How to Improve Male Fertility: What Actually Works
If you search online for ways to improve male fertility, you will find hundreds of suggestions: supplements, special diets, cold showers, testosterone boosters, fertility vitamins and other “sperm hacks”.
Some measures are sensible. Others have surprisingly little evidence.
The most useful approach is usually not to chase a single supplement. It is to identify whether there is a correctable reason for reduced fertility, improve the health factors that influence sperm production, and make sure you are not losing valuable time if a significant fertility problem is present.
Australian and international male infertility guidelines recommend a structured assessment that considers the man and his partner together.[1–4]
First: Find Out Whether There Is Actually a Male Fertility Problem
Before trying to “boost sperm”, it helps to know what you are trying to improve.
A semen analysis measures semen volume, sperm concentration, total sperm number, movement and morphology. Importantly, it is not simply a pass-or-fail fertility test. Men with results outside the laboratory reference range may still achieve pregnancy, while a normal semen analysis does not guarantee fertility.[1–4]
Semen results also vary naturally. Australian guidelines recommend repeating an abnormal semen analysis, generally after approximately six weeks or longer depending on the clinical situation.[1]
If you already have a result, read more about what a semen analysis actually means.
Men with persistent abnormalities such as a low sperm count, very poor sperm movement or no sperm in the semen may benefit from a more detailed assessment.
What Actually Helps Male Fertility?
There is no universal treatment because male infertility has many different causes. However, several measures are consistently supported by fertility guidelines and clinical research.
1. Stop Smoking
Smoking is one of the clearer modifiable risk factors.
A large systematic review involving almost 6,000 men found cigarette smoking was associated with poorer semen quality, including reductions in sperm count and motility.[5]
Stopping smoking is therefore recommended for men trying to optimise fertility. The benefits extend well beyond fertility and include cardiovascular, respiratory and general health.
If you smoke, quitting is likely to be more worthwhile than adding another fertility supplement.
2. Improve Weight and Metabolic Health if Needed
Obesity is associated with poorer reproductive health in men. Possible mechanisms include altered reproductive hormones, inflammation, increased scrotal temperature and metabolic dysfunction.[1,2]
Encouragingly, this may be partly reversible.
In a randomised study of men with obesity, significant weight loss was associated with approximately a 1.5-fold increase in sperm concentration and a 1.4-fold increase in total sperm count. The improvement was maintained in men who maintained their weight loss.[6]
This does not mean every man trying to conceive needs to lose weight. For someone already at a healthy weight, aggressive dieting is unlikely to provide a fertility advantage.
For men who are overweight or have metabolic health problems, however, gradual sustainable weight optimisation, regular exercise and management of conditions such as diabetes may form an important part of fertility treatment.[1,2]
3. Exercise Regularly — Without Going to Extremes
Regular physical activity is associated with better metabolic health and may support normal reproductive hormone function.[1,2]
The goal is not extreme training. Excessive exercise combined with severe calorie restriction, anabolic steroids or performance-enhancing hormones can potentially have the opposite effect.
A practical approach is consistent aerobic and resistance exercise that supports a healthy weight and overall health.
4. Avoid Testosterone and Anabolic Steroids When Trying to Conceive
This is one of the most important messages in male fertility.
Testosterone is essential inside the testicle for sperm production. However, taking testosterone from outside the body can suppress the brain hormones LH and FSH that normally stimulate the testicles.
The result can be a very low sperm count or even azoospermia, where no sperm are seen in the ejaculate.[2,3]
Both EAU and AUA/ASRM guidance recommend against testosterone therapy as a treatment for male infertility and advise against testosterone monotherapy in men seeking current or future fertility.[2,3]
This includes prescribed testosterone replacement therapy and anabolic-androgenic steroids used for bodybuilding.
If you are already taking prescribed testosterone, do not simply stop it without speaking with your treating doctor. Recovery needs to be planned around your symptoms, hormone levels, fertility timeframe and semen results.
Read more about fertility after testosterone or TRT.
5. Reduce Heavy Alcohol Intake
The effect of occasional or moderate alcohol consumption on semen quality is less clear, but high or chronic alcohol intake is associated with poorer reproductive health and can adversely affect testosterone and semen parameters.[2]
For men trying to conceive, reducing heavy alcohol consumption is therefore reasonable.
