What can a man do to increase the chances of pregnancy?

June is Men's Health Month, a perfect time to talk about something that doesn't get nearly enough attention: the critical role sperm contributors play in fertility success. Whatever your path to parenthood, this guide is for you.

When most people think about fertility treatment, they picture the person who will carry the pregnancy. But here's a fact worth knowing: over half of all infertility cases involve a male factor. Yet most fertility clinics only treat women.

Start with a Semen Analysis

The single most important step a sperm contributor can take is getting a comprehensive semen analysis. This test evaluates semen volume (sperm delivery), sperm concentration (the sperm count, which measures sperm production), motility (sperm movement, which measures sperm quality), and other key factors. Many people are surprised to learn that a simple blood test or physical exam isn't enough. A thorough semen analysis is the only way to truly understand sperm health.

At Atlantic Fertility, semen analyses are performed in our on-site andrology lab under the supervision of specialists, which means faster results and higher standards than clinics that outsource this testing.

For those who prefer more flexibility or have scheduling constraints, we also offer a mail-in semen analysis option through our partnership with Fellow. You collect the sample at home, mail it to Fellow's CLIA-certified lab, and results are securely shared with both you and our team who reviews them and determines appropriate next steps. It's a convenient entry point, particularly for a first-time analysis, while keeping your care connected to a physician-led practice. Learn more about the mail-in option here.

Don't assume everything is fine just because you feel healthy. Male factor infertility often has no outward symptoms. Getting tested is the only way to know.

Lifestyle Factors That Affect Sperm Quality

Sperm health is directly influenced by daily habits. The good news: many of the most impactful factors are within your control.

Maintain a Healthy Weight

Both obesity and being significantly underweight can disrupt hormone levels and reduce sperm quality. Aim for a balanced diet rich in antioxidants. Think leafy greens, berries, nuts, and lean proteins, all of which support healthy sperm production.

Exercise 

Regular moderate exercise supports healthy testosterone levels and circulation. 

Manage Heat Exposure

Sperm production requires a temperature slightly below core body temperature. That's why the testes are located outside the body. Frequent use of hot tubs, saunas, or keeping a laptop on your lap for extended periods can reduce sperm count.

Reduce Stress

Chronic stress elevates cortisol, which can suppress testosterone and impair sperm production. Fertility journeys can themselves be stressful. Atlantic Fertility's in-house mental health counseling is available to support everyone on the care team, not just the person carrying the pregnancy.

Limit Alcohol, Tobacco, and Nicotine

Heavy alcohol consumption is associated with lower sperm counts, reduced motility, and increased sperm DNA fragmentation. We generally recommend keeping alcohol to fewer than four drinks per week, with no more than two at a time.

All forms of tobacco and nicotine are harmful to sperm, including cigarettes, vaping, and nicotine pouches such as Zyn. This is a habit worth quitting regardless of fertility goals, but the fertility-specific upside is real: quitting nicotine can lead to meaningful improvements in sperm quality, and it benefits your overall health and longevity as well.

Even moderate reductions can make a meaningful difference.

Testosterone Use and Fertility: What You Need to Know

This is one of the most important and frequently misunderstood topics in male fertility and one that comes up constantly in our clinic.

If you are using testosterone therapy (TRT), testosterone supplements, or anabolic steroids, you need to talk to a reproductive urologist before trying to conceive.

Here's why: the body naturally produces testosterone through a hormonal feedback loop that also signals the testes to produce sperm. When you introduce testosterone from an external source, your brain detects adequate hormone levels and shuts down its internal signaling hormones. The result is significantly reduced, or in some cases, completely absent, sperm production. This effect can persist for months after stopping testosterone use, and for some men can create a permanent dysfunction.

This is true whether you are using prescribed testosterone for low T, testosterone gels, injectable testosterone, or anabolic steroids used for athletic performance.

Testosterone use is one of the most common and correctable causes of male infertility we see. If you're on testosterone and planning to contribute sperm to conceive a child, speak to a reproductive urologist. There are fertility-preserving alternatives, and the sooner you address this, the better your options.

Marijuana and Male Fertility: The Research Is Clear

With marijuana legal in an increasing number of states and widely used recreationally, it's a question we hear often: Does weed affect sperm?

The short answer: yes, and not in a good way.

It's important to understand that this isn't limited to traditional marijuana. Cannabis in all its forms, including gummies, edibles, delta-9 products, and other cannabinoids (even those legal in North Carolina and other states), can negatively affect sperm in a similar way to THC-containing marijuana.

Research consistently shows that regular cannabis use can reduce sperm count, impair sperm motility, alter sperm morphology, and affect the hormones responsible for sperm production. Some studies have also found associations between cannabis use and increased sperm DNA fragmentation. This means damage to the genetic material sperm carry, which can impact fertilization and embryo quality.

These effects are generally dose-dependent, meaning the more frequently cannabis is used, the greater the impact. The good news is that sperm quality tends to improve after stopping use, typically within two to three months, which aligns with the natural sperm production cycle of approximately 74 days.

If you are actively trying to get pregnant, we advise stopping cannabis use, in all its forms, including THC drinks, at least three months before attempting conception or providing sperm.

Other Supplements and Medications to Review

Several common medications and supplements can affect sperm quality, including:

• Certain antidepressants and antipsychotics (SSRIs, in particular, can affect sperm DNA)

• ADHD medications and other stimulants, such as Adderall

• Chemotherapy or radiation (if you have a history of cancer treatment, fertility preservation and evaluation are especially important)

• Calcium channel blockers (used for blood pressure)

• Creatine and other performance supplements 

Never stop a prescribed medication without speaking with your doctor, but do bring a complete medication and supplement list to your fertility consultation.

When to See a Specialist

You should schedule an evaluation with a reproductive urologist if:

• You've had an abnormal semen analysis at any point

• You've been diagnosed with low testosterone

• Your partner or surrogate has experienced recurrent miscarriages or unexplained failed IVF cycles

• You have a history of cancer, trauma, infection, or testicular issues

• You're currently using testosterone or have used it in the past year

• You use cannabis regularly

• You have a history of varicocele

• You're experiencing erectile dysfunction or other sexual health concerns

• You want to proactively understand your fertility before starting a family-building journey

Getting evaluated early gives you more options, more time, and more peace of mind.

This Men's Health Month, the most important thing you can do is show up. Get evaluated. Ask questions. Advocate for your own fertility health and for the family you're working to build.

About the Author

Matt Coward, MD, FACS is a reproductive urologist and nationally recognized leader in male fertility. A Fellow of the American College of Surgeons and past President of the Society for Male Reproduction and Urology, he specializes in male factor infertility, microsurgical sperm extraction, varicocele repair, and vasectomy and vasectomy reversal. Dr. Coward is a co-author of the American Urological Association's 2026 Guideline on Vasectomy and Fertility Restoration after Vasectomy and has published over 80 peer-reviewed articles and book chapters. He sees patients at Atlantic Fertility in Raleigh, NC, working alongside the clinic's reproductive endocrinologists and embryology team to provide fully integrated care for both partners.

Learn more about Dr. Coward →