Is men’s sperm quality and number getting worse?

For over 30 years there have been claims that sperm counts have fallen by over a half, though not everyone has accepted this. Sperm quality, which describes whether the shape and form of the sperm and their swimming ability are normal, is poor (by animal standards) even in normal fertile men, but it may also have changed for the worse in recent years. However, the changes are minor compared with the change in sperm counts, so let’s focus on sperm counts. So have sperm counts really fallen – and if so, does it actually matter? After all, if sperm counts have fallen from about 80 million sperm/ml ejaculate to 40 million/ml, that still leaves a huge excess for a task (fertilising the female egg) that ultimately only requires one sperm!

Without being able to go back in time and check sperm counts (and quality) from 50 years ago, the reality is that we can never be 100% sure that sperm counts were much higher then. 

A healthy lifestyle and exercise is crucial for sperm quality
A well balanced diet is important for a good sperm quality

However, the overwhelming evidence points to over a 50% fall that embraces much of the world. What is beyond dispute is that, in the UK and across Northern Europe, at least 1 in 6 young men today have a sperm count less than 20 million/ml. Keep this in mind as I answer the next question about falling sperm counts – does it matter?

Yes it matters. Indeed, it matters more today than it has ever mattered. Let me explain why. Top-class studies have shown that when couples start trying for a baby, if the man has a sperm count of 40 million/ml or higher there is the maximum chance of him getting his partner pregnant. However, if the man’s sperm count is less than 40 million/ml, and especially if it is less than 20 million/ml, the chances of his partner getting pregnant decreases steeply. This doesn’t mean that such a couple cannot achieve a pregnancy, it just means they will have to keep trying for much longer (eg 1-2 years) than a couple in which the male has a high sperm count. But this necessity hits another ‘today’ problem.

Many couples today don’t start trying for a pregnancy until the woman is in her 30’s or even her 40’s. At age 35, female fertility is only about 60% of what it is in her early 20’s, and between 35-45 years of age her fertility decreases ever faster. If her male partner has a sperm count of less than 20 million/ml, which is the case for 1 out of 6 young men, it will take much more time for them to achieve a pregnancy, but clearly time is not on their side because of the progressive decline in female fertility with age. I call this present day scenario a ‘recipe for couple infertility’. It is why so many such couples end up needing assisted reproduction at a fertility clinic, which can be a physically and emotionally bruising roller-coaster that may also ruin their bank balance.

If a low sperm count/quality is so bad for fertility, is there anything that men can do to increase their sperm count and/or sperm quality? For most men with a low sperm count/quality there are no medical treatments to correct it, but there are some lifestyle changes that men can make which may have some positive effects on both their sperm count, sperm quality and their overall health, although they need to maintain these changes for many months (preferably before starting to try for a pregnancy). First, eat a healthy balanced diet with plenty of fruit and vegetables, more fish than meat, drink alcohol only in moderation and, above all, don’t smoke marijuana or use anabolic steroids. Also keep fit and active and avoid too much sitting around (which warms your testicles and is bad for sperm production), especially if this is what your job involves. Making positive changes such as this could make a difference that helps achieve a pregnancy, but no matter what it will not do any harm.