There is usually no need to become obsessed with eliminating every occasional drink. The greatest concern is regular high intake.
6. Avoid Repeated Excessive Heat Exposure
The testicles sit outside the body partly because sperm production functions best at a temperature slightly below core body temperature.
Repeated high-temperature exposure may therefore interfere with sperm production in some men.
A clinical study of infertile men exposed regularly to hot tubs or hot baths found that semen quality improved substantially in a proportion of participants after the heat exposure was stopped.[7]
It is reasonable to minimise frequent prolonged hot tubs, spas and very hot baths while trying to optimise fertility.
There is much less evidence that you need to ice your testicles, buy specialised cooling underwear or avoid ordinary day-to-day warmth. Extreme cooling strategies are not established male infertility treatments.
7. Look for a Varicocele — When There Is a Reason To
A varicocele is enlargement of veins around the testicle. It is common and many men with a varicocele are completely fertile.
However, in some men it can be associated with reduced sperm production.
Current Australian, European and American guidelines support considering varicocele treatment when a man has infertility, an abnormal semen analysis and a clinical or palpable varicocele.[1–3]
A 2021 Cochrane review found that treating varicoceles in appropriately selected subfertile men may increase pregnancy rates compared with observation, although the certainty of some outcomes remains limited.[8]
This does not mean every varicocele seen on an ultrasound needs surgery.
Learn more about varicocele treatment options and fertility.
8. Treat a Hormonal Problem if One Is Found
Some male infertility problems are caused by abnormalities in the hormonal signals responsible for sperm production.
Examples include hypogonadotropic hypogonadism and hyperprolactinaemia. These are very different from simply having a slightly low testosterone measurement.
When a genuine endocrine cause is identified, treating the underlying disorder may significantly improve sperm production.[2,3]
This is why hormonal treatment should ideally follow an appropriate diagnosis rather than be prescribed simply because a man wants to “boost his testosterone”.
9. Do Not Assume Fertility Supplements Will Fix the Problem
Antioxidant supplements are among the most heavily marketed products in male fertility.
The scientific evidence is mixed.
A Cochrane review of 90 randomised trials found possible improvements in pregnancy and live birth, but the certainty of evidence was low or very low. When higher-risk studies were excluded, a clear live-birth advantage was no longer demonstrated.[9]
The MOXI randomised placebo-controlled trial also found no significant improvement in sperm motility, morphology, DNA fragmentation or live birth with a combination antioxidant supplement.[10]
For this reason, Australian guidelines do not recommend routine antioxidant therapy for male infertility, while AUA/ASRM guidance describes the clinical benefit of supplements as questionable.[1,3]
That does not mean every supplement is useless. It means supplements should not distract from finding potentially important causes such as a varicocele, hormonal abnormality, testosterone suppression, obstruction or severe sperm-production problem.
Be particularly cautious of products claiming to “double sperm count”, “reverse infertility” or guarantee conception.
How Long Does It Take to Improve Sperm?
Sperm production takes approximately two and a half to three months.
This means changes made today are unlikely to produce a meaningful difference on next week's semen analysis.
When lifestyle changes or treatment of a reversible factor are appropriate, semen testing is commonly reassessed after roughly one spermatogenic cycle or longer depending on the situation.[1,2]
But waiting three or six months is not always the right strategy. Your partner's age, ovarian reserve, how long you have been trying and the severity of the male fertility problem can all change the appropriate timeframe.
When Lifestyle Changes Are Not Enough
Lifestyle optimisation is worthwhile, but it cannot correct every cause of male infertility.
A man with obstruction, a genetic cause of impaired sperm production, severe hormonal dysfunction, azoospermia or certain testicular conditions may require specific treatment rather than more lifestyle modification.
Similarly, if a semen analysis shows a very low sperm count, repeatedly abnormal results or no sperm at all, it is generally better to investigate the cause rather than spend many months experimenting with supplements.
Learn more about male infertility assessment and treatment pathways.
Men who have had a vasectomy have a different fertility problem again. Options may include microsurgical vasectomy reversal or sperm retrieval with IVF/ICSI depending on the couple's circumstances.
When Should You Seek a Male Fertility Assessment?
