Each November, Men’s Health Awareness Month encourages men to take a closer look at their health, not only for their own benefit, but for the wellbeing of their families too. While fertility and miscarriage are often seen as women’s issues, men play an equally important part – their general health directly affects their reproductive health, their partner’s conception and pregnancy, and the long-term health of their future children. To help understand these links, Mr Stephen Gordon, Consultant Urologist at New Victoria Hospital, identifies and explains the underlying male factors and offers practical ways to improve male fertility and long-term health.

A man’s overall health at the time of conception, including hormone balance and lifestyle, influences fertility and helps shape every stage of conception and pregnancy, affecting the likelihood of miscarriage, pregnancy complications, and even the child’s long-term wellbeing. Sperm quality is key, and chronic inflammation and health conditions, such as diabetes and obesity, can alter sperm DNA and impact future family health.

• Risk of miscarriage – higher when sperm DNA is damaged or fragmented.
• Pregnancy complications – such as pre-eclampsia, particularly with a first child of a new male partner.
• Child development and long-term health – research suggests links between paternal age, sperm quality, and conditions that may affect a child later in life, such as leukaemia in children of fathers that smoked prior to pregnancy.

Male fertility depends on a number of factors:

• Sperm quality
• General health
• Hormonal imbalances
• Infections
• Environment
• Lifestyle

 

“Healthy sperm isn’t just about achieving a pregnancy. It plays a role throughout the journey – from conception, through pregnancy, to the health of the baby.”
Mr Stephen Gordon, BSc, MBBS, FRCS(Urol), Consultant Urologist at New Victoria Hospital

Sperm carry half of the genetic material that forms a baby, and if this DNA inside sperm becomes damaged – a condition known as sperm DNA fragmentation – it can affect embryo formation and increase the risk of miscarriage.

One major cause of DNA damage is oxidative stress, which occurs when harmful molecules called reactive oxygen species (ROS) outnumber antioxidants in the body. This imbalance can result from:

• Smoking and excessive alcohol consumption
• Poor diet or obesity
• Prolonged exposure to heat (for example, hot tubs or tight clothing)
• Environmental pollutants or toxins
• Infections or untreated varicoceles (enlarged scrotal veins)
• Age-related cellular changes

Importantly, even men with a “normal” semen analysis can experience high DNA fragmentation, which may explain otherwise unexplained miscarriages.

Key Causes Affecting Sperm Quality

• Varicocele: One of the most common and treatable causes of male infertility. It involves enlarged scrotal veins, disrupting normal blood flow and raising testicular temperature by 1–2°C, and is associated with impaired sperm production and quality. Surgical varicocele repair or embolisation improves sperm count, motility, morphology, and DNA integrity in up to 70% of cases, boosting natural pregnancy rates and assisted conception success, while reducing miscarriage risk.
• Infections: Sexually transmitted infections (STIs) like chlamydia, gonorrhoea, and ureaplasma can cause genital inflammation that harms sperm quality and may lead to blockages obstructing sperm flow. Prompt diagnosis and antibiotic treatment are crucial to preventing lasting damage. Chronic or severe infections may require specialist medical or surgical management. Human papillomavirus is also important to be aware of: greater public understanding of HPV and access to vaccination can help protect fertility and reduce the risk of certain cancers in men and women.
• Hormonal imbalances: Low testosterone (hypogonadism) and other hormone disorders from the pituitary, thyroid, or adrenal glands can reduce sperm production, libido, and sexual function. These may be congenital or develop from illness, medication, or treatment such as chemotherapy and radiotherapy. Hormone levels are tested and optimised medically when indicated.
• Obstructions: Physical blockages anywhere in the sperm transport system (vas deferens, epididymis, ejaculatory ducts) caused by infections, scarring from surgery or injury, or congenital abnormalities like cystic fibrosis can lead to absent sperm in the ejaculate (obstructive azoospermia). Surgery may be required to remove or bypass blockages and restore fertility. A formal or correct diagnosis may also help couples decide more swiftly between natural or assisted conception and ensure that appropriate genetic counselling is sought.
• Lifestyle Factors: Smoking, excessive alcohol, drug use, poor diet, obesity, and high stress negatively impact sperm quality by increasing oxidative stress and disrupting hormones. Positive lifestyle changes, including quitting smoking, moderating alcohol intake, balanced nutrition, weight management, exercise, and stress reduction, can improve fertility outcomes.
• Heat Exposure: Prolonged or repeated heat exposure to the testes from hot baths, saunas, tight underwear, or occupational sources raises scrotal temperature, impairing sperm production and motility. Avoiding excessive heat helps protect sperm health.
• Other Conditions: Age-related decline in sperm quality and DNA integrity occurs naturally, typically after age 35-40. Genetic disorders (e.g., Klinefelter syndrome) and previous surgeries such as vasectomy can impact fertility, sometimes requiring advanced reproductive techniques or surgical intervention.
• Environmental and occupational exposures are increasingly recognised as contributors to declining sperm quality. Prolonged contact with industrial chemicals, air pollution, or endocrine-disrupting compounds (found in plastics and pesticides) can reduce testosterone and damage sperm DNA.

