Can Low Sperm Count Improve? Lifestyle, Supplements, and When to See a Specialist

When Cirarn and his wife got their first semen analysis results back, he didn't know what to do with them. The numbers were there in black and white: a sperm concentration well below the clinical threshold, but no one had told him what they meant, what caused them, or what, if anything, he could do. His doctor referred him to a urologist. His wife started Googling. He stayed quiet about it with friends, not sure how to bring it up or whether he even wanted to.

His experience is far from unusual. Male factor infertility is involved in roughly 50% of all infertility cases, either as the primary cause or a contributing one, yet it remains significantly less discussed, less researched, and less emotionally supported than female infertility. Additionally, one of the male factors identified, low sperm count (clinically called oligospermia) is among the most common diagnoses.

The question men most want answered after that diagnosis is also the most important one: Can it get better?

For many, the answer is yes.

Before diving into solutions, it helps to understand what the numbers mean. The World Health Organization defines a normal sperm concentration as 15 million sperm per millilitre of semen or above. A count below that threshold is classified as oligospermia,  though the spectrum matters:

What's worth noting, and what often gets lost in the initial shock of a diagnosis, is that count alone doesn't tell the whole story. Motility (how well sperm swim), morphology (their shape and structure), and total motile sperm count together paint a fuller picture of male fertility potential.

Equally important context: a landmark systematic review and meta-analysis published in Human Reproduction Update tracking data from 53 countries found that sperm counts have fallen by more than 50% over the past five decades, with the rate of decline accelerating since 2000 to a drop of 2.64% per year. Professor Hagai Levine, one of the lead researchers, called this "a canary in the coal mine" for broader human health. In other words, low sperm count isn't just a personal health issue, it's a population-level one, and the drivers are, to a meaningful degree, environmental and behavioral. Which means many of them can be addressed.

Here's the biological foundation for optimism: sperm are not static. Unlike eggs, which women are born with and cannot replenish, sperm are produced continuously throughout a man's life through a process called spermatogenesis. New sperm are constantly being manufactured in the testes, with each cycle of development taking approximately 64 to 74 days, followed by another 10 to 14 days of maturation — meaning the sperm a man ejaculates today started developing roughly three months ago.

This biology has an important implication: the lifestyle choices a man makes today will be reflected in his sperm quality approximately three months from now. Which also means that a semen analysis taken during a period of heavy stress, illness, alcohol use, or sleep deprivation may look worse than a man's baseline — and improvements made consistently over 90 days can show up clearly in a follow-up test.

Most fertility specialists recommend waiting at least two to three months between lifestyle interventions and a repeat semen analysis for this reason.

Dr. Lora Shahine, a Stanford-trained reproductive endocrinologist, breaks down the top natural lifestyle changes for improving sperm health in this practical two-part video series.

The research on modifiable lifestyle factors is robust enough to be genuinely encouraging. A 2024 narrative review in PMC confirmed that lifestyle modifications can significantly enhance male reproductive health outcomes across multiple parameters.

The evidence here is among the strongest and most consistent. Heavy smoking is associated with significantly decreased sperm counts, reduced semen volume, and impaired motility. A 2024 study found that moderate to heavy smoking was among the dominant factors affecting both sperm concentration and motility, with significant odds ratios for abnormal semen results. The good news: sperm produced after quitting smoking reflect the change. Within the 74-day regeneration window, men who quit can begin to see meaningful improvements in count and motility.

The relationship between alcohol and sperm quality is dose-dependent. Moderate consumption has a measurable effect on sperm morphology — the shape and structure of sperm — while heavier, chronic drinking has been associated with testicular atrophy and across-the-board reductions in sperm parameters. A large retrospective study of over 9,400 patients confirmed that alcohol consumption compounds with other factors like age and obesity to further compromise semen quality. Fertility specialists generally recommend minimizing or eliminating alcohol when actively trying to conceive.

