AS FERTILITY SPECIALISTS, we’ve been analysing sperm – or, more correctly, semen – for decades. However, a growing body of research suggests it has far wider implications than fertility and could provide a valuable snapshot of a man’s overall health.
Mounting evidence links factors such as low sperm count and poor motility (issues with how the sperm ‘swims’ to reach an egg) to an increased risk of serious health problems – or early death. A 2021 meta-analysis found men with infertility faced a 26% higher risk of mortality and those with severely low sperm counts a 67% greater risk compared to men with normal results.
A comprehensive U.S. study of nearly 12,000 men also yielded worrying findings, with more than double the deaths in the follow-up period among the men who had abnormal semen parameters.
But let’s not panic prematurely. Infertility itself doesn’t directly cause an early death. However, it can signpost the presence of chronic illnesses that will benefit from early intervention. And the good news is, there are plenty of things you can do today to improve the health of your sperm and even the health of your future children.
A weighty issue
A woman’s health is just 50% of the fertility puzzle, and the link between obesity and male-factor infertility is well established. It’s one of the major factors I see impacting the men in my rooms, with ABS statistics classifying approximately 42.3% of 18 to 24-year-old, 66.1% of 25 to 34-year-old, and 74.8% of 35 to 44-year-old Australian men as overweight or obese.
We know that obesity and cardiovascular disease are closely associated, but excess body weight also negatively affects the shape, motility and concentration of sperm. Metabolic syndrome is common among men with impaired fertility, with the presence of multiple obesity-related conditions such as high blood pressure, low levels of HDL (‘good’) cholesterol, type 2 diabetes or excess weight around the middle associated with sperm DNA fragmentation.
Diabetes also impacts sperm, and sleep apnoea is known to cause oxidative stress that impairs motility.
Uncovering hidden illness
While not traditionally used for this purpose, semen testing can also reveal hidden illness and the early signs of chronic disease. Sperm production and health are impacted by things as diverse as infection, liver or kidney disease, testicular disorders and hormonal imbalances.
A severely low sperm count or azoospermia (lack of sperm in ejaculate) may also point to Klinefelter syndrome – a relatively common cause of undiagnosed gonadal failure (hypogonadism). This genetic disorder increases the risk of autoimmune conditions and osteoporosis, as well as infertility, so early detection with a semen test is very beneficial.
Researchers have also established a strong correlation between male infertility and testicular and prostate cancer, with subfertility also considered a biomarker for increased familial cancer risk.
While the biological mechanisms remain under investigation, scientists suspect shared genetic pathways may influence both reproductive and overall health. Since about 4% of mammalian genes are expressed in the male germline (the cells that produce sperm and pass on genetic information to children), disruptions in DNA repair could impact both fertility and cancer risk.
A lifestyle wake-up call
Abnormal sperm parameters may also indicate that your lifestyle – and diet – needs a bit of a shakeup. An overly processed diet high in refined carbohydrates is known to negatively impact fertility by increasing inflammation and potentially fuelling metabolic disease.
The remedy? The Mediterranean diet. Widely accepted as the gold standard by the medical fraternity, this plant-rich diet is packed with healthy fats (think: olive oil), vegetables, fruits, legumes and whole grains and has been shown to improve sperm concentration and motility.
One 2020 randomised controlled trial of 160 men placed on either a Mediterranean or low-fat diet for six months found significantly higher improvements in sperm count and concentration among the first cohort. Limiting alcohol, stopping smoking and reducing heat exposure and the use of laptops (on the lap) have also been linked to significant improvements in sperm parameters, including motility, concentration and DNA fragmentation.
I also recommend stress management techniques, regular movement and loose underwear in natural, breathable fibres – particularly during summer.
How sperm health can impact your children
Recent research also suggests a link between a father’s health and the risks of conditions like obesity, diabetes and neurodevelopmental differences in children. For instance, men who are obese at conception may pass on altered metabolic signals through sperm, potentially predisposing children to similar struggles.
There is also a strong genetic basis to male infertility, and there has been concern about
transgenerational inheritance of poor fertility in offspring (meaning that if a parent has fertility problems, then their offspring may also have a higher risk of fertility problems). However, this research does not seem alarming, as more recent evidence also seems to reassure us that the reproductive health of young men whose fathers had abnormal semen parameters have similar reproductive outcomes to their peers.
Sperm testing as part of a holistic health check
All of this highlights the potential of semen testing as part of a holistic health check, outside of fertility. It is a relatively simple and inexpensive intervention that gives us an insight into overall health, while serving as an early warning system for metabolic dysfunction and chronic disease that may otherwise go undetected.
Growing evidence suggests it may prove to be one of the most powerful predictors of long-term health in men. Used alongside other investigative tools such as blood tests, it can also help prompt the necessary lifestyle changes to improve not only your fertility outcomes but the odds of living a long and healthy life.
Dr Devini Ameratunga is a Brisbane-based board-certified Reproductive Endocrinologist (CREI) and Gynaecologist, dedicated to providing high-quality care in all areas of fertility and assisted reproduction, gynaecology and minimally invasive surgery. Visit drdevameratunga.com
Related:
New Infertility Statistics Are Out – The Numbers Aren’t Good
When It Comes To Male Fertility, Here Are The Foods You Need To Eat For Healthier Sperm
