How can a man improve his fertility naturally?

Proper stress management, sleep, and healthy lifestyle habits can improve fertility.

• Timing of intercourse: The optimal semen quality has been shown to occur with a 2-3 day abstinence of ejaculation. Intercourse can be timed to the predicated day of ovulation to help appropriately time the male abstinence.
• Weight: Male obesity contributes to abnormalities in reproductive hormones including decline in testosterone and increased estrogen levels. This has been shown to have subtle effects on sperm quality. Further, male obesity is a risk factor for erectile dysfunction. Men are recommended to maintain a healthy body weight to ensure reproductive health as well as general health.
• Smoking: Tobacco use has been shown to correlate with sub-fertility in both men and women. Chronic tobacco use has also been identified as a risk factor in erectile dysfunction. No safe use of tobacco has been established and thus men are recommended to forgo the use of all tobacco products.  The use of marijuana and sperm quality is controversial, but has been implicated in poor sperm parameters as well.
• Alcohol: Heavy use of alcohol causes decreases in both testosterone levels and sperm production in the testicle. Testicular atrophy (decrease in size) has also been noted with heavy use. In addition, significant alcohol consumption is another factor that has been shown to cause erectile dysfunction. Moderate use of alcohol (1-4 drinks per week) or less is recommended.

Some of the factors that may impact male fertility include: age, general medical conditions, medications or supplements, and environmental exposures. There is a lot of conflicting data regarding many of these factors.

For optimal health and fertility, one should avoid obesity, stress and performance-enhancing steroids. Age is not something one can change, though it should be considered when planning for pregnancy. Sperm motility decreases 0.7% every year after a man turns 30, which could have an effect on getting pregnant. Exposure to heat (such as prolonged time in hot-tubs) is an environmental factor that has been shown to lower sperm maturation in the testicles, though it is less clear if this decreases overall rates of fertility.

Additionally, there are many late-night infomercial programs aimed at “boosting male enhancement.” There is not enough data available to form a consensus on whether these “natural” supplements have any longstanding effect on sperm production or infertility. It is always best to consult your doctor before trying a new supplement to discuss side effects, interactions and whether it may be right for you.