In some ways I think of this blog post as a public service announcement.
If you’re actively trying to conceive now, or if you plan to have a baby at some point in the future you’ll want to start considering the role your partner’s health plays in the equation from day one — and that means getting his sperm analyzed right out of the gate.
You may not realize this, but there is a sperm quality crisis happening right under our noses, and very few people are hip to it. In my recent podcast interview with Marc Sklar, he shared several disturbing trends as far as sperm quality goes. Specifically what we consider to be normal in the sperm department.
Did you know that a normal sperm concentration is considered to be 20 million sperm per mL? That might sound like a lot of sperm, I mean 20 million sounds like a pretty big number doesn’t it? If I had 20 million dollars in my bank account that would be a lot of money, but with sperm it doesn’t exactly work like that.
In the 1940s a man was considered to be of normal fertility if his sperm concentration was 60 million sperm per mL or higher. In 2010 the World Health Organization released a report in which they set the lower limit of “normal” sperm concentration to 15 million sperm per mL. That’s a pretty big drop if you ask me.
There is a great deal of research confirming that sperm counts have been declining steadily over the past 50 or more years.
In 1940 the normal sperm concentration of a typical man was about 113 million sperm per mL, whereas in 1990 the normal concentration fell to about 66 million sperm per mL.
What do you think it’s at now? I’m guessing it’s not any higher.
This calls into question how lab results are derived in the first place. Perhaps what’s considered normal is different in different places. I don’t know how all of a sudden 15 million sperm could be considered normal when it was previously 60 million. When we begin to notice a dramatic shift in the fertility of half the population, perhaps it’s a better course of action to start asking why it’s happening instead of putting our heads in the sand and declaring that these lower rates are simply the new normal.
A number of researchers have suggested that 50-60 million sperm per mL be used as the lower threshold of full reproductive potential instead of the WHO number of 15 million.   This is because couples with higher sperm concentrations (and better morphology and motility) typically have an easier time conceiving.
In other words, you and your partner might be able to get by with a sperm concentration of 15-20 million, but if you want to optimize your chances of conceiving your partner will ideally have a minimum sperm concentration of 50 million or higher.
Although the World Health Organization has set the lower reference limit for normal sperm morphology to be 4% I have to question why they keep setting the bar so low.
Let’s say that you have a man who hits this bottom criteria for sperm quality. His ejaculate has a sperm concentration of 15 million sperm per mL and he has 4% morphology. Let’s put that into numbers we can all understand. First you must recognize that 4% morphology means that out of all the sperm he releases, only 4% are normal. That means out of every million sperm, only 40,000 are capable of fertilizing an egg. If you have 15 million sperm, that leaves you with 600,000 healthy sperm.
In 1940 your average man had a sperm concentration of 113 million sperm per mL. One study conducted in 1946 found that 65% of the participants had a sperm concentration of over 100 million sperm per mL. Most people focus on the count, but for me I’m equally concerned with morphology. What a huge difference it makes if only 4% of his sperm are even capable of doing anything useful when they meet up with the egg. Back in 1940 it was common for men to have a morphology closer to 50% (meaning that half of their sperm were normal). A more recent study of men in Paris, Copenhagen, Edinburgh, and Turku in 2001 found that European men had an average morphology closer to 50% and an average sperm concentration closer to 80 million sperm per mL.
Alright, so let’s compare this to what the World Health Organization considers normal — i.e. 600,000 normal sperm per mL of ejaculate — to what was considered normal in 1940 — i.e. 56.5 million normal sperm per mL of ejaculate. Who has the better chance of conceiving? The couple who’s male partner has 600,000 normal sperm per mL or the couple with 56.5 million normal sperm per mL?
In this example, the average man from the 1940s has 94 times more normal sperm than today’s man at the low end of the WHO guidelines.
I like to put things into literal terms, because until we do that the concept remains abstract and esoteric instead of concrete and literal. If some scientist in a lab has concluded that a sperm concentration of 15 million with a normal morphology rate of 4% is normal, that’s lovely, but it has nothing to do with reality. If your partner falls into the lower end of the spectrum you can consider yourselves sub-fertile. It’s going to be harder for you to conceive. Just think 56.5 million vs 600,000 — that’s no joke.
As a side note, these absolute low parameters for “normal” count and morphology may reflect the likelihood of positive IVF outcomes rather than the best parameters for natural conception the good old birds and bees way. 
I don’t know about you, but it’s never been my goal in life to be slightly better than full-on failure. Regardless of what I’m doing I want to knock it out of the park. I can’t think of an experience that has affected my life more than having children, and I firmly believe that if there are things we can do to improve the odds of our children being healthy and happy we should be doing it.
So what can we do to improve sperm quality?
The answer is lots of things. It starts with diet and lifestyle factors. The women I work with are doing back flips and summer salts (metaphorically speaking) to improve their fertility naturally. They’re making dietary changes, like going gluten free and taking supplements, while their partners are hanging out drinking beer.