Obesity affects sperm production through multiple overlapping pathways: elevated scrotal temperature from excess adipose tissue, hormonal disruption (higher estrogen, lower testosterone), increased oxidative stress, and metabolic dysfunction. A 2024 study found that obesity was significantly associated with both abnormal sperm concentration and motility, with an odds ratio of nearly 13 for abnormal motility, the strongest single factor identified in that analysis. Weight loss in overweight or obese men has been shown to improve testosterone levels and sperm parameters, often substantially.

The testes sit outside the body for a reason: sperm production requires a temperature 2°C to 4°C cooler than core body temperature. When scrotal temperature rises, from frequent hot tub or sauna use, tight underwear, prolonged laptop use on the lap, or sedentary occupations, spermatogenesis is disrupted, DNA damage increases, and sperm count and motility decline. Even a transient rise of just 0.5°C to 2.2°C has been shown to impair sperm production. 

Research on laptop use specifically has confirmed that scrotal temperature elevation during use is significant, and that conventional shielding pads don't fully protect against it.

Practical changes: switching to boxers, keeping laptops on a desk, limiting sauna sessions, are low-effort and well-supported. One study found that nocturnal scrotal cooling resulted in a highly significant increase in both sperm concentration and total sperm output after just 12 weeks.

Poor sleep quality and short sleep duration are associated with reduced sperm concentration and motility. Some estimates suggest that men sleeping fewer than six hours per night may have sperm counts meaningfully lower than those sleeping seven to eight hours. Sleep is when testosterone production peaks and when cellular repair, including in reproductive tissue, occurs.

Chronic psychological stress elevates cortisol, which suppresses the hormonal cascade (GnRH → LH → FSH → testosterone) that drives sperm production. A 2023 review in PMC noted that psychological stress can negatively affect sperm quality, pregnancy outcomes, and overall quality of life in men with infertility, and that while evidence for psychological interventions is still building, cognitive behavioral therapy and mind-body approaches may be beneficial. Having open support structures during a fertility journey matters more than many men initially allow themselves to believe.

A 2024 review confirmed that dietary patterns significantly influence male fertility outcomes, with the Mediterranean diet consistently associated with better sperm quality, and the Western diet (high in processed meat, saturated fat, and sugar-sweetened beverages) associated with worse parameters. Foods rich in antioxidants like berries, leafy greens, tomatoes, walnuts, fatty fish help counteract the oxidative stress that damages developing sperm. A comprehensive review in Nutrients found that adequate intake of antioxidant vitamins and omega-3 fatty acids was positively related to sperm count and motility, while high saturated fat and trans fat intake had a negative impact.

One of the most uncomfortable parts of the global sperm decline story is the role of endocrine-disrupting chemicals (EDCs), compounds in our environment that interfere with hormonal signaling in ways that impair sperm production.

BPA (bisphenol A), found in certain plastics and food-can linings, has been detected in the urine of at least 90% of subjects studied in the U.S., Germany, and Canada. Phthalate metabolites (used to soften plastics) have been identified in 75% of Americans. Both are associated with reduced sperm motility, lower sperm concentration, and increased DNA fragmentation in men. A 2023 analysis in Frontiers in Public Health covering nearly 8,000 individuals found high heterogeneity in EDC impact across families of chemicals, but a consistent directional effect on sperm quality.

Pesticide exposure, heavy metals like lead and cadmium, and industrial chemicals add to the picture. Complete avoidance isn't realistic, but harm reduction helps: choosing glass or stainless steel over plastic, avoiding heating food in plastic containers, eating organic when feasible for high-pesticide produce, and being mindful of occupational chemical exposures.

The male fertility supplement market is enormous and largely unregulated — which makes it worth distinguishing between what clinical research actually supports and what's marketing.

Among the most rigorously studied supplements for male fertility. CoQ10 is a mitochondrial antioxidant that plays a direct role in sperm energy production. A 2021 systematic review found consistent evidence that CoQ10 supplementation improves sperm motility, and several trials have shown improvements in sperm concentration as well. In a double-blind controlled trial, men receiving CoQ10 for six months showed significant improvement in sperm motility, with six spontaneous pregnancies in the treatment group compared to three in placebo. Dosages studied typically range from 100 to 300 mg per day.

