Promoting Healthy Spermatogenesis
To promote healthy spermatogenesis, lifestyle modifications including smoking cessation, maintaining a healthy weight, regular physical exercise, and consuming a diet rich in antioxidants, omega-3 fatty acids, selenium, zinc, and CoQ10 are strongly recommended. 1
Lifestyle Modifications
Smoking cessation: Strong evidence suggests that cigarette smoking has a negative effect on semen quality and male fertility. Men trying for pregnancy should abstain from smoking. 1
Weight management: Obesity is associated with impaired sperm parameters. Weight loss can enhance sperm parameters and should be encouraged. 1
Physical activity: Regular exercise has been shown to improve sperm parameters and overall reproductive health. 1
Avoid excessive heat exposure: Limiting exposure to high temperatures (hot tubs, saunas, tight underwear) can help maintain optimal testicular temperature for spermatogenesis. 1
Dietary Recommendations
Beneficial Foods
Seafood, fish, and shellfish: Rich in omega-3 fatty acids which significantly increase sperm concentration (10.98 × 10^6 spz/mL), sperm count (18.70 × 10^6 spz/mL), and improve sperm morphology. 2, 3
Poultry: Associated with better semen parameters compared to red meat. 3, 4
Nuts: Provide essential fatty acids and antioxidants that support sperm health. 5, 3
Whole grains: Contain important nutrients and fiber that support overall reproductive health. 3
Fruits and vegetables: Rich in antioxidants that protect sperm from oxidative damage. 3, 4
Low-fat dairy: Preferable to full-fat dairy products for sperm health. 3, 4
Foods to Limit or Avoid
Processed meats: Negatively associated with semen quality parameters. 3, 4
Red meat: High intake is associated with decreased fecundability. 4
Full-fat dairy products: May have detrimental effects on sperm quality. 4
Sugar-sweetened beverages and sweets: Associated with poorer semen parameters. 4
Excessive alcohol and caffeine: Negatively influence fertility parameters. 4
Nutritional Supplements
While evidence quality varies, several supplements have shown promise in improving spermatogenesis:
Antioxidants: May improve live birth rates, though evidence quality is low. Specific antioxidants with positive effects include: 1
- Vitamin E
- Vitamin C
- β-carotene
Selenium: Increases total sperm concentration (3.91 × 10^6 spz/mL), improves sperm motility (3.30%), and enhances sperm morphology (1.87%). 2
Zinc: Increases sperm concentration (1.48 × 10^6 spz/mL) and improves total motility (7.03%). 2
Coenzyme Q10 (CoQ10): Increases sperm concentration (5.93 × 10^6 spz/mL), sperm count (10.15 × 10^6 spz/mL), total motility (5.30%), and improves morphology (1.06%). 2
Carnitines: Improve sperm total motility (7.84%), progressive motility (7.45%), and morphology (4.91%). 2
Omega-3 fatty acids: Significantly increase sperm concentration, count, and improve morphology. 2
Hormonal Considerations
For men with hypogonadotropic hypogonadism: Gonadotropin therapy with human chorionic gonadotropin (hCG) followed by FSH can initiate and maintain spermatogenesis. 1
For men with idiopathic infertility: FSH treatment may increase sperm parameters in men with idiopathic oligozoospermia who have FSH levels within the normal range. 1
Important Caveats
Avoid testosterone replacement therapy if fertility is desired, as it can suppress spermatogenesis and lead to azoospermia. 1
The evidence for herbal therapies and prebiotic/probiotic supplements is limited and requires further high-powered randomized controlled trials. 1
While selective estrogen receptor modulators (SERMs) and aromatase inhibitors may improve hormonal and semen parameters, their benefits are limited compared to assisted reproductive technologies, and they are not FDA-approved for this use in men. 1
Men with infertility are at higher risk of developing cardiometabolic disorders and have higher cardiovascular mortality, making lifestyle modifications even more important. 1