Male fertility: how partners can help

Why does the person providing sperm need to be part of the plan?

Sperm health plays a part in a large share of fertility difficulties, and it is easy to check. Yet many couples spend months on tracking and timing before sperm is looked at. Starting both assessments together saves time and avoids the feeling that one person carries all of the work.

This guide uses neutral language about who provides sperm. It applies to couples of different genders, people using donor sperm and anyone who wants to look after sperm health.

What is a semen analysis?

The AUA/ASRM guideline recommends assessing both partners at the same time. For the person providing sperm, that means a reproductive history and one or more semen analyses. A semen analysis counts sperm, measures how they move and looks at their shape. It also checks the volume and other features of the sample.

The results need interpreting in context. A single reading is not a pass or fail, because sperm counts vary from day to day and from sample to sample. A clinician may repeat the test before drawing a conclusion. There is no single "fertile" or "infertile" badge, and you should be wary of any online score that claims otherwise.

If the results are abnormal, a male reproductive specialist can look for causes. Lifestyle changes and supplements should not delay this assessment.

How do you prepare for a semen analysis?

The clinic or lab gives specific instructions. In general:

• You provide a sample, usually in a private room at the clinic or in a container at home that you deliver quickly.
• You may be asked to wait a short number of days after your last ejaculation.
• Tell the lab about recent illness, fever or medicines, because they can change a result.
• Ask whether you should repeat the test if the first result is unusual.

The test does not hurt, and most people find the process more awkward in theory than in practice.

Which habits and medicines matter?

• Smoking. Smoking has established harms for fertility. Vaping is not a safe replacement. Support to quit is available through providers and pharmacies.
• Cannabis and other substances. Evidence on exactly how cannabis affects fertility is less consistent, and it is sensible to avoid it while trying to conceive.
• Medicines. Tell your provider about everything you take. Testosterone treatment can suppress sperm production, which is why the AUA/ASRM guideline advises against testosterone alone when fertility is wanted. Anabolic steroids work the same way.
• Sexual health. Difficulties with erections or ejaculation are common and treatable, and a provider can help.
• General health. A varied diet and regular activity support overall health, and no particular diet has been shown to improve natural fertility. Evidence for many lifestyle and environmental risk factors is limited.

Sperm take roughly three months to develop, so a change in habits takes time to show up. That is a reason to start early, and it is no reason to hold off an assessment while you wait.

What did the supplement trials find?

Many products promise better sperm. The best trials have not found a clear benefit for pregnancy.

• FAZST (2020). Among 2,370 couples planning infertility treatment, folic acid plus zinc taken by the male partner did not improve live birth: 34% with the supplement and 35% with placebo. Stomach symptoms were more common in the supplement group, and so was sperm DNA fragmentation.
• Cochrane review (2022). A review of 90 trials found very low-certainty evidence that antioxidants might raise live-birth rates. The apparent benefit disappeared when the studies at high risk of bias were removed.
• SUMMER (2025). In 1,171 men, a combined supplement did not significantly improve ongoing pregnancy within six months: 33.8% compared with 37.5% for placebo.
• ESHRE guideline (2023). Europe's society for reproductive medicine conditionally advises against adding oral antioxidants for women and men having fertility treatment, citing very low-certainty evidence.

These results do not show that every supplement is harmful. They show that a supplement cannot stand in for an assessment, and that a "90-day reset" should never delay one. If you want to take a supplement, show the label to a pharmacist first. A person who has a diagnosed deficiency is a different case, and a provider can treat it.

What if the results are not typical?

An unusual result is common, and it is not the end of the road. A male reproductive specialist can look for a cause, such as an infection, a hormone issue, a varicocele (enlarged veins in the scrotum) or a medicine effect. Treatment depends on the cause and might include a change of medicine, a procedure, or fertility treatments such as intrauterine insemination or IVF with sperm injection. Guidelines also advise looking at the male partner when assisted reproduction fails or when a couple has repeated pregnancy loss.

Masculinity has nothing to do with sperm results. Many people feel shame when a result is low, and talking to a counsellor or a trusted friend can help.

How can partners support each other?

• Plan the first appointment together and bring a list of medicines and supplements.
• Agree how much tracking feels manageable, and take a break when it becomes stressful.
• Share the load of timing, tests and decisions, and keep talking about how each of you feels.
• Keep intimacy a part of your life that is not about the calendar.
• Learn the fertile window together. The ovulation day guide and the best time to conceive calculator can help.