Fertility is a shared responsibility

Why sperm health matters

For too long, fertility has been framed as a female issue. In reality, male factors contribute to approximately 50% of infertility cases worldwide (World Health Organization, 2023). Sperm health is not secondary; it is equally essential in creating a healthy pregnancy. Whether conceiving naturally or through assisted reproductive technologies such as IVF or ICSI, sperm quality matters.

A standard semen analysis assesses volume, concentration, count, motility (movement), and morphology (shape). Many laboratories use WHO reference ranges established in 2010 and updated in 2021. These values are based on the lowest 5th percentile of men whose partners conceived within 12 months, meaning they represent the lower end of fertility, not an optimal benchmark (Panner Selvam & Agarwal, 2021). Normal does not necessarily mean optimal.

Even sperm that appear normal under a microscope may carry DNA damage. During ICSI, an embryologist selects the best-looking sperm based on movement and shape, but DNA integrity cannot be visually assessed. Each parent contributes 23 chromosomes. If sperm DNA is fragmented, this may impact fertilisation, embryo development, miscarriage risk, and pregnancy outcomes (Nowicka-Bauer et al., 2018; Boitrelle et al., 2021). This is why, in some cases, further testing such as DNA fragmentation analysis may be worth discussing with your healthcare provider.

What Impacts Sperm Health?

Sperm are highly sensitive to oxidative stress - an imbalance between free radicals and antioxidants in the body. Oxidative stress is considered one of the central mechanisms behind sperm dysfunction (Nowicka-Bauer et al., 2018; Panner Selvam & Agarwal, 2021).

Contributors include:

• Chronic psychological stress

• Smoking and excessive alcohol intake

• Poor sleep

• Nutritional deficiencies

• Chronic inflammation

• Endocrine-disrupting chemicals (found in plastics and pesticides)

• Increased scrotal temperature (frequent saunas, hot baths, tight clothing, laptops on lap, phone’s in pockets)

  
  

Over time, these factors can impair sperm count, motility, morphology, and DNA integrity (Panner Selvam & Agarwal, 2021). Sperm production takes approximately 70–90 days. This means meaningful improvements can often occur within three months when supportive changes are made. Simple but powerful steps include:

• Prioritising consistent, restorative sleep

• Limiting alcohol and coffee and avoiding smoking

• Reducing ultra-processed foods

• Eating antioxidant-rich foods (berries, leafy greens, citrus, nuts)

• Keeping the testicles cool (limiting hot baths and saunas)

• Considering evidence-based antioxidant supplementation under guidance

Where Acupuncture May Help

Emerging research suggests acupuncture may improve sperm parameters including count, motility, and morphology (Jerng et al., 2014; Zhou et al., 2024). Some studies also indicate acupuncture may reduce oxidative stress, a key mechanism involved in sperm damage. While more research is needed, acupuncture offers a low-risk, holistic approach that supports nervous system regulation, stress reduction, and overall reproductive health.

When one partner undergoes hormonal stimulation, egg retrieval, and repeated cycles of treatment, it is reasonable, and important that sperm health is equally optimised. Fertility is not one person’s responsibility. It is shared biology, shared effort and shared care.

References

Boitrelle, F., Shah, R., Saleh, R., Henkel, R., Kandil, H., Chung, E., Vogiatzi, P., Zini, A., Arafa, M., & Agarwal, A. (2021). The sixth edition of the WHO manual for human semen analysis: A critical review and SWOT analysis. Life, 11(12), 1368. https://doi.org/10.3390/life11121368

Jerng, U. M., Jo, J. Y., Lee, S., Lee, J. M., & Kwon, O. (2014). The effectiveness and safety of acupuncture for poor semen quality in infertile males: A systematic review and meta-analysis. Asian Journal of Andrology, 16(6), 884-891. https://doi.org/10.4103/1008-682X.129130

Nowicka-Bauer, K., Lepczynski, A., Ożgo, M., Kamieniczna, M., Fraczek, M., Stanski, L., Olszewska, M., Malcher, A., Skrzypczak, W., & Kurpisz, M. (2018). Sperm mitochondrial dysfunction and oxidative stress as possible reasons for isolated asthenozoospermia. Journal of Physiology and Pharmacology, 69(3), 403-417. https:// 10.26402/jpp.2018.3.05

Panner Selvam, M. K., & Agarwal, A. (2021). A systematic review on sperm DNA fragmentation in male factor infertility: Laboratory assessment and clinical implications. Life, 11(12), 1368. https://doi.org/10.1016/j.aju.2017.12.001

World Health Organization. (2023). Infertility fact sheet. https://www.who.int/news-room/fact-sheets/detail/infertility