One of the areas we mentioned last week when we were breaking down possible influences on miscarriages was sperm quality. Men are of course half the equation when it comes to a healthy pregnancy, but are often not tested until after the one-year mark of not being able to conceive. Instead, all of the focus (and often pressure) is placed on the woman, which is unfortunate since poor sperm quality is a major contributor to miscarriage, especially early miscarriage. Let’s learn more about what sperm quality means and what impacts it, plus how you can assess.

What Makes Up Sperm Quality?

A man’s sperm quality is determined by several factors:

• Sperm Concentration: The number of sperm cells per milliliter of semen. A normal sperm concentration is typically over 15 million sperm per milliliter.
• Total Motility: The percentage of all moving sperm in the sample.
• Progressive Motility: The percentage of sperm that are moving actively and in a straight line or large circle, which is important for fertilizing an egg.
• Sperm Morphology: The shape and structure of sperm. Sperm are evaluated based on the percentage of normally shaped sperm in the sample. Abnormal morphology can affect the sperm’s ability to fertilize an egg.
• Semen Volume: The total amount of semen produced in a single ejaculation. Normal volume ranges from 1.5 to 5 milliliters.
• pH Level: The acidity or alkalinity of the semen. Normal semen pH ranges from 7.2 to 8.0. Abnormal pH can indicate issues with the seminal vesicles or prostate.
• Liquefaction Time: The time it takes for semen to liquefy after ejaculation. Normal liquefaction occurs within 20-30 minutes. Delayed liquefaction can affect sperm motility.

Additional Markers

• Sperm Vitality: The percentage of live sperm in the sample. This test is important when motility is low to distinguish between immotile (but alive) and dead sperm.
• White Blood Cells: The presence of white blood cells in semen can indicate an infection or inflammation. Normally, very few white blood cells are present.
• Sperm DNA Fragmentation: Some advanced tests measure the integrity of sperm DNA, which can affect fertility even if the basic sperm parameters appear normal.
  • 0–4.9%: Excellent sperm DNA integrity
  • 5–14.9%: Adequate sperm DNA integrity
  • 15–29.9%: Elevated levels of DNA fragmentation, which may impact fertility potential
  • ≥30%: Severely elevated levels of DNA fragmentation, which are very likely to impact fertility potential
  • This is an important one when it comes to recurrent miscarriages. You typically need to ask your provider for this test.

Our favorite sperm analysis is this one. You can order it yourself and complete it at a local lab. There are a lot of sperm tests out there that have great marketing. Please make sure you look at what they test and make sure they are comprehensive and worth the money. We’ve seen many that only test 2-3 things and don’t give as much information as the one we linked.

What Impacts Sperm Quality?

Sperm health is a direct reflection of your overall health and also gives insights into gut health and the gut microbiome. Here are the areas we want to assess/work on when it comes to improving sperm quality:

Digestion & Gut Health

How are bowel movements? Is there any bloating, poor appetite, reflux, indigestion, or skin issues (eczema, dermatitis, psoriasis) that could be indicating digestive/gut health issues?

Imbalances in the gut microbiome can lead to inflammation and increase insulin resistance. These can both lead to poor sperm quality and DNA damage.

Nutrient Deficiencies

• Zinc: Essential for the formation of the outer membrane and tail of sperm, as well as for DNA synthesis and chromatin stability.
• Folate (Vitamin B9): Crucial for DNA synthesis and repair, folate deficiency can lead to abnormal sperm production and function.
• Vitamin C: Acts as an antioxidant, protecting sperm from oxidative damage, which can lead to improved sperm quality.
• Vitamin E: Another antioxidant that protects the sperm membrane from oxidative stress, contributing to improved sperm motility and viability.
• Selenium: Important for sperm motility and protection against oxidative stress. It is a component of selenoproteins, which are crucial for sperm function.
• Coenzyme Q10 (CoQ10): An antioxidant that is also involved in energy production, helping to improve sperm motility and overall function.
• Magnesium: Involved in the regulation of cellular energy production and is necessary for the proper function of many enzymes involved in spermatogenesis.
• Vitamin B12: Essential for DNA synthesis and energy production, deficiencies in B12 can lead to reduced sperm count and motility.
• Antioxidants (e.g., Glutathione): Help protect sperm from oxidative damage, which is crucial for maintaining the integrity of sperm DNA and overall sperm quality.

Excess amounts of nutrients can also negatively impact sperm quality like copper excess and iron overload.

Inflammation, Toxins In The Environment, & Antioxidant Status

Looking at our environment, alcohol, smoking, and toxins that will not only lower testosterone but often increase estrogen is important when it comes to supporting sperm quality as well. Sometimes we cannot minimize all toxic exposures. For example, sometimes heavy metals are an exposure we get through our job. How can we combat this? You can consider incorporating glutathione, humic/fulvic minerals, green tea, turmeric, and lactobacillus based probiotics.

Sperm health is essential for healthy conception and pregnancies, which is why we address this in our Nurture Your Fertility program. We believe in supporting the health of both partners in order to optimize the chances of a healthy pregnancy.

If you want to learn more about how your partner can work on their gut health here are two great podcast episodes from the are you menstrual? podcast.
– Gut Health 101
– How to have healthy digestion