Male-Cause Infertility - the Secret’s Out
Male Cause Infertility - the Secret’s Out
When a couple is trying to conceive and things aren’t going as planned, the focus usually shifts straight to the woman. Her hormones. Her cycle. Her stress. Her labs. Her supplements. What’s going on with her.
But the truth is, male factor infertility plays a role more than a third of all fertility challenges, and in 50% of miscarriages.
(Yes we said HALF)!!
And yet, it’s something we don’t often talk about—at least not with the same openness or support.
Whether it’s Father’s Day, World Infertility Awareness Month, or Pregnancy & Infant Loss Awareness Month - to us, it always feels like the perfect time to widen the conversation. Not to point fingers, but to share facts, offer support, and bring both partners into the process, because a fertility journey is never just one person’s story.
It takes two to make a baby. It takes two to investigate why it’s not happening. It takes two to heal and move forward.
Let’s talk about the male side of the fertility equation—and what we can do about it.
Male Fertility 101: It’s More Than “Just Sperm Count”
When we say “male infertility,” most people think of low sperm count. But it’s more nuanced than that. There are four regularly discussed markers of healthy sperm:
Count (How many are produced)
Motility (How well they swim)
Morphology (How they’re shaped)
DNA integrity (How genetically stable they are)
And all of them are influenced by nutrition, sleep, stress, toxin exposure, inflammation, and hormone balance - yes, in men too.
This isn’t just about making babies. Sperm quality is a reflection of overall male vitality - testosterone, energy, cardiovascular health, and even long-term disease risk.
What affects male fertility?
Modern life isn’t exactly sperm-friendly. Some of the most common hidden disruptors include:
Chronic stress + elevated cortisol
Low testosterone (and estrogen dominance in men, hello metabolic crisis)
Poor sleep (commonly caused by sleep apnea)
Toxin exposure (plastics, pesticides, heavy metals, etc.)
Alcohol, smoking, or vaping
Nutrient deficiencies (zinc, selenium, B12, folate, CoQ10, vitamin C, just to name a few)
High body fat percentage + insulin resistance (circling back to that low T again)
Excess heat (think: laptops on laps, hot tubs, tight underwear - especially those made of synthetic fibers… but we could write a whole ‘nother blog on just that)
These aren’t just male issues; they’re human issues. But they directly affect sperm health. The good news? They’re also addressable through lifestyle changes.
When should he have a sperm test or semen analysis?
Last Tuesday.
Kidding! But not really.
I often joke that a high-quality semen analysis should be a wedding registry gift (if the couple knows they want to start a family, of course). But all jokes aside, it’s painfully common to hear the status quo recommendation of
“If you’ve been trying to conceive for 6+ months without success, especially if you’re over 35, let’s test.”
And while it’s reasonable—and helpful—to check in on both sides of the equation at that point… with the issues of miscarriage rates, infertility, and both maternal and childhood health conditions on the rise… we say “Why wait?” Let’s give you the best knowledge to act on, from the start.
Testing Options - Going Beyond Sperm Count
A simple semen analysis can give you insight into sperm health and is often a great place to start because it’s usually covered by health insurance. However, we truly don’t want to stop there if you’re serious about getting the full picture (and especially if you’ve found this blog because you’re already concerned about fertility challenges, recurrent miscarriages or losses, and are in the thick of TTC wondering “will it ever happen for us?” or “why am I not pregnant yet?” )!
Sperm count is the most common point of analysis, and it has been dropping drastically in recent years and decades. So much so, that the “normal” ranges have even been altered (whoa - they’re been doing this with the “normal” ranges for testosterone as well, label us very concerned). In our minds, it might be better to investigate the reason for the drops, instead of just moving the goalpost. Our standard for minimum acceptable count is 15 million.
Depending on how low the count is, it could be an anatomical issue, like a blockage. This is where volume will come in as well. Analyzing volume alongside total count allows us to look at concentration as well. So, if this is off, it’s very important to know early on in your fertility journey so appropriate treatment can be planned!
