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Fertility Is a Shared Responsibility: Let’s Talk About Sperm Health
- 2 days ago
- 5 min read
For the purpose of this article, the term male is used to refer to individuals assigned male at birth (AMAB), and female to those assigned female at birth (AFAB). We acknowledge that gender identity and expression are diverse and may not align with these biological classifications. Our intention is to discuss reproductive health using terminology relevant to anatomy and physiology, while remaining respectful and inclusive of all gender identities.
For too long, fertility challenges have been seen as a female issue, with tests, treatments, and emotional pressure often falling solely on them. But the truth is that male fertility plays a role in at least 50% of all infertility cases. Despite this, male reproductive health and sperm quality often receive far less attention, even though healthy sperm is just as crucial for couples trying to conceive as egg quality. Understanding how to improve sperm health, boost male fertility, and support overall reproductive wellbeing is an essential part of the journey to parenthood.
Why Male Fertility Matters Just as Much
Sperm health needs to be evaluated right from the start of any fertility journey. Whether you are trying to conceive naturally or using assisted reproductive techniques such as IVF (in vitro fertilisation) or ICSI (intracytoplasmic sperm injection), understanding sperm quality and quantity is essential.
Many people still believe that ICSI can bypass sperm issues, but that is not true. During ICSI, the embryologist selects the sperm that looks best under the microscope, the one that moves well (motility) and has the right shape (morphology). However, they cannot see what is happening inside the sperm’s DNA.
Each parent contributes 23 chromosomes, forming the full genetic blueprint for the baby. If the sperm’s DNA is damaged, that blueprint may not form properly, even if the sperm looks perfect under the microscope.
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What Damages Sperm
Sperm are surprisingly fragile. They can be easily damaged by oxidative stress caused by factors such as:
chronic stress
hormonal dysregulation
alcohol and smoking
high scrotal temperature from tight clothes, saunas or laptops
endocrine-disrupting chemicals (EDCs) are found in plastics and pesticides
nutritional deficiencies
chronic inflammation
When sperm are exposed to these stressors, their movement, shape and DNA integrity can be compromised.
Even during ICSI, if the sperm’s DNA is fragmented, it can lead to infertility, increased time to conception, IVF and ICSI failure, poor embryo quality, miscarriage, birth defects, or even long-term health and cognitive issues in offspring.
That is why a comprehensive semen analysis, including DNA fragmentation testing, is crucial. Without it, we might miss a key part of the fertility picture, which means more emotional and physical strain, particularly on those who go through hormonal stimulation, egg retrieval and repeated IVF cycles.
When the female partner undergoes such significant intervention to achieve quality eggs, it is only fair and necessary that males ensure their sperm are equally optimised.
Understanding Semen Analysis Results
When reviewing semen analysis results, it is essential to know what you are comparing them to.
The World Health Organisation (WHO) reference ranges most laboratories use were set in 2010, based on those whose partners conceived within a year. The 5th percentile represents the lowest-performing individuals who still managed to conceive, not necessarily the ideal standard.
A better benchmark is the 50th percentile, representing average performers with greater reproductive potential.
Parameter | Reference ranges based on the 5th percentile | Reference ranges based on the 50th percentile |
Semen Volume | > 1.5ml | 3.7ml |
Sperm Concentration | >15 million/ml | 73 million/ml |
Total Sperm Count | >39 million | 255 million |
Sperm Motility (progressive) | >32% | 55% |
Sperm Morphology | > 4% | 15% |
Reference Ranges for DNA Fragmentation
DFI Percentage | Interpretation | Impact on Fertility |
< 15% | Normal | Low risk of fertility issues. Good sperm DNA integrity. |
15-25% | Moderate DNA fragmentation | Some risk of infertility, reduced embryo quality, and miscarriage. |
> 25% | High DNA fragmentation | Higher risk of infertility, poor embryo development, failed IVF/ICSI, and miscarriage. |
> 30-40% | Very high DNA fragmentation | Significant fertility challenges, increased risk of IVF/ICSI failure, and miscarriage. |
Some studies however show significant issues with IVF outcomes including embryo quality, pregnancy rates and miscarriage rates with DNA fragmentation as low as 20%. We aim for sperm DNA fragmentation to be under 10% to give the best possible outcome.
The Male Factor: Fertility Is a Shared Responsibility is a new eBook written by Raul Pastrana; he shares science, clinical stories and strategies to help males understand their role in conception and to support their partners equally on the often challenging but rewarding fertility journey.
Click here to get your copy today
What If Your Results Are Not Ideal?
There is no need to panic. Sperm health is constantly changing. It takes about 72 to 74 days for new sperm to form, meaning improvements can happen within a few months if you take the right steps. Keep in mind every person is different, and in some cases, it can take a bit longer for improvements to be seen; however, there are many things you can do to start boosting your fertility.
Simple Changes That Can Make a Difference
Prioritise consistent and restorative sleep
Limit alcohol, avoid smoking and reduce processed foods
Keep the testicles cool by avoiding hot baths and saunas
Eat antioxidant-rich foods such as berries, leafy greens, citrus and nuts
Consider evidence-based antioxidant supplements
These changes can be more easily said than done; as holistic healthcare professionals, naturopaths are experts in supporting effective change and interventions that allow these goals to become a reality for you.
Beyond lifestyle and diet, individualised clinical evaluation of your circumstances and test results allows us to give specific recommendations that will have the most significant impact in your circumstances. This is where we see the best clinical outcomes, having helped many hundreds of men and couples go on to achieve successful pregnancy when it was otherwise considered unlikely.
If you (or your partner!) are struggling with fertility (or just want to optimise your contribution to invest in the health of your future family), consider booking a discovery call with us. We can help identify and address the barriers impacting sperm quality.
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Raul is an experienced, degree-qualified naturopath with a special focus on fertility and reproductive health. He is passionate about helping patients achieve their fertility goals, including personalised support for IVF cycles and optimal preconception care.
Raul’s areas of expertise extend to menopause, male fertility and general health, gut health and weight management, reflecting his commitment to addressing diverse health concerns. His practice integrates evidence-based nutrition, herbal medicine, and lifestyle strategies to empower clients on their journey toward better health.
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