Infertility affects millions of couples globally, and male factors contribute to roughly 50% of all infertility cases. Despite these numbers, male infertility remains surrounded by myths, stigma, and misinformation. We aim to set the record straight with guidance from a reproductive urologist and updated scientific findings, helping couples make empowered and informed decisions on their path to parenthood.
Does tight underwear cause male infertility?
The age-old boxers vs. briefs debate has led many to believe that tight underwear harms fertility by raising scrotal temperature. While it's true that sperm production is sensitive to heat, recent large-scale studies, like one in Human Reproduction, show no significant difference in sperm quality between men who wear tight versus loose underwear.
A 2022 cohort study found that while extreme heat exposure (e.g., hot tubs, saunas) can impair sperm parameters, underwear choice has minimal impact. Instead, focus on avoiding prolonged scrotal heat exposure from laptops or hot baths.
RELATED: Can men take prenatal vitamins?
Do only women need to worry about their biological clock?
The idea that male fertility remains constant throughout life is outdated. While men don’t experience menopause, sperm quality does decline with age. Older paternal age is associated with a higher risk of certain genetic conditions and fertility issues.
A recent literature review found that advanced paternal age can be linked to increased risks of autism, schizophrenia, and genetic mutations, along with longer time to pregnancy.
Dispelling the myth that only women face a biological clock is crucial for couples planning their families and seeking fertility advice.
Is male infertility always permanent?
One of the most pervasive myths is that male infertility is a fixed condition. The belief that male infertility is a life sentence is simply not true. In many cases, the condition is treatable or reversible, depending on its root cause.
Treatments may include:
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Lifestyle changes
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Medication
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Surgery (e.g., varicocele repair)
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Assisted Reproductive Technologies (ART) like IVF or ICSI
New research is exploring stem cell therapy and antioxidant protocols for restoring testicular function, though these are still experimental.
Do lifestyle factors impact male fertility?
Lifestyle choices significantly influence male fertility. Unhealthy habits such as smoking, alcohol abuse, drug use, and poor diet can impair sperm quality.
A 2021 literature review published in Human Reproduction Update showed that smoking decreases sperm count, motility, and morphology. Meanwhile, a diet high in antioxidants, omega-3s, and key micronutrients (like zinc and folate) supports better sperm parameters.
A healthy lifestyle matters for both partners.
RELATED: The fertility-boosting diet: Mediterranean Diet for fertility
Does age affect male fertility?
Though female age-related fertility decline is more widely discussed, men are not immune to the effects of aging on fertility.
Research in Fertility and Sterility confirms that men over 40 experience:
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Increased DNA fragmentation
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Lower semen volume
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Reduced sperm motility
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Increased risk of miscarriage and neurodevelopmental disorders in offspring
Proactive fertility planning isn’t just for women, men should be equally informed and engaged.
Does male reproductive anatomy have impact on fertility?
Conditions such as varicocele, which is an enlargement of veins within the scrotum, can significantly impact male fertility.
According to The Cochrane Database of Systematic Reviews, varicocele repair surgery can improve pregnancy rates and sperm parameters, especially in cases of palpable varicoceles with abnormal semen analysis.
Other anatomical factors, such as obstructions in the reproductive tract, undescended testes, or congenital absence of the vas deferens, may also contribute to infertility and can often be treated or managed with the help of a reproductive urologist.
Male infertility is not rare, nor is it untreatable. By debunking long-standing myths and understanding the real science, couples can take actionable steps toward achieving their fertility goals.
If you're facing challenges with conception, seek guidance from a reproductive urologist or fertility specialist. Remember, fertility is a shared journey, and it starts with knowledge, support, and care for both partners.
A note from WeNatal on supporting optimal sperm health
As we've uncovered, male infertility is complex, but often manageable with the right knowledge, lifestyle changes, and medical support. We believe in addressing both sides of the fertility equation and that’s why we’ve created a science-backed prenatal supplement for men, specifically formulated to support sperm count, motility, morphology, and overall reproductive health.
WeNatal for Him includes:
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Methylated B vitamins for DNA integrity
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Zinc, selenium, and CoQ10 for sperm function and antioxidant protection
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Omega-3s to reduce inflammation and support cell membranes
Just as women prepare their bodies for pregnancy, men must optimize their fertility to give their future children the healthiest start possible.
RELATED: Q&A with Reproductive Urologist Dr. Ariel Moradzadeh
References
Birowo P, Tendi W, Widyahening IS, Atmoko W, Rasyid N. The benefits of varicocele repair for achieving pregnancy in male infertility: A systematic review and meta-analysis. Heliyon. 2020;6(11):e05439. Published 2020 Nov 5. doi:10.1016/j.heliyon.2020.e05439
Emokpae MA, Brown SI. Effects of lifestyle factors on fertility: practical recommendations for modification. Reprod Fertil. 2021;2(1):R13-R26. Published 2021 Jan 8. doi:10.1530/RAF-20-0046
Harris ID, Fronczak C, Roth L, Meacham RB. Fertility and the aging male. Rev Urol. 2011;13(4):e184-e190.
Janeczko D, Hołowczuk M, Orzeł A, Klatka B, Semczuk A. Paternal age is affected by genetic abnormalities, perinatal complications and mental health of the offspring. Biomed Rep. 2020;12(3):83-88. doi:10.3892/br.2019.1266
Kaltsas A, Moustakli E, Zikopoulos A, et al. Impact of Advanced Paternal Age on Fertility and Risks of Genetic Disorders in Offspring. Genes (Basel). 2023;14(2):486. Published 2023 Feb 14. doi:10.3390/genes14020486
Kumar N, Singh AK. Trends of male factor infertility, an important cause of infertility: A review of literature. J Hum Reprod Sci. 2015;8(4):191-196. doi:10.4103/0974-1208.170370
Kupis Ł, Dobroński PA, Radziszewski P. Varicocele as a source of male infertility - current treatment techniques. Cent European J Urol. 2015;68(3):365-370. doi:10.5173/ceju.2015.642
McKinnon CJ, Joglekar DJ, Hatch EE, et al. Male personal heat exposures and fecundability: A preconception cohort study. Andrology. 2022;10(8):1511-1521. doi:10.1111/andr.13242
Mei Y, Ji N, Feng X, Xu R, Xue D. Don't wait any longer, conceive in time: a systematic review and meta-analysis based on semen parameters after varicocelectomy. Int Urol Nephrol. 2024;56(10):3217-3229. doi:10.1007/s11255-024-04080-y
Mínguez-Alarcón L, Gaskins AJ, Chiu YH, et al. Type of underwear worn and markers of testicular function among men attending a fertility center. Hum Reprod. 2018;33(9):1749-1756. doi:10.1093/humrep/dey259
Wang J, Liu C, Fujino M, et al. Stem Cells as a Resource for Treatment of Infertility-related Diseases. Curr Mol Med. 2019;19(8):539-546. doi:10.2174/1566524019666190709172636