It is reasonable to seek assessment after 12 months of regular unprotected intercourse without pregnancy. Earlier assessment is often appropriate when the female partner is aged 35 or older or where there is a known male fertility risk.[1–4]
Earlier review may also be useful if there is a history of an undescended testicle, testicular surgery or injury, chemotherapy or radiotherapy, testosterone or anabolic steroid use, a varicocele, very small testes, sexual or ejaculatory difficulties, or an abnormal semen analysis.
The purpose of assessment is not necessarily to recommend treatment. It is to identify whether there is a correctable issue and determine the most appropriate pathway for the couple.
Take home message
The most evidence-based approach to improving male fertility is usually much less complicated than social media suggests.
Stop smoking. Avoid fertility-suppressing testosterone and anabolic steroids. Reduce heavy alcohol use. Improve weight and metabolic health when appropriate. Exercise regularly. Avoid excessive repeated heat exposure. Have an abnormal semen analysis properly assessed. And investigate potentially treatable conditions such as a clinical varicocele or hormonal disorder rather than relying on supplements alone.[1–3]
Most importantly, remember that fertility belongs to the couple, not one semen-analysis number.
Improving sperm parameters can be useful, but the real goal is choosing the pathway that gives a couple an appropriate opportunity to achieve pregnancy while taking both partners' fertility and timeframe into account.
Concerned About Your Fertility?
If you have an abnormal semen analysis, have been trying to conceive without success, have used testosterone or anabolic steroids, or want to understand whether a male fertility problem may be treatable, a specialist assessment can review your history, examination, semen results and any appropriate investigations.
Learn more about male fertility assessment or request an appointment.
Vancouver Reference Summary
Katz DJ, O'Donnell L, McLachlan RI, Moss TJ, Boothroyd CV, Jayadev V, et al. The first Australian evidence-based guidelines on male infertility. Med J Aust. 2025;223(11):653-663. doi:10.5694/mja2.70080.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health. Arnhem, The Netherlands: EAU Guidelines Office; 2026.
American Urological Association, American Society for Reproductive Medicine. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. 2020; amended 2024.
World Health Organization. Guideline for the prevention, diagnosis and treatment of infertility. Geneva: World Health Organization; 2025. ISBN: 978-92-4-011577-4.
Sharma R, Harlev A, Agarwal A, Esteves SC. Cigarette smoking and semen quality: a new meta-analysis examining the effect of the 2010 World Health Organization laboratory methods for the examination of human semen. Eur Urol. 2016;70(4):635-645. doi:10.1016/j.eururo.2016.04.010.
Andersen E, Juhl CR, Kjøller ET, Lundgren JR, Janus C, Dehestani Y, et al. Sperm count is increased by diet-induced weight loss and maintained by exercise or GLP-1 analogue treatment: a randomized controlled trial. Hum Reprod. 2022;37(7):1414-1422.
Shefi S, Tarapore PE, Walsh TJ, Croughan M, Turek PJ. Wet heat exposure: a potentially reversible cause of low semen quality in infertile men. Int Braz J Urol. 2007;33(1):50-57.
Persad E, O'Loughlin CA, Kaur S, et al. Surgical or radiological treatment for varicoceles in subfertile men. Cochrane Database Syst Rev. 2021;4(4):CD000479.
de Ligny W, Smits RM, Mackenzie-Proctor R, Jordan V, Fleischer K, de Bruin JP, et al. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2022;5(5):CD007411. doi:10.1002/14651858.CD007411.pub5.
Steiner AZ, Hansen KR, Barnhart KT, Cedars MI, Legro RS, Diamond MP, et al. The effect of antioxidants on male factor infertility: the MOXI randomized clinical trial. Fertil Steril. 2020;113(3):552-560.e3.
Medical Disclaimer
This article provides general educational information about male fertility and is not a substitute for individual medical advice, diagnosis or treatment. Fertility depends on factors affecting both partners, and an individual semen result cannot predict whether pregnancy will occur. Treatment should be based on appropriate clinical assessment and individual circumstances.
Do not start, stop or change prescribed medicines, including testosterone therapy, based on this article without discussing this with your treating doctor. Information about supplements is provided for general education and should not be interpreted as an endorsement of a particular therapeutic product. Outcomes from medical or surgical treatment vary between individuals, and no treatment can guarantee pregnancy or live birth.