Consultant Urologists at New Victoria Hospital can provide a thorough evaluation to help identify potential causes of male fertility concerns. This may include:

• Medical history and physical examination – reviewing overall health, lifestyle, medications, and any past illnesses, injuries, or surgeries that may affect fertility. A physical assessment may also check for conditions such as varicocele or testicular abnormalities.
• Health checks and diagnostic tests – Well Man Health Checks with a GP or a consultation with a Urologist at New Victoria Hospital provide a full overview of your health, identifying any potential concerns early.
• Hormone evaluation – if indicated, assessing testosterone and other key hormones that influence sperm production and sexual health.
• Semen testing – when appropriate, analysing a semen sample to assess sperm count, movement, and shape.
• Further investigations – where needed, your Consultant may recommend imaging and offer additional specialist testing to help guide the most effective treatment plan.

Infertility Treatment: How a Urologist Can Help

Following diagnosis, treatment plans are tailored to the underlying causes and may involve:

• Varicocele correction, usually with embolisation, which has demonstrated improvements in semen quality and fertility outcomes.
• Medical treatment of infections affecting reproductive organ health.
• Hormonal therapies to optimise testosterone levels and support sperm production.
• Surgical intervention for obstructions within the reproductive tract.
• Lifestyle guidance to reduce oxidative stress: quitting smoking, moderating alcohol, weight management, avoiding excess heat in the scrotal area, and minimising environmental toxin exposure.
• Advice on antioxidant supplements and diet to support sperm health.
• Advice on assisted reproductive technologies (IUI/IVF/ICSI/PICSI) when appropriate.

New Victoria Hospital provides access to expert care and professional advice to support patients at every stage – from diagnosis to treatment and ongoing care.

• Maintaining a healthy weight, limiting processed foods, and eating a balanced diet rich in fresh fruit, vegetables, lean protein, and whole grains.
• Stopping smoking and reducing alcohol consumption, both of which can damage sperm and lower testosterone.
• Staying active and managing stress, as regular exercise supports circulation and hormone regulation.
• Avoiding prolonged heat exposure to the testes (such as hot baths, saunas, or tight clothing).
• Reducing exposure to environmental toxins, including pesticides, heavy metals, and certain plastics.
• Ensuring adequate sleep and rest, which helps regulate testosterone and improve overall wellbeing.
• Having regular health checks and hormone testing to spot any issues early and address them proactively.

Q: What’s the most common cause of male fertility problems?

A: Lifestyle factors such as smoking, obesity, and stress can reduce sperm quality. Conditions like varicocele and infections can also contribute.

Q: Does testosterone affect fertility?

A: Yes. Low testosterone can impair sperm production, libido, and sexual performance, all of which impact fertility. However, replacement testosterone alone is not the answer and can impair sperm production. Alternative options to boost natural testosterone production are available.

Q: Does age affect male fertility?

A: Yes. While the so-called andropause does not compare to menopause, sperm quality, motility, and DNA integrity do, indeed, decline gradually with age.

Q: Are there medical treatments for poor sperm quality?

A: Yes. Depending on the cause, treatment might include medication, varicocele repair, infection management, and reducing oxidative stress.

Q: Can improving sperm quality prevent miscarriage?

A: In many cases, yes. Removing risk factors and improving overall health can reduce DNA fragmentation and improve sperm function and, as a result, pregnancy success rates.

Q: When should men have a fertility check?

A: Any man who has been trying to conceive for more than 6–12 months, or whose partner has experienced miscarriage, should seek a urology assessment.

Men’s health, environment, and hormones all play a crucial role in conception and pregnancy. But it’s not about blame – it’s about understanding and informed choices. By discussing fertility openly and seeking advice early, men can boost the chances of conception and promote a healthy pregnancy for their partner, as well as support the best possible start in life for their future children. With expert support from a Consultant Urologist at New Victoria Hospital, men can take proactive steps toward better reproductive health and family wellbeing.

Mr Gordon emphasises, “It’s not about fault – it’s about knowledge. Understanding and improving sperm health can make a real difference not just for conception, but for long-term family wellbeing. When both partners understand their fertility health, they can make informed decisions and support each other through treatment.”

If you and your partner are planning a family, have experienced miscarriage, difficulty conceiving, or have concerns about sperm health, consulting a Urologist specialising in male fertility can be invaluable.

To book a private appointment with Mr Stephen Gordon or one of our Urology Consultants specialising in Men’s Health at New Victoria Hospital, please call 020 8949 9020 or fill in our online form.