Traditionally, women have often been perceived as contributing far more to a couple’s fertility difficulties than men, leading to an unfair level of focus on the female partner, but in reality, the male partner contributes to about half of all infertility cases in couples (Leslie et al., 2025).
In addition, men are less likely to seek health care than women (De Jonge et al., 2023), and a greater proportion of men feel uncomfortable discussing fertility issues with family or friends (VHI, 2016). Hopefully we can change this by getting more information out there. I am normally contacted for help using acupuncture and traditional Chinese herbal medicine, but it is very helpful to also consider other well-researched lifestyle factors that may influence the chances of a successful pregnancy. So, here are five key lifestyle factors that can influence male fertility. This is for information only; it is best to consult your doctor before making any changes.
Male infertility can be associated with low testosterone levels, and research has found that having a high percentage body fat or waist circumference is correlated with lower testosterone levels.
A 2008 study from the U.S. (Hall et al., 2008) found that, when compared to men with normal testosterone levels, men with symptomatic low testosterone had a higher BMI and weight, and had a waist circumference 20 cm larger on average.
Another study, which looked at thousands of individuals and compared percentage body fat to testosterone (Ma et al., 2024) found that, generally, as percentage body fat increases, testosterone levels decrease. The correlation in females differs from that observed in males.
Percentage body fat and waist circumference are often used as indicators for metabolic health and general health. For men looking to lose weight and boost testosterone levels, diet and exercise will be high up on the priority list, which brings me to my second point.
A literature review from 2025 (Zańko et al., 2025) states that “Although some studies suggest no association between physical activity and male fertility, and others report mixed results, the vast majority of research indicates a positive impact of physical activity on male fertility.”
The study concludes with: “Moderate and regular exercise enhances cardiovascular health, improving blood flow and oxygen delivery to the reproductive organs, which are essential for optimal spermatogenesis and hormone function.”
The authors also mention how excessive levels or intensity of exercise can adversely impact male fertility, a point echoed in a 2023 review (Belladelli et al., 2023), which states:
“Physically active men have been shown to have a larger proportion of motile spermatozoa compared to sedentary men… However, more extreme levels of PA have been associated with impaired semen quality”
I think it makes sense that extreme levels of physical activity can impair semen quality, but this represents a very small proportion of the population compared to those who are not active enough.
Next up is another favourite topic of mine, which is stress.
The broad consensus is that stress has a negative impact on semen quality, with some variability in the research.
A 2015 review (Nargund, 2015) states that “…many clinical studies … have shown that stress is associated with reduced paternity and abnormal semen parameters. Enough scientific evidence exists to suggest that psychological stress could severely affect spermatogenesis.”
Stress is a complex topic, and not all studies are aligned on the effect that stress has on male reproductive health. One review (Ilacqua et al., 2018) stated that “…overall, these [reviewed] studies provide evidence that semen quality is impaired by psychological stress.” They also point out some of the conflict found in study outcomes.
Beyond the direct impact on semen quality, it can also predispose individuals to other unhealthy behaviours, such as smoking or excessive alcohol intake, as well as having a well-recognised negative impact on general health, and so ultimately affecting fertility.
Moving on to some research on the nutritional side of fertility, and here we are specifically looking at ultra-processed foods (UPFs). There has been a surge of interest and research on the impact of ultra-processed food on our health in recent years.
One Italian study from 2024 (Ceretti et al., 2024) found that men who consumed the most UPFs had lower sperm concentration and progressive motility compared to those who consumed the least. Another study from China (Lv et al., 2022) with over 1000 participants, also found that higher consumption of UPFs was associated with increased risk of poor sperm motility. Finally, a 2024 Spanish study (Valle-Hita et al., 2024) also found that sperm concentration and motility were lower in participants who consumed the highest amount of UPFs compared to the lowest.
So far, most of the evidence in this area is observational, and it is fair to say that more research is needed on this. However, the findings are aligned with many other health studies that have found consumption of large amounts of UPFs to be associated with poorer health outcomes. That brings us up to the last category, number 5 – endocrine- or hormone-disrupting chemicals.
Much of the research in this category focuses on:
Firstly, in the pesticide category, one 2023 systematic review and meta-analysis (Ellis et al., 2023) looked at two particular insecticides, and they stated: “This comprehensive investigation found sufficient evidence of an association between higher OP and NMC insecticide exposure and lower sperm concentration … the strength of evidence warrants reducing exposure to OP and NMC insecticides now to prevent continued male reproductive harm”
One review (Cannarella et al., 2023) stated: “In humans, exposure to EDCs has been associated with poor semen quality, increased sperm DNA fragmentation, increased gonadotropin levels…”
Finally, this 2016 systematic review and meta-analysis (Wang et al., 2016) found: “…consistent increases in the risk of abnormal sperm quality were found in phthalate ester group… and organochlorine group.”
Trying to tackle exposure to hormone disrupting chemicals is a fascinating topic which would warrant a review of its own, so if you would be interested in seeing more on this let me know.
Male fertility issues are a complex topic with many more variables than what is mentioned in this short video, and even within the categories mentioned you will find variations in the quality of evidence, so more research is needed.
That being said, fertility issues are often a subject that we avoid discussing unfortunately, particularly men. Both men and women should feel comfortable seeking professional help for fertility problems.
