 20–30% of infertility cases and contribute to ∼50% of all infertility cases.
Despite these statistics, many men do not seek a diagnosis until their partners have already undergone extensive and sometimes invasive evaluations.
Male fertility testing is relatively straightforward and painless, involving semen analysis and, occasionally, testicular ultrasounds. Since male and female fertility issues often coexist, both partners should be evaluated simultaneously when conception proves challenging.
2. Complete Absence of Sperm Affects 1% of Men
Approximately one percent of the male population has no sperm in their semen, a condition known as azoospermia. This doesn’t necessarily mean fatherhood is impossible. If you and your partner are struggling to conceive, a semen analysis from a urologist can provide crucial information about sperm count, motility, and morphology.
Depending on the results, various interventions may be available, from medication to surgical procedures that remove blockages or retrieve sperm directly from the testicles. Early diagnosis is key to exploring all available options.
3. Men Have Biological Clocks Too
While men can father children well into their later years, the notion that male fertility remains constant throughout life is scientifically inaccurate. Research shows that male reproductive capacity declines with age in several significant ways.
After age 40, men typically experience gradual decreases in sperm volume, motility, and morphology. Studies show that sperm DNA fragmentation increases with age, potentially leading to fertility challenges and pregnancy complications.
Testosterone production naturally declines by about 1-2% annually, affecting both sperm production and sexual function, which may result in longer conception times and increased miscarriage risk.
4. DNA Fragmentation Affects All Ages
Sperm DNA fragmentation isn’t just a concern for older men. This condition, where the genetic material within sperm contains abnormal breaks or damage, can affect men of all ages and significantly impact fertility.
High DNA Fragmentation Index (DFI) is linked to lower chances of natural conception and may contribute to unexplained infertility, even though the standard semen analysis results appear normal. Damage to sperm DNA leads to poor embryo quality and development, implantation failure, or early pregnancy loss.
5. Lifestyle Factors Can Impact Male Fertility
Besides internal health, external factors and everyday habits can also affect sperm health. Smoking and heavy drinking can damage sperm DNA and lower sperm count and quality. A poor diet may cause a lack of essential nutrients like zinc, vitamin C, and folate, which are needed to produce healthy sperm. High stress levels can raise cortisol, a hormone that disrupts the balance of reproductive hormones. Exposure to harmful substances—like chemicals in plastics, pesticides, and air pollution—can also interfere with normal sperm development.
The good news is that many lifestyle factors are modifiable. Simple changes can often improve sperm parameters within just a few months.
Breaking the Silence
The conversation around male fertility remains limited compared to discussions about female fertility. This knowledge gap can leave couples struggling with unexplained infertility when male factors are contributing causes.
Both partners, not just women, should think about their reproductive timelines. While men can typically father children later in life than women can conceive, their fertility is not unlimited and can decline with age or lifestyle factors.
Understanding these aspects of male fertility empowers couples to make informed family planning decisions and take proactive steps to optimise their chances of conceiving.
References
- Liang, Y., Huang, J., Zhao, Q., Mo, H., Su, Z., Feng, S., Li, S., & Ruan, X. (2025). Global, regional, and national prevalence and trends of infertility among individuals of reproductive age (15–49 years) from 1990 to 2021, with projections to 2040. Human Reproduction, 40(3), 529–544. https://doi.org/10.1093/humrep/deae292 (PubMed)
- Sharma, M., & Leslie, S. W. (2023). Azoospermia. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved May 21, 2025, from https://www.ncbi.nlm.nih.gov/books/NBK578191/ (NCBI)
- Pino, V., Sanz, A., Valdés, N., Crosby, J., & Mackenna, A. (2020). The effects of ageing on semen parameters and sperm DNA fragmentation. JBRA Assisted Reproduction, 24(1), 82–86. https://doi.org/10.5935/1518-0557.20190058 (PubMed Central)
- Li, F., Duan, X., Li, M., & Ma, X. (2024). Sperm DNA fragmentation index affects pregnancy outcomes and offspring safety in assisted reproductive technology. Scientific Reports, 14, Article 356. https://doi.org/10.1038/s41598-023-45091-6 (nature.com)
