Men's Wellness

Male Fertility Concerns

Problems on the male side are as likely as problems on the female side when a couple has trouble conceiving, and many of the habits that help sperm are the same ones that help general health. This page covers sperm and male fertility habits, when to get checked, and what supplements and claims do and do not show.

General information, not medical advice. Last updated November 1, 2026. Written by the AlternativeMed editorial team. Not medically reviewed.

Start here

If you have been trying for a year without success, or you already know of a testicular, hormone or sexual problem, book a visit with a doctor and ask for a semen analysis; both partners can be checked at the same time.
Stop smoking, keep alcohol low, and move toward a healthy weight if you are above it; these have the best-supported links with sperm quality.
Tell your doctor before you start any testosterone product, steroid or "booster" if you hope to father a child.

Be careful with

Testosterone treatment, anabolic steroids and many "boosters" can reduce sperm production. Do not start or stop any hormone or prescribed medicine on your own; talk to the prescriber first.
A lump, swelling or change in a testicle needs prompt medical care, and sudden severe testicle pain is an emergency.
Supplements marketed for male fertility vary in quality, and in a large trial one popular combination did not help and was linked with more digestive upset. Check with a pharmacist or doctor before taking any.

Get help when

No pregnancy after a year of regular unprotected sex (the NHS advises seeing a GP at this point), or sooner if you know of a testicular, hormone or sexual problem, have had cancer treatment, or think you may have had a sexually transmitted infection.
Sudden, severe pain in a testicle, or testicle pain with feeling or being sick or tummy pain: go to emergency care straight away (the NHS names 999 in the UK).
A lump, swelling, change in shape or feel, or one testicle becoming bigger than the other: ask for an urgent appointment.
Low mood, hopelessness or thoughts of self-harm while trying to conceive: speak to a doctor or local crisis service. Fertility worries can weigh heavily on both partners.

About Male Fertility Concerns

What this goal means

This goal is about the male side of fertility: making and delivering healthy sperm. The World Health Organization defines infertility as failure to achieve a pregnancy after 12 months or more of regular unprotected sex, and says it may be due to male, female or unexplained factors. NICHD notes that problems in the male are just as likely as problems in the female, and that a combination from both partners is equally likely.

This page uses these evidence labels: high, moderate, low, very low, mixed, insufficient and against.

^1,2

What it can feel like

Many men have no symptoms at all and only learn that sperm are low in number or slow-moving after a semen analysis. Waiting month after month can bring worry, strain between partners and a feeling of being judged. The NHS notes that trying to conceive can be an emotional process and that it helps to support each other. It also says it is always best for both partners to visit the GP, because fertility problems can affect either or both.

What can contribute

The WHO says male infertility is most commonly caused by problems in the ejection of semen, absence or low levels of sperm, or abnormal shape and movement of sperm. Other causes include blockage of the reproductive tract, hormone disorders, and testicular failure to produce sperm, for example from varicoceles (enlarged veins in the scrotum) or from chemotherapy. The NHS adds infections, testicular cancer or surgery, undescended testicles and injury.

Lifestyle factors the WHO names are smoking, excessive alcohol and obesity, plus exposure to environmental pollutants and toxins. The NHS also lists age, sexually transmitted infections, and exposure to certain pesticides, solvents and metals. Anabolic steroid use can also cause abnormal semen results.

^1,4,5

Conditions and findings a doctor may look for

A doctor can look into male causes with a medical history, an examination of the testicles and penis, and tests. The NHS lists semen analysis and a chlamydia urine test among the tests for men, and MedlinePlus lists sperm count and hormone levels among the tests used when the testes may not be producing enough hormone. The AUA/ASRM guideline outlines the evaluation of the male partner and notes that the detection of male infertility is linked with a higher risk of later health problems, which is one more reason to be checked rather than wait.

The NHS says many cases of abnormal semen are unexplained, and that for 1 in 4 couples no cause is found.

^3,6,7,4

Realistic expectations

The NHS says more than 8 out of 10 couples, where the woman is under 40, will conceive naturally within a year of regular unprotected sex (every 2 to 3 days), and that of those who do not, about half will conceive in the second year. So a slower start is common and is not by itself a sign of a problem.

Lifestyle changes are reasonable and low risk, but the studies on them are mostly observational, so they show links rather than proven fixes. Where a cause is found, the AUA/ASRM guideline says specific treatment and assisted reproduction are effective at managing male infertility.

