When couples struggle to conceive, the focus often falls on the woman. But male factor infertility contributes to 40-50% of all infertility cases. The good news? Unlike egg quality, sperm quality can often be improved with lifestyle changes and supplements.
This evidence-based guide covers what actually works to optimize sperm for IVF — and what doesn't.
The 70-Day Rule
Sperm take approximately 70 days (2.5-3 months) to fully develop. Any changes you make today won't show up in a semen analysis for about 3 months. Start optimizing early — ideally at least 3 months before your IVF cycle.
What Sperm Quality Means
A semen analysis measures several parameters:
Beyond these basic measures, DNA fragmentation — damage to the genetic material inside sperm — is increasingly recognized as important. High DNA fragmentation can contribute to failed implantation, miscarriage, and poor embryo development even when other parameters look normal.
Supplements That May Help
Research supports several supplements for improving sperm parameters. Here are the ones with the strongest evidence:
CoQ10 (Coenzyme Q10)
Supports mitochondrial function and protects sperm from oxidative damage. Studies show improvements in concentration, motility, and morphology. One of the most well-researched male fertility supplements.
Omega-3 Fatty Acids (Fish Oil)
Meta-analyses rank omega-3s as the top supplement for improving sperm concentration. A 2024 study found 1g twice daily increased sperm concentration from ~11 to ~34 million/mL in infertile men.
Zinc
Essential for testosterone production and sperm development. Deficiency is associated with low sperm count. Studies show improvements in concentration and motility with supplementation.
Selenium
Important for sperm formation and motility. Works synergistically with other antioxidants. Don't exceed recommended doses — too much selenium can be harmful.
Lycopene
The antioxidant that makes tomatoes red. Studies suggest it may improve sperm count by up to 70% in men with low counts. Also found in watermelon, pink grapefruit, and papaya.
Vitamin C + Vitamin E
Work together as antioxidants to protect sperm from DNA damage. Vitamin E specifically improves sperm motility by about 15% according to some studies.
L-Carnitine
An amino acid that provides energy to sperm cells. Research shows improvements in motility and morphology, particularly in men with low baseline values.
Folate (Vitamin B9)
Important for DNA synthesis in developing sperm. Combined with zinc, may improve sperm concentration and reduce genetic abnormalities in sperm.
A Note on Evidence
While these supplements show promise in studies, the overall quality of evidence is moderate. A 2025 systematic review concluded that no single supplement has "convincing evidence" of improving pregnancy or live birth rates — though they may improve sperm parameters. Supplements are not a substitute for medical treatment, and you should discuss them with your doctor.
Lifestyle Changes That Matter
Diet
What you eat affects sperm quality:
- Eat more: Fish, nuts (especially walnuts), fruits, vegetables, whole grains
- Eat less: Processed foods, sugar, trans fats, red meat
- Mediterranean diet patterns are associated with better sperm quality in studies
Weight
Obesity significantly impacts male fertility:
- BMI over 30 is associated with lower sperm count and motility
- Excess body fat converts testosterone to estrogen
- Losing weight can improve testosterone levels and sperm parameters
Exercise
✓ DO: Moderate Exercise
Regular moderate exercise (walking, jogging, swimming, resistance training) improves testosterone and sperm quality. Aim for 150 minutes per week.
✗ AVOID: Excessive Endurance Training
Extreme endurance exercise (marathons, triathlons) and overtraining can actually lower testosterone and harm sperm quality. More isn't always better.
Temperature
Sperm production requires temperatures slightly below body temperature — that's why testicles hang outside the body. Avoid:
- Hot tubs and saunas
- Laptops directly on lap
- Tight underwear (switch to boxers)
- Prolonged sitting
- Heated car seats
What to Avoid
Smoking and Vaping
Smoking damages sperm DNA, reduces count, and impairs motility. Vaping isn't safe either — early research suggests it may harm sperm quality. Quit at least 3 months before IVF.
Excessive Alcohol
Heavy drinking lowers testosterone and affects sperm production. Moderate consumption (1-2 drinks occasionally) is likely fine, but limiting alcohol during IVF preparation is wise.
Cannabis and Other Drugs
THC affects sperm motility and morphology. Other recreational drugs also harm fertility. Avoid all recreational substances when trying to conceive.
Anabolic Steroids
Steroids dramatically reduce or eliminate sperm production — sometimes permanently. If you've used steroids, tell your fertility doctor. Recovery can take 6-12 months or longer.
Environmental Toxins
BPA (in plastics), pesticides, and industrial chemicals can disrupt hormones. Minimize exposure: avoid plastic food containers, choose organic produce when possible, and be aware of occupational exposures.
When to See a Specialist
If basic semen analysis shows problems, a urologist specializing in male fertility can evaluate for:
- Varicocele: Enlarged veins in the scrotum that heat the testicles — the most common treatable cause of male infertility. Surgical repair can improve sperm parameters.
- Hormonal imbalances: Low testosterone or other hormone issues that may be treatable
- Infections: Sometimes infections affect sperm quality and can be treated with antibiotics
- Genetic factors: Some genetic conditions affect fertility and may influence treatment decisions
Special Considerations for IVF
Even with poor sperm parameters, IVF with ICSI (Intracytoplasmic Sperm Injection) can achieve fertilization by injecting a single sperm directly into each egg. However, optimizing sperm quality still matters because:
- Better sperm DNA quality may improve embryo development
- Lower DNA fragmentation may reduce miscarriage risk
- Healthier sperm may contribute to healthier embryos
Sperm quality affects more than just fertilization — it influences the entire journey from embryo to baby.
Timing Before IVF
3 months before: Start supplements and lifestyle changes
2-5 days before egg retrieval: Abstain from ejaculation (per your clinic's guidance)
Day of retrieval: Provide fresh sample at the clinic
Planning IVF in Colombia?
Colombian clinics offer comprehensive male fertility evaluation and ICSI at a fraction of US costs. We'll help you find the right clinic for your situation.
Get Free ConsultationKey Takeaways
- Male factor contributes to 40-50% of infertility — don't ignore it
- Start optimizing 3 months before IVF (the sperm development cycle)
- CoQ10, omega-3s, zinc, and selenium have the strongest research support
- Lifestyle matters: maintain healthy weight, exercise moderately, avoid heat exposure
- Eliminate smoking, limit alcohol, avoid recreational drugs
- Even with poor sperm, ICSI makes IVF possible — but optimization still helps
Read more: IVF Cost Guide | Embryo Grading | Two-Week Wait Guide
Working with a Reproductive Urologist
If initial semen analysis shows significant abnormalities or if lifestyle modifications dont improve results, consulting a reproductive urologist can be valuable. These specialists focus specifically on male fertility and can identify treatable causes that might be missed otherwise. They can perform physical examinations to check for varicoceles (enlarged veins in the scrotum that can impair sperm production), order additional testing including hormone panels and genetic testing, recommend surgical interventions if appropriate, and coordinate care with your fertility clinic to optimize treatment outcomes. Many male factor issues are treatable, and addressing them can significantly improve IVF success rates.