Next up, we want to examine the morphology. We love to have this looked at because if it is wildly out of normal (think misshapen tails, extra heads… you get picture), you can be sure that there is going to be a DNA issue (even if you don’t opt for the extra genetic testing we’re going to get to in a minute here).
The other piece we look at is sperm motility. Getting to the egg (and then actually burrowing in for fertilization to occur) is actually pretty darn hard work. Even if you have a good count, volume and morphology, if those guys are just lazing around, you’re going to have a pretty slim chance of getting pregnant. We want to know not just that some are moving & grooving, but how many are swimming, often called a total motile count.
We typically would also look at metabolic health (a comprehensive metabolic panel and standard CBC will also be standard at annual checkups), including fasting glucose (and fasting insulin) as well as free and total testosterone, in addition to other bio-individual labs based on the male partner’s unique history and exam in our functional medicine office.
Lastly, if you’re really wanting to start off with all the information, we recommend advanced testing from a company like Legacy. They also offer freezing, post-thaw analysis and advanced DNA fragmentation testing of sperm. We are not associated with Legacy, but they do run discount specials (we’ve seen up to 20% around Father’s Day) and it is what we recommend for our clients. The cost of their testing was $570 at the time of this writing, which includes the DNA fragmentation testing (a $275 charge that is well worth the investment) - which is why I think this makes an awesome wedding registry item! Freezing is offered by Legacy at an additional charge, and you can learn all about it at their website.
For many couples I work with, getting this information brings a sense of clarity and relief. It’s one more piece of the puzzle, and it can often guide the next right steps.
Supporting His Fertility Naturally: 5 Starting Points
Whether you're prepping for Father’s Day or prepping for IVF, these are easy, impactful shifts for supporting male reproductive health:
Ditch the plastics and processed food
BPA and phthalates are hormone disruptors. Switch to glass containers and eat more whole foods. Keeping processed foods and refined sugars to a bare minimum makes a huge difference not just in sperm health, but also in endocrine & metabolic health (oh hey again, testosterone).Focus on sleep and stress
Aiming for seven to eight hours of sleep and reducing chronic stress can significantly improve testosterone and sperm quality. Remember the rules of sleep - dark, cool and consistent (schedule)!Boost nutrient density
Key players: zinc (oysters!), vitamin C, CoQ10, omega-3s, and folate-rich greens and B vitamins. L-carnitine is also a helpful addition if you don’t eat much red meat, as well as herbs and adaptogens such as Ashwaganda and Astragalus.Move daily—but don’t overtrain
Strength training and daily movement support hormones. But overdoing cardio or HIIT on top of strength, especially while under high amounts of stress, can backfire. Recovery and proper fueling are crucial to get the hormetic (aka positive, adaptive stress) response we’re looking for that boosts testosterone and overall health!Check his labs
Functional testing for total and free testosterone, insulin, inflammation markers, and oxidative stress can reveal a lot and provide a clear path for actionable steps to improve outcomes, on top of a great semen analysis.
💬 A Note for You, Partner to Partner
If you’re the one reading this and wondering how to bring it up with your partner, know this: you’re not alone. These conversations can feel delicate, especially when you both want the same outcome but aren’t sure what’s holding things up.
My advice? Share this article. Start the conversation. Make the appointments together. And if he’s open to it, a functional fertility protocol can support you both.
What helps most is shifting the focus from “what’s wrong” to “how can we support our health—together?” You’re on the same team. And shared understanding can bring you closer, even in a hard season.
Fatherhood Starts Before Baby
This Father’s Day, and every day, I invite you to see fertility as more than a lab result. It’s a reflection of what’s going on in the whole body—and the good news is, the body responds beautifully to the right kind of care.
The body that builds a child is the same body that will raise one. And the energy, resilience, and emotional presence you bring to fatherhood… it starts now.
If you’re ready to support your fertility from the inside out—naturally and intentionally—we’d love to support you both.