^3,8,9

Who this applies to

Men who are trying to father a child or planning to, and partners supporting them. If your main concern is low testosterone symptoms, see the linked testosterone goals. Erectile function is covered on its own page. Fertility testing and care of the female partner is a separate matter that her own doctor can guide.

Related conditions and symptoms

Prostatitis and pelvic pain in men → Erectile dysfunction → Men's health safety: sudden symptoms and unsupervised hormone use →

A manageable starting plan

An educational starting point, not a personal prescription. Adjust it to your own situation and any advice from your clinician.

Your first actions

Book a medical check and semen analysis if you have been trying for a year, or sooner if you have a known risk.
Stop smoking and keep alcohol low.
Work toward a healthy weight with gradual changes.
Tell your doctor about every medicine, supplement, steroid or hormone product you use before you start trying for a child.

Optional additions

Build meals around vegetables, fruit, whole grains, fish and nuts.
Have sex every 2 to 3 days through the month.
Talk to a pharmacist before buying any fertility supplement.

What to track

Date you started trying and how long it has been.
A list of medicines and supplements to show the doctor.
Smoking and alcohol per week.
Appointments and test results for both partners.

When to reassess

Give lifestyle changes a few months, since sperm take time to renew. If no pregnancy after a year of trying, or sooner with a known risk, ask a doctor to review both partners.

When to seek professional support

See a doctor early if you have a lump, swelling, pain, or hormone or sexual symptoms.
Ask about counselling or a support group if the wait is weighing on you.

What helps

Ordered by how well the research supports each step. Evidence strength is shown on every card; precautions sit next to the advice.

Start here

Ask for a medical check and a semen analysis if you have been trying for a year

High certainty

Addresses: Finds treatable causes early and avoids months of guessing

Why it may help: The NHS suggests seeing a GP if you have not conceived after a year of trying, and sooner if you are already aware of a possible fertility problem. A semen analysis checks for low sperm count or sperm that are not moving properly, and the GP can also examine the testicles and test for chlamydia. The AUA/ASRM guideline sets out how the male partner should be evaluated.

How to apply it: Book a visit, list any medicines, herbal remedies and supplements you take, and be open about sex, smoking, alcohol, weight, drug use and stress, since the doctor will ask about these.

Who it may suit: Any man who has been trying for a year, or sooner with a known risk.

Precautions: Do not rely on over-the-counter home kits or supplements instead of a medical review if you are worried.

^5,3,7

Men's health: when to get help → Understand hormone tests →

Stop smoking

Moderate certainty

Addresses: Higher sperm count and better movement of sperm

Why it may help: A meta-analysis of 20 studies (5,865 men) found cigarette smoking was linked with reduced sperm count and motility and with a small drop in normal shape; the effect was larger in moderate and heavy smokers. The WHO and NHS also name smoking as something that can affect fertility, and the NHS says smoking, including passive smoking, can reduce semen quality.

How to apply it: Ask a pharmacist, doctor or national quitline for support; pick a quit date and tell your partner so they can back you.

Who it may suit: Men who smoke, especially those trying for a child.

Precautions: Studies are observational. Quitting is worthwhile for general health whatever the effect on sperm.

^10,1,5

Keep alcohol low and avoid heavy drinking

Low certainty

Addresses: Protects semen volume and sperm shape

Why it may help: A meta-analysis of 15 cross-sectional studies (16,395 men) found alcohol intake had a detrimental effect on semen volume and normal sperm shape, with a bigger gap between daily and occasional drinkers than between occasional drinkers and non-drinkers, suggesting moderate drinking did not clearly harm. The authors advise avoiding heavy drinking. The NHS says drinking too much can affect sperm quality, and that UK chief medical officers advise adults to drink no more than 14 units a week, spread over 3 days or more.

How to apply it: Cut down toward or below the national low-risk limit and have alcohol-free days.

Who it may suit: Men who drink most days or in heavy sessions.

Precautions: Cross-sectional studies cannot prove cause. If you find it hard to cut down, ask a doctor for support.

^11,5

Move toward a healthy weight if you are above it

Low certainty

Addresses: Lower chance of low or absent sperm count

Why it may help: A meta-analysis of 21 studies (13,077 men) found overweight and obesity were linked with a higher prevalence of low or absent sperm count (compared with normal weight, odds were higher in overweight men, higher again in obese men and about double in morbidly obese men). The authors say whether weight normalization improves sperm parameters still needs testing. The NHS says being overweight or obese reduces fertility.

