Male infertility: 10 factors that affect sperm count and morphology

It is estimated that about one in seven couples faces difficulty conceiving.  In Hong Kong, male infertility can be problematic owing to the widely acknowledged stressful lifestyle and a high level of urogenital infections (extremely common in this region.) While people think that most fertility problems involve the woman around 40% of infertility cases are attributed to the man. Male infertility can stem from a variety of reasons including low sperm count, abnormal sperm shape (morphology), suboptimal movement (motility) and/or function.

If you’ve been having regular unprotected sex for more than 12 months (or less, if you’re over 35) and you’re still not pregnant, you are right in thinking that you may have a fertility problem.

10 reasons why you may have low sperm count or poor morphology:

1.Frequent exposure to heat

Do you sit for a long period of time (e.g. long-distance driver, avid cyclist)? Do you use hot tubs, heated car seats or wear tight underwear? All of these factors can effect normal sperm production. The testicles are located outside the body in the scrotum to keep sperm cool. Studies show that actions or activities that raise testicular temperature can decrease sperm count.


A fairly common condition among men. Varicoceles are enlarged dilated veins in the scrotum, which results in an elevated temperature in the testicles, which can lead to fertility problems.

3.Exposure to chemicals

Sperm health can be affected by overexposure to certain environmental elements, such as industrial chemicals (e.g. benzenes, toluene), pesticides and heavy metals. A 2015 Harvard study revealed that men who ate fruits and vegetables with higher levels of pesticide residues (e.g. strawberries, spinach, peppers) had lower sperm counts and lower percentages of normal sperm than those who ate produce with lower pesticide levels.

4.Processed Meat

It turns out that processed meats, such as bacon and sausage may also decrease sperm count. In another Harvard study, researchers found that men who ate between one and three servings of processed meats per day had worse quality sperm than those who ate the fewest servings. In comparison, sperm quality was better in men who ate white or fatty fish (e.g. cod, halibut, salmon, tuna). Note that soy can also negatively affect sperm quality as it contains isoflavones which mimic oestrogen, a primary female sex hormone.

5.Heavy Smoking

Smoking over 20 cigarettes a day has been shown to reduce both sperm count and sperm motility.

6.Mobile phones

Heat and radiation from mobile phones also have an effect on sperm health. Studies show that using Wi-Fi can decrease a man’s fertility by decreasing sperm motility and increasing sperm DNA fragmentation. 

7.Exposure to radiation from X-rays or cancer therapy

With high doses of radiation, sperm production can be permanently reduced.

8.Being overweight

In a Harvard study it was found that overweight men are 11% more likely to have a low sperm count and 39% more likely to have no sperm in their ejaculate. Obesity can reduce fertility by lowering testosterone levels (greater fat storage can end up turning testosterone into the female hormone oestrogen, leading to a slowing or cessation of sperm production), directly raising testicular temperature due to extra insulating fat tissue and increasing the risk of erectile dysfunction.

9.Infrequent Sex

Men with normal sperm counts who are abstinent for 11 or more days may experience significant decreases in the percentage of sperm motility and normal morphology.

10.Untreated infections

Untreated infections can decrease sperm count and quality or cause scarring that blocks the passage of sperm. These include inflammation of the epididymis (epididymitis) or testicles (orchitis) and some sexually transmitted infections (STI), including HIV and gonorrhoea.

Worried that you may be suffering from male infertility? It may be time for a comprehensive semen analysis, which will give details of sperm count, sperm motility and morphology (and if there are defects, where the defects lie – in the head, body, tail, etc.). It can also rule out possible infections.

What to do next

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