How Can I Be Sure I Have Healthy Sperm and Not Unhealthy Sperm?

When it comes to male infertility, which affects nearly 10 percent of all adult men, the culprit is often the star of the reproduction show: sperm.

While it can be easy to point to sperm as the main cause of infertility, figuring out why the sperm may be unhealthy can often prove to be a challenge. Find out how you can be sure you have healthy sperm versus unhealthy sperm.

What causes poor sperm health?

Determining the cause of an individual's poor sperm health can be difficult. Many factors can contribute. The medical community does, however, know five of the most common reasons for diminished sperm parameters.

1. Smoking

Men who smoke put their sperm health at tremendous risk. The toxins found in cigarette smoke are strongly associated with negative effects on sperm count, semen volume and sperm motility.

A 2016 meta-analysis of 20 research projects with nearly 6,000 participants concluded that semen quality, especially sperm count and motility, were heavily impacted in men who were moderate to heavy smokers.

2. Lack of exercise

Health experts recommend 150 minutes of aerobic exercise per week, but research has shown some particular types of workouts to be more impactful on sperm health. According to a 2017 study, an intense exercise program involving weight training was especially helpful.

3. Poor diet

Sperm counts in recent years have been declining globally—a multifactorial and not completely understood phenomenon. However, our increasingly poor, processed food-heavy diet is thought to be at least partially to blame.

One meta-analysis found evidence suggesting that men who ate diets rich in fruits and vegetables and consumed fish or low-fat dairy products as their primary sources of protein had better-quality sperm.

4. Alcohol and drug use

Studies have demonstrated that long-term substance use may have a detrimental effect on semen quality.

One systematic review suggested that low to moderate drinking had a minimal impact, but daily alcohol use indicated a much greater effect.

5. Obesity

Being obese appears to affect numerous semen parameters. One study noted that men whose BMI was 30 or above had reduced semen volume, sperm count, sperm motility and a higher percentage of sperm with abnormal morphology.

How does age affect sperm health?

Generally speaking, men produce sperm their entire lives. We've seen that recently with both Al Pacino and Robert DeNiro fathering children in their late 70s and early 80s. It is certainly possible for older men to reproduce.

However, robust evidence suggests that certain semen parameters, such as sperm morphology and motility, may be negatively affected as men get older. Factors such as sperm count and total number of sperm may remain close to what they are in younger men, but certain genetic defects are more common in children fathered by older men.

Something called DNA fragmentation is suspected to be behind these abnormalities.

"Age really doesn't have too much effect on sperm counts or the number of sperm, which is the nice thing," said Neel Parekh, M.D., a men's fertility and sexual health specialist with Cleveland Clinic. "Unlike women who have a set number of eggs which decline with age, men typically produce the same number of sperm. The only difference is that there have been some studies or evidence that suggest that older men have a little bit higher likelihood of conceiving children with autism or Down's syndrome."

Do men stop producing sperm?

As we've seen, aging men don't stop producing sperm. However, as men age, the quality of their sperm may decline. Also, their sperm may have more difficulty fertilizing an egg due to abnormalities in sperm morphology (the shape of the sperm) and reduced motility.

Studies looking at the sperm of men who used fertility clinics strongly suggested that certain sperm parameters were negatively impacted in men age 45 and older, and that these sperm had a lower chance of successful fertilization.

Generally speaking, though, regardless of the impact on the quality of the sperm and barring some other condition, most men will continue to produce sperm throughout their lives.

How can poor sperm health affect fertility?

Sperm must possess certain qualities for men to be fertile, and tests for these qualities are included in a standard laboratory semen analysis. These include quantity, motility and morphology.

Sperm quantity

Men typically produce about 525 billion sperm over the course of a lifetime. In a single ejaculation, a healthy man releases between 40 million and 1.2 billion sperm cells.

Even with these eye-popping numbers, guys still need to have a certain concentration of sperm in order to give them the best chance of reaching an egg. About 15 million sperm per milliliter (mL) of ejaculate is considered the baseline for healthy semen.

Sperm motility

Sperm cannot fertilize an egg if they can't get to it. That's why motility—the ability of the sperm cells to move forward—is so important. Medical science assumed that sperm moved as their tails wiggled from side to side. Interestingly, though, new research indicates that sperm tails wriggle to one side only, and they move forward by rolling in circles.

At least 40 percent of sperm cells need to be moving in order to best ensure a pregnancy, according to Mayo Clinic.

Sperm morphology

Healthy sperm typically have a rounded head and a long, strong tail to help them make the journey up the vaginal canal to fertilize the egg. A high incidence of abnormally shaped sperm can make it more difficult for a man to impregnate a partner.

How do I test sperm health?

The gold standard for understanding semen health begins with a visit to your doctor and having them order a lab test.

The first step is to produce a semen sample. (FYI: It's become much more common to have the man ejaculate at home and drop off the sample in order to avoid the awkwardness of having to do it in a clinical setting.)

Trained laboratory technicians will test semen for a number of parameters, including the following:

• Semen volume
• Sperm morphology
• Sperm motility
• Semen pH level (how acidic or alkaline the semen is, which can affect its ability to survive in the vaginal canal)
• Sperm quantity
• Sperm vitality (how many are alive)
• Time to liquefaction (how long it takes the semen to change into a more liquid form)
• White blood cells (which can detect inflammation or infection)

The optimal scenario is to have the test analyzed professionally in a local lab. That said, there are home testing kits that produce same-day results. These kits are limited in terms of what they can reveal about your semen and sperm health compared to a professional lab.

"They typically just tell you the concentration of sperm," Parekh said. "They don't tell you an exact number, but they'll tell you it's above 15 million or it's below 15 million (per mL). I think there's one on the market that might tell you the motility, but that's kind of the extent of the information they can give you. It doesn't tell you about the shape or pH or consistency or any of those things."

In other words, a home kit might be useful as a first step for someone who is curious about their sperm health or for someone who lives far from any testing center. A low sperm count on one of these tests might be the nudge they need to go in for more extensive testing.

Conclusions

Just as with all bodily functions, sperm quality is closely linked to a man's overall health.

You can go a long way toward keeping your fertility optimal by making healthy lifestyle choices and making those choices a daily habit.