How to apply it: Aim for gradual change through food, movement and sleep rather than crash diets.

Who it may suit: Men with a BMI above the healthy range.

Precautions: Very restrictive dieting or extreme exercise is not advised. The same review found a possible small rise in risk in underweight men, though the result was not clear-cut.

^12,5

Lose Weight Sustainably → Build Better Everyday Health Habits →

Eat a varied, healthy diet

Low certainty

Addresses: Small possible gains in semen quality

Why it may help: A systematic review of 35 observational studies found that healthy diets rich in omega-3 fatty acids and some antioxidants (vitamins C and E, selenium, zinc, lycopene), vitamin D and folate, and low in saturated and trans fats, were linked with better semen quality. Fish, poultry, cereals, vegetables, fruit and low-fat dairy were linked with better sperm measures. The authors stress that observational studies show association, not cause.

How to apply it: Build meals around vegetables, fruit, whole grains, fish and nuts; cut back on processed meat and sugary drinks.

Who it may suit: Most men trying to conceive.

Precautions: A food-based approach is safer than high-dose pills. Allergies and medical diets need individual advice.

^8,13

Meet Your Nutritional Needs →

Avoid steroids and unsupervised testosterone

High certainty

Addresses: Prevents a drop in sperm production

Why it may help: The WHO says anabolic steroid use can cause abnormal semen parameters, and NIDA lists decreased sperm production and shrinking of the testicles among consequences of steroid misuse in men. The Endocrine Society recommends against starting testosterone therapy in men planning fertility in the near term.

How to apply it: If you already use these, speak to a doctor before trying for a child; do not stop a prescribed medicine on your own.

Who it may suit: Men who lift weights, use "boosters" or are being offered testosterone treatment.

Precautions: Recovery after stopping varies and needs medical guidance.

^1,14,15

Testosterone and low testosterone → Testosterone boosters claim check →

Additional options

Have regular sex through the cycle

Moderate certainty

Addresses: Improves the chance of conceiving each month

Why it may help: The NHS defines regular unprotected sex as every 2 to 3 days and uses this pattern in its figures for how quickly most couples conceive.

How to apply it: Aim for sex every 2 to 3 days rather than trying to time one day. If sex is difficult or painful, mention it to a doctor; the NHS notes that if the problem is related to sex, it might be overcome easily.

Who it may suit: Couples trying to conceive.

Precautions: Pressure to perform can affect desire; talk openly. Erectile concerns have their own page.

Erectile dysfunction →

Limit exposure to pesticides, solvents and metals at work or home

Low certainty

Addresses: May avoid direct harm to sperm

Why it may help: The WHO says exposure to environmental pollutants and toxins can be directly toxic to sperm, and the NHS says exposure to certain pesticides, solvents and metals has been shown to affect fertility, particularly in men.

How to apply it: Follow workplace safety rules, wear the protective gear provided and ask an occupational health service if you handle such materials.

Who it may suit: Men who work with farm chemicals, paints, solvents, welding or heavy metals.

Precautions: The sources do not set safe limits; individual risk depends on the job and exposure.

^1,5

Look after stress and your relationship

Low certainty

Addresses: Supports desire and shared coping

Why it may help: The NHS says stress can affect the relationship and cause a loss of sex drive, and in severe cases may affect sperm production. It suggests partners support each other.

How to apply it: Talk openly, share the load of appointments and consider counselling if worry takes over.

Who it may suit: Couples who have been trying for a while.

Precautions: Stress is one factor among many; do not blame yourself or your partner.

^5,3

Feel Calmer During the Day →

Still being studied

Antioxidant supplements for men with low sperm quality

Low certainty

Addresses: Possible gain in live birth rates, with weak evidence

Why it may help: A Cochrane review of 61 trials (6,264 subfertile men; 18 different antioxidants) found low-quality evidence from 7 small trials that antioxidants may improve live birth rates (odds ratio 1.79) for couples attending fertility clinics, and no evidence of more miscarriages, though mild stomach upsets may be more common. The authors called the evidence inconclusive because of risk of bias and small sample sizes.

How to apply it: Not a first step. If you want to try, ask a fertility doctor or pharmacist which product, if any, suits you.

Who it may suit: Men already under fertility-clinic care.

Precautions: Products vary; high doses of single nutrients can cause harm. The review did not look at men with normal semen.

