By Adrian Stone, BHSc (Nutritional Medicine), BHSc (Naturopathy), Living Holistic Health — sperm health is half of fertility, it takes around three months to change, and it says something about a man’s overall health too.
Most preconception advice is written for women. Yet a pregnancy needs a healthy sperm as much as a healthy egg, and sperm are surprisingly responsive to how a man eats, drinks, sleeps and moves.
So this one is for the blokes, and for the partners who forward it to them. It’s part three of our Preconception Essentials series.
The short version:
- A male factor is involved in about half of couples who struggle to conceive naturally.
- Sperm take about 70 days to make, so changes show up after roughly three months.
- Smoking, excess weight and heat have the clearest links to poorer semen quality.
- Antioxidant supplement trials are inconclusive once the weaker studies are set aside.
Why Does Sperm Health Matter for Both Partners?
Because a male factor is involved in about half of couples who have trouble conceiving naturally. Sperm health also seems to reflect a man’s general health. Men with poorer semen quality have, on average, more health problems later on. That makes a semen check useful for fertility and as a nudge towards a general health check.
Australian men’s health guidance puts the figure plainly: in about half of cases where couples have trouble getting pregnant naturally, the problem lies with the man. The Cochrane review of antioxidants for men cites a similar estimate.
The wider health link is the part that surprises people. According to PubMed, a US study followed 11,935 men who had a fertility assessment. Over an average of 7.7 years, men with two or more abnormal semen measures had 2.3 times the risk of death of men with normal results. Importantly, that’s an association, not a cause. The authors suggest semen quality may simply be a marker of overall health.
Are Sperm Counts Really Falling?
The best available data suggest they are. A large 2023 analysis estimated that average sperm concentration fell by about half between 1973 and 2018, and that the decline has sped up since 2000. The causes are still being studied, so be wary of any single explanation.
According to PubMed, that review pooled 223 studies of semen samples collected across all continents. Among men not selected for fertility, mean sperm concentration fell 51.6% over the period. Moreover, the yearly rate of decline more than doubled after 2000. The authors list environmental chemicals and lifestyle among possible causes, but they don’t claim to have proven any of them.
How Long Does It Take to Improve Sperm Health?
Around three months. Making a mature sperm takes about 70 days, so the sperm released today began developing more than two months ago. Changes to diet, alcohol, smoking or heat exposure mostly show up in samples taken about three months later. That’s also why doctors usually space out repeat semen tests.
Andrology Australia makes the same point about heat: because sperm take about 70 days to be made, it may take a few months for counts to recover once the testicles are kept cool again. In practice, that’s the window I plan around. Positive change means sacrifice, and with sperm the payoff simply arrives on a delay.
What Does a Semen Analysis Measure?
A standard semen analysis looks at semen volume, how many sperm there are, how well they swim (motility) and what proportion have a normal shape (morphology). Together these give a picture of sperm production and function. However, a single result can vary a lot, and it doesn’t measure everything that matters for fertility.
A semen analysis is the main test of sperm health, and results depend heavily on careful laboratory technique. For that reason, the World Health Organization publishes a standard laboratory manual, most recently updated in 2021, so that results from different labs can be compared. Ideally, use a laboratory experienced in semen analysis that follows it.
A semen analysis is usually ordered through your GP or fertility specialist, and it can also be arranged privately. Either way, we can help you make sense of the result alongside your history.
What Lifestyle Factors Affect Sperm Health, Motility and Morphology?
Smoking, excess weight, heat and diet have the clearest links to semen quality. Heavy drinking matters too, while the evidence on coffee is mixed. Most of these findings come from observational studies, so they show associations. Even so, they point the same way, and they overlap with what’s good for long-term health anyway.
Smoking and weight
According to PubMed, a 2016 meta-analysis of 20 studies and 5,865 men linked smoking with lower sperm count, motility and morphology. The effect was larger in moderate and heavy smokers. On weight, a 2026 review found that lifestyle programmes for men with obesity improved progressive motility and normal morphology, although the certainty of evidence was low. Both are among the most changeable parts of sperm health.
Heat, alcohol and coffee
Heat is easy to overlook. In a small Italian study, ten men had two sauna sessions a week for three months, and their sperm count and motility fell sharply. Encouragingly, everything returned to baseline six months after they stopped. For alcohol, Australian men’s health guidance says moderate drinking doesn’t appear to harm fertility, while heavy and binge drinking can affect testicular function.
Coffee is less clear. A review of 28 studies and 19,967 men found inconsistent results for coffee and tea. In contrast, cola and caffeinated soft drinks were more often linked with lower semen quality.
Diet
A 2025 meta-analysis of eight studies (1,835 men) linked closer adherence to a Mediterranean diet with higher sperm count, motility and normal morphology. It didn’t, however, show better pregnancy outcomes. In a randomised trial of 117 young men, adding a daily handful of walnuts to a Western-style diet for twelve weeks improved sperm vitality, motility and morphology.
Does Age Matter for Men?
Yes, though less than it does for women. Semen volume, sperm motility and possibly sperm DNA quality decline gradually with age. A 2020 meta-analysis also found that miscarriage risk rose modestly with the father’s age, after accounting for the mother’s age. So age isn’t only a women’s issue.
According to PubMed, compared with fathers aged 25 to 29, the risk of miscarriage was 23% higher when the father was 40 to 44 and 43% higher at 45 or older. The authors note the effect is smaller than that of maternal age, and they can’t fully exclude other explanations.
Do Supplements Help Male Fertility?
The honest answer is that we don’t know yet. A large Cochrane review found antioxidant supplements may increase pregnancy and live birth rates in couples with male-factor subfertility. However, the evidence was very low certainty, and the live birth effect disappeared once trials at high risk of bias were removed.
