How to Talk Fertility: Men and Sperm Quality

We’re kicking off this comprehensive series with a few tips on how to talk to potential dads about their virility, including their essential role in the health of a pregnancy and baby’s long term health. In this article, we’ll brainstorm ways to discuss:

1. Fertility and reproductive health as it contributes to men’s overall health
2. How men’s health and sperm quality factors into pregnancy and the health of baby
3. The mental and emotional aspects to begin considering before trying to conceive 

Here we go!

If you’ve read my breakdown of how healthcare practitioners use fertility to learn more about other areas of your overall health, this first point won’t be a complete surprise. However, for men, in particular, there are a few additional points to be aware of that are sex-specific.

1. Make it personal & make it positive.

In serious conversations about men’s health, it can be helpful to highlight lifestyle concerns in the positive.

Let me explain, because this is honestly a tremendous general communication tool! You see, our culture often stigmatizes certain behaviors, and you could potentially want to address some of them with your partner as you begin to talk about optimizing fertility.

For example, you can employ this “personal & positive” approach to your dialogue if your partner: 

• Drinks alcohol excessively
• Smokes or uses recreational drugs
• Eats a nutrient-poor diet
• Does not exercise
• Suffers from unchecked conditions, from sleep issues to digestive problems
• Has a high-stress career that exposes them to (figuratively) toxic environments
• Works a job that exposes them to (literally) toxic environments

It’s 2023. We all know that smoking is bad for us, that we should eat lots of fresh, diverse, whole foods, work up a sweat regularly, and get enough sleep.* But those who regularly disregard scientifically proven facts around health are usually not doing so because they have their head in the sand. 

People are a lot more complicated than that.

There are myriad reasons why some of us habitualize unhealthy behaviors, despite knowing better. Trauma, addiction, stress & anxiety, undiagnosed mental health issues or mood disorders, and even simple unconscious repetition all play a part.* I’d wager to say that many of us have fallen into a not-so-healthy habit at one point or another! 

But here’s the thing. Your partner is an intelligent, capable human being. Chances are, any conversations you kick off with “Did you know that kale is healthier than that deep-fried Oreo you're holding?” or “I’m afraid your entire career is affecting our ability to get pregnant” aren’t going to get you too far, and could potentially be hurtful or demeaning.*

Why? Because it immediately signals to your partner that they should be playing defense. It also paints you as judgmental, which may be human, but is not helpful.

Remove the pretense of any stereotyping and work to present the most honest, accepting version of yourself. Culturally, some men can be averse to diving into their feelings, so being as open and empathetic as possible can help them feel excited instead of embarrassed or frustrated. 

You can even start within the frame of overall health. If lifestyle factors that lower sperm count and quality are at play, throwing in the facts can help as long as there is no spin on the ball. Low sperm count has been associated with an increased risk of metabolic syndrome. In the most extensive study to date evaluating semen quality, reproductive function, and metabolic risk, researchers discovered that men with low sperm counts had a higher risk of greater body fat, higher blood pressure, insulin resistance, and dyslipidemia (1).* This and other recent studies have yielded more insight into how fertility status can be a biomarker for future health.* Delivering your message with your desire to help your partner improve overall health allows you to weave in the fertility component. 

If you like that direction, seek out a small handful of articles, videos, and other educational materials they can read and absorb on their own time. Avoid making it overwhelming, and try to present these during conversations (rather than, say, texting links to every single article on men’s fertility that pops into your newsfeed!). This is not only emotionally considerate; it allows the topic to remain a point of focused, serious concentration across multiple conversations, providing space for both of you to digest, think, and come back to conversations around fertility more informed. You can also help your partner understand that they aren’t being negatively singled out by suggesting that you make adjustments as a team.

EXAMPLES

Say your partner’s diet is a concern.

“I read an animal study that showed how sperm and semen from men who don’t get enough nutrients can cause babies to be overweight and impact how they manage their blood sugar and metabolize fat (2).* I’m trying to eat more fruits and vegetables to get ready to have a baby - do you want to try with me? Let’s pick out some recipes together!”

Perhaps you’re nervous about environmental exposure.

This one can be hard because it can put your partner in a challenging position if it's career-related. Switching occupations to avoid high stress or toxic exposure isn’t exactly a small ask, especially if he enjoys what he does.