¹⁶

Vitamin E → Coenzyme Q10 →

Omega-3 fats from fish or supplements

Low certainty

Addresses: Possible small improvement in semen quality markers

Why it may help: A systematic review of 16 studies found 14 reported an improvement or association between omega-3 and at least one semen quality marker, but the studies were very different from one another, few were randomized, and no meta-analysis was possible. The authors say more research is needed.

How to apply it: Fish in the weekly menu is a reasonable food-first option.

Who it may suit: Men who like fish or already take omega-3 for other reasons.

Precautions: Fish oil can interact with blood thinners; ask a pharmacist. Choose fish with care in line with local mercury advice.

¹³

Fish oil →

Food & nutrition

An overall eating pattern

A systematic review of 35 observational studies found healthy diets, rich in vegetables, fruit, cereals, fish and poultry and low in saturated and trans fats, were linked with better semen quality. Diets heavy in processed meat, potatoes, full-fat dairy, sugar-sweetened drinks and sweets were linked with poorer results in some studies. Because these are observational findings, the authors say they need confirming in trials.

⁸

Foods and nutrients that have been studied

No single food has been shown to treat male infertility. The reviews link several nutrients with better sperm measures when eaten as part of the diet.

Fish and seafood

Low certainty

Addresses: Possible small gain in semen quality

Why it may help: Fish and seafood were linked with better sperm quality in a review of observational studies, and a second review found most studies of omega-3 intake or fish reported at least one improved semen marker.

How to apply it: Include fish in meals during the week.

Who it may suit: Men who eat fish.

Precautions: Follow local advice on mercury in some fish; seafood allergy.

^8,13

Fish oil →

Vegetables and fruit, including tomatoes

Low certainty

Addresses: Supplies vitamins C, E, folate and lycopene that were linked with better sperm measures

Why it may help: The review of 35 observational studies linked vegetables and fruit, and diets high in vitamins C and E, folate and lycopene, with better semen quality.

How to apply it: Aim for a variety of colours each day.

Who it may suit: Most men.

Precautions: Food sources are different from high-dose pills, which are not shown to be better.

⁸

Tomatoes →

Nuts such as walnuts

Not enough evidence

Addresses: Source of healthy fats and zinc-type nutrients

Why it may help: The sources read for this page did not test nuts directly for fertility, but nuts fit the healthy fat and nutrient pattern linked with better semen quality in the review.

How to apply it: A small handful as a snack.

Who it may suit: Men without a nut allergy.

Precautions: Nut allergy; calories add up.

⁸

Walnuts →

Food and drink to keep modest

The same review linked processed meat, sugar-sweetened drinks and sweets, and in some studies high coffee and alcohol intakes, with poorer sperm results, and a high intake of alcohol, caffeine and red or processed meat with a lower chance of pregnancy in partners. These links come from observational studies and do not prove cause, so treat them as a reason to moderate, not a reason to cut everything out.

The NHS and a meta-analysis suggest keeping alcohol to a low level.

^8,11,5

Remedies & supplements

Traditional use, laboratory findings and human trials are kept apart. "Natural" does not mean safe.

Antioxidant supplements

Low certainty

Studied form and route: Oral vitamins and minerals, alone or in combination

Intended outcome: Possible improvement in live birth rates

Human evidence: A Cochrane review of 61 trials (6,264 subfertile men) combining 18 antioxidants found low-quality evidence from 7 small trials that live birth may improve (odds ratio 1.79) for couples attending fertility clinics, and no evidence of more miscarriage. The authors judged the overall evidence inconclusive.

Limits: Mixed products and doses; few trials reported live birth; men with normal semen were not studied.

Interactions and precautions: Mild stomach upsets may be more common. High doses of single vitamins and minerals can be harmful; ask a pharmacist, especially if you take regular medicines.

¹⁶

Vitamin C → Vitamin E → Coenzyme Q10 →

Folic acid with zinc

Evidence against

Studied form and route: Daily oral supplement

Intended outcome: No benefit found

Human evidence: A multicenter randomized trial of 2,370 men from couples planning infertility treatment found no significant difference in live birth (34% with folic acid and zinc versus 35% with placebo) or in most semen measures after 6 months. Sperm DNA fragmentation was higher with the supplement, and abdominal discomfort and nausea were more common.

Limits: Studied couples attending fertility treatment; results may differ in other groups, and the combination tested was a high-dose one.

Interactions and precautions: Not supported as a fertility treatment. Do not take large amounts of zinc or folic acid without advice.