Traditional cultures knew of the importance both partners played in the fertility equation, and as such many traditional cultures had a practice of feeding both men and women special diets for several months before they would marry (i.e. before they were even trying to conceive). 
Since vitamin A deficiency and exposure to excessive heat in the scrotum/testicle area are two factors that can significantly impair sperm quality, addressing those factors is an important first step towards improving sperm health. Vitamin A foods include cod liver oil, liver (i.e. pastured beef liver, bison, lamb, chicken, duck, goose, etc.), organ meats, fish eggs, raw milk, and animal fats (i.e. grass fed butter, pastured lard, duck fat, tallow, bone marrow, etc.).
Cutting out alcohol, pot smoking, regular smoking, processed foods, highly refined sugar, and tight-fitting underwear will also go a long way.
If you’re looking for overnight results, you’ll want to note that the process of spermatogenesis takes about 3 months. Your partner’s sperm analysis results today reflect what was going on for him health-wise 3 months ago. To see the results you’re looking for you’ll have to commit to the cause for a minimum of 3-6 months.
Although that seems like a long time, I assure you that 6 months will arrive whether you make changes or not. The question is, do you want better sperm 6 months for now? Because it’s coming either way. It can’t hurt to adopt a healthier diet, and in the end it will not only help you to conceive, but you’re proactively improving the health of your future children before they’re even born.
What I hope you’ll take from this is that it’s not always all about you. If you’re in a relationship with a male partner and you are actively trying to conceive don’t minimize his contribution. You may carry the baby, but he contributes 50% of the genetics. If his sperm aren’t up to the job you can go out of your way and do everything possible to make yourself healthy, and it’s not going to do a whole lot to help you conceive.
For more on supporting your partner to optimize his diet and lifestyle to improve his sperm parameters grab a copy of The Fifth Vital Sign: Master Your Cycles & Optimize Your Fertility today!
Hi Lisa, thanks for this post! I also really enjoyed the episode with Mark Sklar. Question for you about getting sperm tested in Canada- do you know how accessible this is? Like can I walk into the doctor’s office and request this or does it need to be in a fertility clinic type setting? I rarely go to the doctor so haven’t had the opportunity to ask about this yet. Just want to have an idea of the process before my partner goes in to inquire… Thanks!!
Fertility Friday says
You’d have to check with your regular physician first to see if you’d need a referral. You can always call your doctor’s office and speak to the secretary since it could be different from doctor to doctor. 🙂
Yes. Sadly we have been TTC for 3+ years and my husband has vet low numbers and <1% normal morphology. The ironic factor? We are trying for my first biological child but he has a six year old (his spitting image, so certainly his) from his first marriage. The difference? When his son was 3 my husband enlisted in the airforce and is now a combat and weapons specialist and trainer. So lots of weapons and weapon systems and lots of radiation. Our obgyn has advised IVF with ICSI is really our best (only) hope. The only nice part is that the airforce is assisting us financially (not entirely, but every bit helps). 😞
Yes, I completely agree with this. After struggling to conceive after our daughter, who is now 3 and a half, we decided to blood analysis on myself and sperm analysis on my husband. My hormone/thyroid levels all came back normal but my husbands morphology came back at 0.5% his motility and count were both good). The doctor suggested it would take us some time to get pregnant and we could well need to go down the icsi route. We did some.researxh and my husband made significant changes to his diet: he cut out alcohol, caffeine, processed food, and wore baggy clothing after cycling home. It must have had an effect because combined with me taking evening primrose oil, we are now pregnant! 😀
Jesse Yescas says
Here are my numbers..
Vol: 1.58 ( 4 days abstinence)
Total sperm count: 1.11 million
Total motile: 0.6
** Been on Testosterone Cypionate x 3 yrs now… chances of conceiving normally????
Fertility Friday says
It’s time to seek support with those numbers. He is subfertile. Optimal concentration is 50 million, optimal morphology is over 12%. have a listen to this episode http://fertilityfriday.com/134 Also, I have a chapter in my book that focuses on evidence based ways to address poor sperm quality (beyond IVF). Access a free chapter here. Purchase here.
My husband’s numbers:
Concentration: 2x 10*6/ml
Live Spermatozoa: 43%
We have been trying for approx 7mths
Fertility Friday says
Hi Dominique. Have a read through Chapter 17 of The Fifth Vital Sign. Based on what you’ve provided, the sperm concentration is low. In the book I detail evidence based ways to improve sperm quality and also to time sex accurately using fertility awareness techniques.
Lindsay Burnette says
Thank you for this post and podcast. I’ve loved listening to your research and advice. My husband and I have been trying for 5 months. I’ve been tracking my cycle and my ovulation signs have been fairly consistent. My husband is a cyclist and rides his bike for about 10 hours per week. He is a very healthy eater, at a good weight and doesn’t drink or smoke. I’d hate for him to have to give up cycling all together, but do you know if there’s any chance it would help for him to stop cycling just around the week of my ovulation? We are going to get him tested as well. Thank you.
Desiree Steuber says
I was hoping to get some more information on male fertility with hot tub use and how long it takes to regenerate sperm after using hot tub.