“Did you know that dad’s smoking and excessive exposure to welding fumes may increase baby’s risk of asthma (3)?* I’d love to try and strategize together to keep you as healthy as possible. Are there any additional precautions you can take at work? Which of these (antioxidant-rich) foods can we both be incorporating into our diets?” 

Your healthcare practitioner is an excellent source of information, so don’t hesitate to reach out to them and ask for sources and advice. If they are anything like me in my private practice, they will probably want to see both of you as you try to conceive. Additionally, remember you can always send your man to The Knowledge Well for in-depth reads on these topics!

Here are quick links to some of my favorites!

Understanding the Fertility Spectrum3 Factors that Affect Men’s FertilityWhy You Need Healthy Sperm5 Tips to Improve Male FertilitySperm Quality, Motility, & Oxidative Stress(podcast)When two people consider bringing a new life into the world, the conversations surrounding that decision should be nurturing but also thorough. Next, take it from the personal level and zoom out a bit.

2. It takes two to tango. That’s just science.

A nice conversational flow might be most productive if you next tie in the science of the bigger picture. As I’ve covered, fertility is not just a women’s issue. It is the responsibility of both men and women to ensure they are on the right track toward a healthy family. But again, culture butts its head here.

It’s widely acknowledged that maternal lifestyle, diet, and exposure to environmental toxins influence the development of offspring and even future generations. This has led to society placing an enormous weight on women’s shoulders, a weight that somehow implies that men’s health plays less of a role. That’s because men’s sperm have historically been viewed as having only one job in reproduction: to fertilize a woman’s egg. But a growing body of new research suggests that sperm are so much more than just contributors of DNA. Modern science’s understanding of how similar paternal factors may directly or indirectly impact fertilization, embryo development, pregnancy, and the long-term health of offspring is rapidly evolving. 

Check it out:

CONCEPTION

New research is showing that the impact of sperm on fertilization happens before an egg is even fertilized, with some animal studies suggesting that sperm can deliver signals to female reproductive tissues once they enter the reproductive tract, which can increase the chance of conception (4).* Other studies have also found that dad’s genes impact the development of the placenta more than mom’s, which means that he influences how mom adapts to pregnancy, baby’s nourishment, and ultimately, baby’s growth. (5) (6) (7)!* Right from the beginning, healthy, well-nourished sperm have several consequential jobs.

PREGNANCY

After conception, we usually look to mom as the one who is solely responsible for her pregnancy outcomes. However, research shows that the consequences of dad’s health and exposure are still impactful during pregnancy. For example, sperm quality impacts the womb, and chemicals that enter mom’s body through semen can circulate before and during pregnancy.* High oxidation levels in semen and sperm have been studied to significantly increase the likelihood of pregnancy loss (8).* Animal studies have noted that sperm quality impacts mom’s immune system, affecting the womb as baby grows and develops (2).* Translation: Dad taking care of himself and his reproductive health can help YOU reduce your risk of  pregnancy interventions, straying from your birth plan, and potential long-term health issues (9).*

RE: BABY

Studies point towards the significant genetic and lifestyle factors that can potentially reprogram your baby's health throughout its life!*

What’s more, so many rules that are widely perceived as female-specific apply to men as well. While women cross over into the realm of “advanced maternal age” around 35, it’s coming into focus that dad’s age can also impact pregnancy outcomes and children. Specifically, studies have shown that babies born to dads who are 45 years or older influence whether mom has a shorter gestation period than dads in the range of 25-34 (10).*

3. It’s more than just physical.

I’d be remiss not to recognize that the entire pregnancy process is one of the most emotional times in life for both men and women. At the same time, it can help to logistically plan for pregnancy and discuss how it will go for the two of you. Set clear expectations. 

Remember to go even further and plan for what will happen once you deliver. Some things to think about:

The list of preparation items is endless and can feel overwhelming, but we have two clutch articles we want you to pocket and save for further discussion somewhere down the line. 

The first is our postpartum recovery checklist, which will itemize all of this and show you helpful tools that will make your and your partner’s lives easier. Bookmark it, then share it with your friends!

For the second, we want you to zoom out and take a macro view of it all by acknowledging that postpartum depression (or even a LOT of varying feelings) can affect your entire family, not just mom. Fertility and pregnancy journeys are roller coasters, so it’s normal for mom, dad, and older siblings to go through some mood swings. Let your partner know that their support and involvement is significantly associated with reduced odds of postpartum depression. If it is something you encounter, it’s essential to be prepared to work together as a team (11).

Ask for help just as readily as you'd give it.