¹⁷

Zinc → Folate →

Ashwagandha

Low certainty

Studied form and route: Root extract capsules or powders

Intended outcome: Possible higher sperm concentration and motility

Human evidence: A systematic review found four clinical trials (only one randomized). Mostly before-and-after comparisons showed higher sperm concentration, volume and motility after about 90 days, but the authors said the data, though promising, were too limited to be robust.

Traditional use: Used for centuries in Ayurvedic practice as an anti-stress herb and for impotence and infertility.

Limits: Few trials, small groups, no independent confirmation in large randomized studies.

Interactions and precautions: Medicine interactions, thyroid and liver concerns and pregnancy use of the partner are covered on the ashwagandha safety pages; check with a doctor first.

¹⁸

Ashwagandha → Ashwagandha for testosterone, fertility and sexual health →

Maca

Not enough evidence

Studied form and route: Root powder or extract

Intended outcome: Unclear effect on semen quality

Human evidence: A systematic review found five randomized trials; three showed mixed results in men with infertility and two showed mixed effects in healthy men. A meta-analysis did not show a clear effect on sperm concentration. The authors said the number of trials and participants was too small for firm conclusions.

Traditional use: A Peruvian root food long used for energy and fertility.

Limits: Small trials; different products.

Interactions and precautions: Product quality varies. Ask a doctor if you have hormone-sensitive conditions or take regular medicines.

¹⁹

Maca →

Omega-3 fatty acids

Low certainty

Studied form and route: Fish or fish-oil supplements

Intended outcome: Possible small improvement in semen markers

Human evidence: A systematic review of 16 studies found 14 reported an improvement or association with at least one semen quality marker, but the studies differed widely and a meta-analysis was not possible.

Limits: Few randomized trials; different doses and groups.

Interactions and precautions: Fish oil can affect bleeding with blood thinners; ask a pharmacist.

¹³

Fish oil →

Testosterone boosters and steroid-like products

Evidence against

Studied form and route: Supplements and hormone products

Intended outcome: None advised

Human evidence: The WHO and NIDA link steroid use with abnormal semen and decreased sperm production, and the Endocrine Society recommends against starting testosterone therapy in men planning fertility in the near term.

Limits: Unlabelled ingredients are possible in some products.

Interactions and precautions: Avoid unless a doctor who knows your plans advises otherwise.

^1,14,15

Testosterone boosters claim check → Tongkat ali →

Therapies & care

Established professional care starts with a medical history, an examination and a semen analysis, then treats any cause that is found. This page does not recommend medicines or doses, and you should not stop or change a prescribed medicine on your own.

Medical evaluation of the male partner

High certainty

Clinical assessment A GP or urologist asks about your medical and sexual history, medicines, smoking, weight, alcohol, drug use and stress, examines the testicles and penis, and arranges a semen analysis. The AUA/ASRM guideline sets out the evaluation of the male in an infertile couple.

Who it may suit: Men who have not conceived after a year, or sooner with a known risk.

Precautions: Tests can take time; both partners may need checking.

^3,7

Men's health: when to get help →

Testing for infection and hormone problems

Moderate certainty

Clinical tests The NHS lists a chlamydia urine test among tests for men, and MedlinePlus lists sperm count and hormone levels among tests used when the testes may not be making enough hormone. Treating an infection or a hormone problem can be part of care.

Who it may suit: Men with an abnormal semen result or symptoms.

Precautions: Interpretation needs a clinician; home kits are not a substitute.

^3,6

Understand hormone tests →

Treating a cause

Moderate certainty

Medical or surgical care Where a cause is found, treatment depends on it. The NHS says surgery can correct a blockage in the epididymis, and surgical sperm retrieval is an option in some situations. It also mentions that some hormone-stimulating medicines may improve fertility in men. A specialist decides what suits.

Who it may suit: Men whose tests point to a treatable cause.

Precautions: Treatment choice, risks and likelihood of success need specialist advice.

^20,9

Assisted conception

High certainty

Fertility clinic care The NHS lists intrauterine insemination (IUI) and IVF among assisted conception treatments, and the AUA/ASRM guideline concludes that specific treatment and assisted reproductive techniques are effective at managing male infertility. The NHS advises choosing a clinic licensed by the Human Fertilisation and Embryology Authority (HFEA) in the UK and notes that treatment such as IVF can cause complications.

Who it may suit: Couples where natural conception is unlikely or has not happened despite other steps.

