What actually helps male fertility?

What actually helps

• Get a semen analysis early. Both partners should be evaluated together, and any abnormal result should lead to a visit with a male fertility specialist (a reproductive urologist).
• Stop smoking. It lowers sperm count and movement.
• Keep things cool: loose underwear, fewer long stretches of sitting, and no hot tubs or saunas while you're trying.
• Keep alcohol moderate. In couples doing IVF, men drinking more than about six drinks a week had lower live birth rates.
• Move toward a healthy weight, and exercise if you're mostly sedentary.
• Give it time. Sperm take about two to three months to develop, so changes made now show up in a semen analysis a few months later.

The evidence for each of these is modest, but they're low-cost, good for your health, and the ones the urology guideline recommends.

Be careful

Safety consideration Testosterone and anabolic steroids switch off sperm production. The US urology guideline says men who want children, now or later, shouldn't be prescribed testosterone. If you take it, tell your doctor before you start trying — recovery can take months.

What about supplements?

The two best trials were both negative. In FAZST (2,370 couples), folic acid and zinc didn't improve live births or sperm quality, and sperm DNA damage was slightly higher on the supplement. In MOXI (171 couples), a multi-antioxidant formula didn't improve sperm, and live births were lower (15% vs 24%) before the trial stopped early. The urology guideline calls supplements "of questionable clinical utility."