These two antioxidants work synergistically to reduce oxidative stress in seminal plasma. Multiple studies have shown that simultaneous supplementation reduces sperm DNA damage, one of the harder-to-detect but clinically significant markers of male infertility. A randomized clinical trial combining vitamin C, vitamin E, CoQ10, zinc, folic acid, and selenium showed improvements across sperm count, motility, and morphology in oligospermic men after three months.

Zinc is essential for testosterone production and sperm maturation, and deficiency has been associated with reduced sperm count. Folic acid plays a role in DNA synthesis and cell division, both critical to spermatogenesis. A 2026 study in SAGE Journals found greater sperm count in patients receiving folic acid and a combination of L-carnitine, L-arginine, CoQ10, and zinc compared to other protocols.

L-carnitine plays a key role in sperm energy metabolism and motility. Multiple trials have found that supplementation improves progressive sperm motility, and some have shown improvements in morphology as well. It's particularly relevant for men with asthenospermia (poor motility) alongside low count.

Lycopene (the antioxidant that gives tomatoes their red color) has shown promising effects on sperm concentration and motility in several trials. Selenium supports sperm structure and DNA integrity. Both appear in systematic reviews as beneficial ingredients in multi-antioxidant protocols for male infertility.

A note of caution: Supplement quality and dosing vary enormously, and more is not always better. Before starting a regimen, it's worth discussing specifics with a urologist or andrologist who can assess your individual semen analysis results and identify which deficits are most relevant to address.

Lifestyle optimization is powerful, but it isn't always sufficient, and for some causes of low sperm count, medical or surgical intervention is the right path. Dr. Bob Berookhim, a urologist specializing in male fertility, makes this point plainly in a widely-viewed video for Health magazine: around 50–70% of couples dealing with male factor infertility are ultimately able to conceive after treatment — but that often requires a proper diagnosis first.

A varicocele (an enlargement of the veins within the scrotum, similar to varicose veins) is the most common surgically correctable cause of male infertility, found in approximately 20% of adult men and in up to 40% of men presenting with infertility. Varicoceles raise scrotal temperature and increase oxidative stress, both of which impair spermatogenesis. 

Microsurgical varicocelectomy has been shown in multiple studies to significantly improve sperm count, a 2025 study found a mean increase of 7.7 million/mL postoperatively, as well as motility and morphology, with the greatest benefit in men with higher-grade varicoceles.

Hypogonadism, elevated prolactin, thyroid dysfunction, and low FSH or LH can all suppress sperm production through the hormonal axis. These are identifiable through blood testing and often treatable.

A low sperm count diagnosis can feel like a door closing. In reality, for most men, it's the beginning of a process. One that, with the right information and the right support, often leads somewhere better than where it started.

The 74-day sperm cycle is one of reproductive medicine's most underappreciated facts. It means that the body is constantly renewing itself, and that the choices made today like quitting smoking, cutting back on alcohol, losing weight, cooling down, sleeping more, reducing stress, eating better can show up as measurable change in a follow-up semen analysis three months from now. That's not wishful thinking. 

It's biology. For some men, lifestyle changes will move the numbers significantly on their own. For others, targeted supplementation will help fill in the gaps. For others still, a medical evaluation will reveal a correctable cause like a varicocele, a hormonal imbalance, or a medication side effect that no amount of walnuts and early bedtimes would have fixed. That's why getting evaluated matters, and why waiting it out quietly rarely serves anyone well.

Male infertility carries a psychological weight that often goes unspoken. The shame, the silence, the sense of failing at something that feels like it should be automatic. But infertility is a medical condition, not a character flaw. And it's one that the majority of couples who seek treatment are ultimately able to work through. Dr. Joshua Halpern, a urologist and Adjunct Assistant Professor at Northwestern University, covers this full landscape including evaluation, treatment options, and what the evidence actually supports in a detailed male infertility guidelines lecture that's worth watching for anyone wanting to go deeper.

The path forward starts with information. The first step is deciding that your fertility and your health is worth taking seriously.

The information in this article is for educational purposes and does not constitute medical advice. Please consult a urologist, reproductive endocrinologist, or your primary care provider about any concerns related to male fertility.