Precautions: Success is not guaranteed and private treatment can be costly; choose a licensed clinic.

^20,9

Emotional support and counselling

Low certainty

Supportive care The NHS notes that trying to conceive can be an emotional process and that partners should support each other. Counselling or a support group can help if worry, grief or strain build up.

Who it may suit: Couples and individuals finding the wait hard.

Precautions: Seek help promptly for low mood or thoughts of self-harm.

What to avoid

Habits, products and claims that can get in the way. Never stop a prescribed medicine without talking to the professional who prescribed it.

Risks that apply to most people

Smoking, including passive smoke

Moderate certainty

Why: A meta-analysis of 20 studies found smoking linked with lower sperm count and motility, and the NHS says smoking, including passive smoking, can reduce semen quality.

Who it applies to: Any man trying to father a child.

Try instead: Ask for help to quit, and keep your home and car smoke-free.

^10,5

Regular heavy drinking

Low certainty

Why: Daily drinkers had lower semen volume and fewer normally shaped sperm than occasional drinkers in a meta-analysis; the NHS says drinking too much can affect sperm quality.

Who it applies to: Men who drink most days or binge.

Try instead: Stay within national low-risk limits and have alcohol-free days.

^11,5

Anabolic steroids

High certainty

Why: The WHO says steroid use can cause abnormal semen parameters, NIDA lists decreased sperm production and shrinking of the testicles among the consequences, and the NHS says long-term misuse can reduce sperm count and mobility.

Who it applies to: Gym users, athletes and anyone offered steroids by a friend or online seller.

Try instead: If you have already used them and hope to have children, see a doctor; do not self-treat.

^1,14,4

Starting testosterone treatment while planning a child

High certainty

Why: The Endocrine Society recommends against starting testosterone therapy in men planning fertility in the near term.

Who it applies to: Men with low-testosterone symptoms who also want children.

Try instead: Tell the prescriber about your plans; a doctor can discuss options that fit them.

¹⁵

Recognize When Low Testosterone Needs Evaluation →

Personal triggers to check

Medicines and treatments that can lower sperm

Moderate certainty

Why: The NHS says certain medicines can sometimes cause fertility problems in men, including some anti-inflammatory medicines (effects temporary and usually reversing on stopping), chemotherapy and misused steroids. It advises telling the GP about any medicine, herbal remedy or supplement.

Who it applies to: Men on long-term prescriptions or about to start cancer treatment.

Try instead: Ask your prescriber whether a medicine could affect sperm. Never stop a prescribed medicine on your own.

^4,3

Illegal drug use

Low certainty

Why: The NHS includes illegal drug use among lifestyle factors the GP asks about when looking at fertility and names it as a possible cause of low testosterone (hypogonadism).

Who it applies to: Men trying to conceive who use recreational drugs.

Try instead: Be honest with the doctor so the cause can be found; ask for confidential support to cut down or stop.

^3,4

Untreated infections and injury to the testicles

Moderate certainty

Why: The NHS lists infections, injury, surgery and undescended testicles as causes of damage to sperm production, and offers a chlamydia test as part of male fertility tests.

Who it applies to: Men with past testicular problems or possible exposure to an infection.

Try instead: Get checked and treated promptly; do not wait on a lump, swelling or pain.

^4,3,21

Overheating the testicles

Not enough evidence

Why: The NHS says there is a link between increased scrotal temperature and reduced semen quality, but it is uncertain whether loose underwear improves fertility.

Who it applies to: Men who sit for long hours or use very hot baths often.

Try instead: Comfortable clothing and regular breaks from sitting are sensible, but no proven fix is known.

⁴

Products that need caution

Folic acid and zinc combinations sold for male fertility

Evidence against

Why: In a randomized trial of 2,370 men from couples starting infertility treatment, folic acid plus zinc for 6 months did not improve semen quality or live birth versus placebo, and was linked with more sperm DNA fragmentation and more digestive symptoms.

Who it applies to: Men attracted by fertility blends that list these ingredients.

Try instead: Do not rely on them; talk with a fertility doctor first.

¹⁷

Zinc → Folate →

Testosterone "boosters" and steroid-like products

Evidence against

Why: Hormone-active products can lower sperm production, and the sources read for this page found no proven sperm benefit for boosters. Unlabelled ingredients are a risk.

Who it applies to: Men buying online products that promise "more testosterone".

Try instead: Use the claim check and have symptoms assessed by a doctor.