According to PubMed, that 2022 review included 90 trials and 10,303 men. Pooled results suggested higher live birth rates with antioxidants (odds ratio 1.43), based on twelve small or medium-sized trials. Removing the trials at high risk of bias left no clear difference (odds ratio 1.22, not statistically significant). Antioxidants were also linked with slightly more mild stomach upset.
Sperm are especially vulnerable to oxidative stress, which is one of the four root drivers I look for in almost everyone I see. That makes antioxidants a reasonable thing to study. Still, a reasonable hypothesis isn’t the same as a proven result, and for sperm health, food, weight, smoking and heat come first.
General information only, not individual medical advice. Always discuss supplements and herbal medicines with your treating practitioner.
When Should Men Get Their Sperm Health Checked?
If you and your partner have been trying for 12 months, or six months if the female partner is 35 or older, you should both have an assessment, not just her. Go sooner if you’ve had testicular problems or surgery, chemotherapy or radiotherapy, or mumps affecting the testicles. Your GP is the place to start.
We don’t diagnose or treat male infertility; that stays with your doctor. Our part is the nutritional, herbal and lifestyle work that sits alongside their care. Please don’t stop or change any prescribed medication without speaking to your doctor first.
If you’d like help with the lifestyle side of sperm health, you’re welcome to get in touch with the clinic at our Geelong or Drysdale rooms. You can also read more about our fertility and pregnancy support.
Frequently Asked Questions
How long does it take for sperm to regenerate?
Making a mature sperm takes about 70 days, so it’s best to think in three-month blocks. After a fever, heat exposure or a lifestyle change, sperm counts may take a few months to reflect it. That’s also why doctors usually space repeat semen tests well apart.
Do heat, laptops or saunas affect sperm?
Regular saunas do: in one study, two sessions a week for three months lowered count and motility, which recovered six months after stopping. The testicles work best a couple of degrees below body temperature. Direct evidence on laptops is limited, but avoiding prolonged heat on the area is sensible.
Does alcohol affect sperm health?
Moderate drinking doesn’t appear to harm male fertility, according to Australian men’s health guidance. Heavy and binge drinking are different, and can affect testicular function. If you’re trying to conceive, cutting back alongside your partner is a practical step.
Can supplements improve sperm count?
Some trials report changes in semen measures, but the Cochrane review found the evidence on pregnancy and live birth inconclusive. Supplements also aren’t a substitute for medical assessment. Discuss any supplement with your treating practitioner before starting it.
How do you get a semen analysis?
A semen analysis is usually ordered through your GP or fertility specialist, and it can also be arranged privately. Either way, we can help you make sense of the result alongside your history. Ideally, choose a laboratory experienced in semen analysis.
References
Sperm health and semen quality research
- Eisenberg ML, Li S, Behr B, et al. Semen quality, infertility and mortality in the USA. Hum Reprod. 2014;29(7):1567-74. https://doi.org/10.1093/humrep/deu106
- Levine H, Jørgensen N, Martino-Andrade A, et al. Temporal trends in sperm count: a systematic review and meta-regression analysis of samples collected globally in the 20th and 21st centuries. Hum Reprod Update. 2023;29(2):157-176. https://doi.org/10.1093/humupd/dmac035
- World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. 2021. https://www.who.int/publications/i/item/9789240030787
- Andrology Australia. Your sperm and how to look after them. Published via Your Fertility. https://www.yourfertility.org.au/sites/default/files/2018-08/Your-sperm-and-how-to-look-after-them_final.pdf
Lifestyle, diet and sperm health studies
- Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 World Health Organization laboratory methods for the examination of human semen. Eur Urol. 2016;70(4):635-645. https://doi.org/10.1016/j.eururo.2016.04.010
- Peel A, Lyons H, Tully CA, et al. The effect of obesity interventions on male fertility: a systematic review and meta-analysis. Hum Reprod Update. 2026;32(2):154-180. https://doi.org/10.1093/humupd/dmaf025
- Garolla A, Torino M, Sartini B, et al. Seminal and molecular evidence that sauna exposure affects human spermatogenesis. Hum Reprod. 2013;28(4):877-85. https://doi.org/10.1093/humrep/det020
- Ricci E, Viganò P, Cipriani S, et al. Coffee and caffeine intake and male infertility: a systematic review. Nutr J. 2017;16(1):37. https://doi.org/10.1186/s12937-017-0257-2
- Agarwal R, Salas-Salvadó J, Davila-Cordova E, et al. Mediterranean diet, semen quality, and medically assisted reproductive outcomes in the male population: a systematic review and meta-analysis. Adv Nutr. 2025;16(8):100454. https://doi.org/10.1016/j.advnut.2025.100454
- Robbins WA, Xun L, FitzGerald LZ, et al. Walnuts improve semen quality in men consuming a Western-style diet: randomized control dietary intervention trial. Biol Reprod. 2012;87(4):101. https://doi.org/10.1095/biolreprod.112.101634
- du Fossé NA, van der Hoorn MP, van Lith JMM, et al. Advanced paternal age is associated with an increased risk of spontaneous miscarriage: a systematic review and meta-analysis. Hum Reprod Update. 2020;26(5):650-669. https://doi.org/10.1093/humupd/dmaa010
Antioxidant evidence
- de Ligny W, Smits RM, Mackenzie-Proctor R, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2022;5:CD007411. https://doi.org/10.1002/14651858.CD007411.pub5
This article is general information and not a substitute for individual medical advice. If you have been trying to conceive for some time, or have a health condition, please speak with your GP. For private health consultation claiming, please enquire with your health fund to assess coverage. Nutrition consultations are covered by some private health funds — please check with yours first.