Your doctor will be a primary point of contact for this, and there are many other resources, such as excellent IVF clinics, who specialise in this topic. On top of this, some people find therapies such as my own field of acupuncture and Chinese herbal medicine helpful, while others may benefit most from emotional and psychological support if this is a significant difficulty. If you are struggling with this, know that these kinds of problems are more common than you might think. There is help available, and you don’t have to try to deal with it on your own.
Seamus Fitzgerald, Réiteach Integrative Health.
Acupuncture and Chinese Herbal Medicine. Dungarvan, Co. Waterford.
References
Belladelli, F., Basran, S. & Eisenberg, M. L. 2023. Male Fertility and Physical Exercise. World J Mens Health, 41, 482–488.
Caetano, G., Bozinovic, I., Dupont, C., Léger, D., Lévy, R. & Sermondade, N. 2021. Impact of sleep on female and male reproductive functions: a systematic review. Fertil Steril, 115, 715–731.
Cannarella, R., Gül, M., Rambhatla, A. & Agarwal, A. 2023. Temporal decline of sperm concentration: role of endocrine disruptors. Endocrine, 79, 1–16.
Cavalhas-Almeida, C., Cristo, M. I., Cavadas, C., Ramalho-Santos, J., Álvaro, A. R. & Amaral, S. 2025. Sleep and male (In)Fertility: A comprehensive overview. Sleep Medicine Reviews, 81, 102080.
Ceretti, E., Bonaccio, M., Iacoviello, L., Di Castelnuovo, A., Ruggiero, E., Donato, F., Lorenzetti, S., Zani, D. & Montano, L. 2024. Consumption of Ultra-Processed Foods and Semen Quality in Healthy Young Men Living in Italy. Nutrients, 16, 4129.
De Jonge, C. J., Gellatly, S. A., Vazquez-Levin, M. H., Barratt, C. L. R. & Rautakallio-Hokkanen, S. 2023. Male Attitudes towards Infertility: Results from a Global Questionnaire. World J Mens Health, 41, 204–214.
Ellis, L. B., Molina, K., Robbins, C. R., Freisthler, M., Sgargi, D., Mandrioli, D. & Perry, M. J. 2023. Adult Organophosphate and Carbamate Insecticide Exposure and Sperm Concentration: A Systematic Review and Meta-Analysis of the Epidemiological Evidence. Environ Health Perspect, 131, 116001.
Hall, S. A., Esche, G. R., Araujo, A. B., Travison, T. G., Clark, R. V., Williams, R. E. & Mckinlay, J. B. 2008. Correlates of low testosterone and symptomatic androgen deficiency in a population-based sample. J Clin Endocrinol Metab, 93, 3870–7.
Ilacqua, A., Izzo, G., Emerenziani, G. P., Baldari, C. & Aversa, A. 2018. Lifestyle and fertility: the influence of stress and quality of life on male fertility. Reprod Biol Endocrinol, 16, 115.
Leslie, S. W., Soon-Sutton, T. L. & Khan, M. A. B. 2025. Male Infertility. StatPearls. Treasure Island (FL).
Lv, J. L., Wu, Q. J., Wang, X. B., Du, Q., Liu, F. H., Guo, R. H., Leng, X., Pan, B. C. & Zhao, Y. H. 2022. Intake of ultra-processed foods and asthenozoospermia odds: A hospital-based case-control study. Front Nutr, 9, 941745.
Ma, H., Sun, J., Wu, X., Mao, J. & Han, Q. 2024. Percent body fat was negatively correlated with Testosterone levels in male. PLOS ONE, 19, e0294567.
Nargund, V. H. 2015. Effects of psychological stress on male fertility. Nature Reviews Urology, 12, 373+.
Tricotteaux-Zarqaoui, S., Lahimer, M., Abou Diwan, M., Corona, A., Candela, P., Cabry, R., Bach, V., Khorsi-Cauet, H. & Benkhalifa, M. 2024. Endocrine disruptor chemicals exposure and female fertility declining: from pathophysiology to epigenetic risks. Frontiers in Public Health, Volume 12 – 2024.
Valle-Hita, C., Salas-Huetos, A., Fernández De La Puente, M., Martínez, M., Canudas, S., Palau-Galindo, A., Mestres, C., Manzanares, J. M., Murphy, M. M., Marquès, M., Salas-Salvadó, J. & Babio, N. 2024. Ultra-processed food consumption and semen quality parameters in the Led-Fertyl study. Hum Reprod Open, 2024, hoae001.
VHI Healthcare (2016) The F Factor – Vhi lifts the lid on attitudes to Fertility issues in Ireland. Available at: https://www1.vhi.ie/about/media-releases-and-publications/2016/11 (Accessed 23 January 2026).
Wang, C., Yang, L., Wang, S., Zhang, Z., Yu, Y., Wang, M., Cromie, M., Gao, W. & Wang, S.-L. 2016. The classic EDCs, phthalate esters and organochlorines, in relation to abnormal sperm quality: a systematic review with meta-analysis. Scientific Reports, 6, 19982.
Zańko, A., Pawłowski, M. & Milewski, R. 2025. The Impact of Physical Exercise on Male Fertility Through Its Association with Various Processes and Aspects of Human Biology. J Clin Med, 14.