^1,14,15

Testosterone boosters claim check → Product quality and contamination →

Unsupported claims

"Male fertility blends are proven to raise sperm count"

Evidence against

Why: The sources read did not find proper evidence for marketed blends as a whole. The best trial of a common combination was negative, and the Cochrane review calls antioxidant evidence inconclusive.

Who it applies to: Product labels and social media.

Try instead: Use medical assessment and lifestyle steps first.

^17,16

"Tight underwear is the cause of low sperm"

Not enough evidence

Why: The NHS says a link with scrotal temperature exists, but it is uncertain whether loose underwear improves fertility.

Who it applies to: Online lists of fertility tips.

Try instead: Do not rely on a clothing change; see a doctor if you have been trying for a year.

⁴

Common mistakes

Assuming the problem is only on the woman's side

High certainty

Why: NICHD says problems in the male are just as likely as problems in the female, and the NHS says it is always best for both partners to visit the GP.

Who it applies to: Couples at the start of testing.

Try instead: Book male and female checks together.

^2,3

Waiting a long time before getting checked

Moderate certainty

Why: The NHS advises seeing a GP after a year of trying, or sooner if there is a known risk. A visit can also pick up health problems that go along with poor semen quality.

Who it applies to: Men who feel embarrassed to ask.

Try instead: Book an appointment; the questions are routine and kept confidential.

^5,7

Trying hormone products on your own

Moderate certainty

Why: Hormone products and steroids can reduce sperm production, and a doctor needs to know what you take to interpret tests.

Who it applies to: Men with low energy or low drive who are also trying for a child.

Try instead: Have symptoms assessed and discuss fertility plans before any hormone treatment.

^15,14

Evidence & safety

What the research shows

Health agencies agree that male factors cause a large share of fertility problems, that smoking, heavy drinking, obesity, steroids and some exposures can lower sperm quality, and that a medical evaluation with semen analysis is the right step after a year of trying. Lifestyle links come mostly from observational studies. Supplements have limited evidence: antioxidants show low-quality, inconclusive benefit, one large trial of folic acid with zinc was negative, and ashwagandha and maca have small, mixed trials.

Limits of the evidence

Most lifestyle and diet findings are observational and cannot prove cause.
Many supplement trials are small, short or use different products and doses.
Trials often measure sperm counts rather than live birth.
Studies include a mix of men from the general population and from fertility clinics, so results may not apply to every man.
The sources read were mainly in English and from the US, UK and international bodies.

Precautions and interactions

Tell your doctor about every supplement, herb, hormone product or steroid you use.
Do not start or stop testosterone, prostate or other prescribed medicines without medical advice.
Single-nutrient high-dose products can cause harm; food first.
Treat claims of fast fixes with caution.

Life-stage considerations

Age: the NHS lists age as a factor that affects fertility.
Pregnancy and breastfeeding: this page covers the male partner only. A partner who is pregnant, trying to conceive or breastfeeding should ask her own clinician about her supplements and herbs.
Teens and young men: steroid and booster use can affect later fertility; seek advice before using them.
Men with cancer treatment ahead: ask the care team about fertility options before treatment starts.

Warning signs

Sudden, severe testicle pain, or testicle pain with sickness or tummy pain: emergency care straight away (999 in the UK per the NHS).
A testicular lump, swelling, change in shape or feel, or one testicle bigger than the other: urgent medical appointment.
Pain lasting more than an hour or continuing at rest.
Fever with urinary or testicular symptoms, blood in urine or semen, or new back pain with weight loss: see a doctor promptly.
Low mood, hopelessness or thoughts of self-harm: speak to a doctor or crisis service.

Claim checks

Antioxidant pills will fix low sperm count

Low certainty

A Cochrane review found low-quality evidence of possible benefit for live birth in men attending fertility clinics and called the evidence inconclusive.

¹⁶

Folic acid and zinc improve sperm and pregnancy rates

Evidence against

A large randomized trial found no improvement in live birth or most semen measures and more DNA fragmentation and stomach upset.

¹⁷

Ashwagandha is a proven fertility treatment

Low certainty

Promising before-and-after data from four trials, but only one was randomized, and the authors judged the data too limited.

¹⁸

Maca raises sperm count

Not enough evidence

Five randomized trials gave mixed results and the pooled effect on sperm concentration was not significant.

¹⁹

Taking testosterone is a way to improve fertility

Evidence against

The Endocrine Society recommends against starting testosterone therapy in men planning fertility, and steroid misuse reduces sperm production.

