How to Increase Sperm Count: Evidence-Based Steps

Sperm count is one of the few fertility numbers that lifestyle can measurably change. It is also easy to waste money on: most of what is sold to improve sperm has weak evidence. A male factor is estimated to account for up to half of infertility cases, so this is worth getting right.¹¹ This guide starts with what normal looks like, then goes through the changes with real evidence, roughly in order of impact.

Start with a semen analysis

You cannot fix what you have not measured. A semen analysis reports volume, concentration, total count, motility and morphology. Results vary from sample to sample, so labs usually test twice, after two to seven days of abstinence.² At-home mail-in kits such as Fellow and Legacy send your sample to a lab.

What is a normal sperm count?

The reference values compiled for the WHO’s 2021 manual come from more than 3,500 fertile men in 12 countries on five continents. The 5th percentile values, the usual lower reference limits, are:¹

These values describe fertile men; they are not sharp cut-offs between fertile and infertile.¹ Our guide to semen analysis results explains each number.

Why changes take three months

Sperm take about 74 days to develop in the testes.² A habit you change today affects sperm that will be ejaculated about 10 to 12 weeks from now. Retest after about three months; our 90-day sperm health plan sets out a week-by-week schedule.

1. Never take testosterone or anabolic steroids

This is the single most important point. Testosterone from outside the body, whether prescribed or used for bodybuilding, lowers the testosterone level inside the testes that sperm production depends on.⁹ The AUA/ASRM guideline advises against exogenous testosterone for men who want current or future fertility.⁹ Semen analysis shows low counts or no sperm in about 66% to 77% of anabolic steroid users.⁹ Recovery after stopping takes longer after higher doses and longer use.⁹ If you take testosterone, read TRT and fertility and talk to a urologist before stopping or changing anything.

2. Stop smoking

A meta-analysis of 5,865 men found cigarette smoking was linked to lower sperm count and motility, with greater effects in moderate and heavy smokers.³ Cannabis matters too: ASRM notes men who smoke cannabis have been reported to have 29% lower sperm counts, with a dose-dependent effect, although two large US studies found no link between cannabis use and time to pregnancy.⁷

3. Reach a healthy weight

Weight has a measurable effect. A meta-analysis of 21 studies with 13,077 men found a J-shaped link between BMI and low or absent sperm count. Compared with normal-weight men, the odds were 11% higher for overweight men, 28% higher for obese men and about double for morbidly obese men.⁴ Whether losing weight reverses this still needs study.⁴

4. Keep alcohol moderate

A meta-analysis of 15 studies with 16,395 men found alcohol reduced semen volume and normal morphology, mainly in daily drinkers; moderate drinking did not appear to harm semen.⁵ ASRM notes chronic alcohol dependence is linked to lower sperm counts, motility and testosterone.⁷

5. Avoid heat on the testes

In a small study of 11 infertile men with regular wet heat exposure, such as hot tubs and hot baths, five improved after stopping, with total motile sperm counts rising by an average of 491%, mainly from better motility.⁶ It was small and uncontrolled, but stopping is free.

6. Do not save it up

Long abstinence does not help. ASRM notes abstinence of more than five days may lower sperm counts, and that men with normal semen kept normal concentration and motility even with daily ejaculation.⁷ Sex every one to two days in the fertile window is the advice.⁷

7. Get checked for a varicocele

A varicocele is an enlargement of the veins in the scrotum, and it can be treated surgically or by radiological embolization. A 2021 Cochrane review of 48 studies found that treatment may improve pregnancy rates compared with no or delayed treatment (RR 1.55, low certainty), though its effect on live birth is uncertain.⁸ Among surgical approaches, microscopic subinguinal repair probably works slightly better.⁸ A doctor diagnoses it on examination.

What about supplements?

The evidence is weaker than the marketing. In the FAZST trial of 2,370 men, 30 mg of zinc plus 5 mg of folic acid daily for six months did not improve semen quality or live birth rates.¹⁰ Cochrane’s review of antioxidants for male subfertility found very low-certainty evidence that they may increase live births, an effect that disappeared in trials at low risk of bias.¹¹ Supplements are not FDA-approved before sale.¹³ If you still want one, read our guide to zinc and selenium first.

When to see a urologist

ASRM recommends a fertility evaluation after 12 months of trying, or after 6 months if the partner trying to conceive is 35 or older; make sure both partners are tested.⁷ Ask for a urologist or male reproductive specialist sooner if a semen analysis is abnormal, or if you have a known male-factor issue, a history of cancer treatment, or testosterone or steroid use. The AUA/ASRM guideline sets out how male infertility is evaluated and treated.¹²

More for partners at every step is in the Partners hub.