^15,14

Loose underwear improves sperm

Not enough evidence

The NHS says a link with higher scrotal temperature exists but it is uncertain whether loose underwear helps.

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Questions people ask

How common is male infertility?

NICHD notes that problems in the male are just as likely as problems in the female, and that a combination from both partners is equally likely. The NHS says around 1 in 7 couples may have difficulty conceiving.

When should I see a doctor?

The NHS suggests seeing a GP if you have not conceived after a year of trying, and sooner if you know of a testicular, hormone or sexual problem, have had cancer treatment or may have had a sexually transmitted infection.

What tests are done?

The NHS says a GP may examine the testicles and penis, and tests for men include a semen analysis and a chlamydia urine test. MedlinePlus lists sperm count and hormone levels among tests used when the testes may not be producing enough hormone.

Can lifestyle changes help?

Smoking, heavy alcohol use and obesity can affect fertility, so addressing them is reasonable. The studies are mostly observational, so they show links rather than guaranteed results.

Do antioxidants improve sperm?

A Cochrane review found low-quality evidence they may improve live birth rates in men at fertility clinics, but called the evidence inconclusive.

Do folic acid and zinc help?

In a large randomized trial they did not improve semen quality or live birth, and sperm DNA fragmentation and stomach upset were higher. They are not supported as a fertility treatment.

Should I take testosterone while trying to have a child?

The Endocrine Society recommends against starting testosterone therapy in men planning fertility in the near term. Tell your doctor about your plans before any testosterone product.

Do anabolic steroids affect sperm?

Yes. The WHO says steroid use can cause abnormal semen parameters, and NIDA lists decreased sperm production and shrinking of the testicles.

Is ashwagandha or maca worth trying?

The evidence is limited. A review of four ashwagandha trials (one randomized) was promising but too limited for firm conclusions, and a review of five maca trials gave mixed results. Check with a doctor or pharmacist first.

Will loose underwear help?

The NHS says there is a link between higher scrotal temperature and reduced semen quality, but it is uncertain whether loose underwear improves fertility.

Does stress affect sperm?

The NHS says stress can affect the relationship and sex drive, and in severe cases may affect sperm production. Supporting each other and seeking counselling if needed is sensible.

References

World Health Organization. Infertility fact sheet. Read 2026-11-01. source
NICHD (NIH). What are some causes of infertility? Read 2026-10-22. source
NHS. Diagnosing infertility. Read 2026-11-01. source
NHS. Causes of infertility. Read 2026-11-01. source
NHS. Infertility (page last reviewed 9 August 2023). Read 2026-11-01. source
MedlinePlus (NLM). Hypogonadism. Read 2026-10-22. source
Schlegel PN, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril. 2021. PMID 33309062. source
Salas-Huetos A, et al. Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Hum Reprod Update. 2017. PMID 28333357. source
Schlegel PN, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part II. Fertil Steril. 2021. PMID 33309061. source
Sharma R, et al. 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. PMID 27113031. source
Ricci E, et al. Semen quality and alcohol intake: a systematic review and meta-analysis. Reprod Biomed Online. 2017. PMID 28029592. source
Sermondade N, et al. BMI in relation to sperm count: an updated systematic review and collaborative meta-analysis. Hum Reprod Update. 2013. PMID 23242914. source
Falsig AL, et al. The influence of omega-3 fatty acids on semen quality markers: a systematic PRISMA review. Andrology. 2019. PMID 31116515. source
NIDA (NIH). Anabolic Steroids DrugFacts. Read 2026-11-01. source
Bhasin S, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018. PMID 29562364. source
Smits RM, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2019. PMID 30866036. source
Schisterman EF, et al. Effect of Folic Acid and Zinc Supplementation in Men on Semen Quality and Live Birth Among Couples Undergoing Infertility Treatment: A Randomized Clinical Trial. JAMA. 2020. PMID 31910279. source
Withania somnifera (Indian ginseng) in male infertility: An evidence-based systematic review and meta-analysis. Phytomedicine. 2018. PMID 30466985. source
Lee HW, et al. Maca (Lepidium meyenii Walp.) on semen quality parameters: A systematic review and meta-analysis. Front Pharmacol. 2022. PMID 36110519. source
NHS. Treatment for infertility. Read 2026-11-01. source
NHS. Testicle pain (page last reviewed 26 June 2025). Read 2026-11-01. source