A man’s sperm count is a marker of his general health

sperm count by Agnes Ryu

Equally, his general health status is reflected in his sperm

I have just received another lab report for my patient, a middle-aged gentleman with male factor issues. He initially came in June 2019 with his December 2018 semen analysis result: total motility 27% (normal over 40%), progressive motility 20% (normal over 32%) and morphology under 3% (normal over 4%). With any male fertility evaluation, I would need recent sperm analysis performed on two separate occasions at least 10 weeks apart and so I asked him to arrange another test as a matter of urgency. His July sperm assay revealed that sperm quality and quantity was progressively decreasing, total motility 19%, progressive motility 14% and morphology 4%. This rate of decline within less than a year is quite alarming.

From August 2019 he was taking our custom-formulated medication and he was encouraged to have another test in 3 months to evaluate its effect. Now in mid-November, we have his most recent result. Total motility 52%, progressive motility 36% and morphology 5%. The sperm count has increased 300% ! My clients are overjoyed as they now have a much higher chance of natural conception. I can’t overemphasise how frequently pregnancies mysteriously result when the male side of the situation is addressed. The male factor is often the most easily modifiable, cost-effective measure that can improve the chance of natural conception for months and years to come.

I personally advocate testing regularly to monitor the progress being made. Many people are impressed by the irrefutable changes in numbers in reproductive hormone levels and sperm assays results revealed in my patients. Some people ask me my formula for male fertility enhancement assuming exotic ingredients are used which can be beneficial for everyone. There is no one-size-fits-all prescription. There are just individual needs. During the first encounter with my patient, I carefully accrue signs and symptoms for an evaluation of my client’s cardiometabolic status. Body composition is a crucial factor and any other lab data, however irrelevant it may seem, can provide valuable clues. With this data, it is possible to provide an overview of the current situation and a realistic way forward. Our medications always have to be custom formulated as each individual has a unique profile and there is no statistical man.

Repeatedly I see in my practice, regaining metabolic health, especially cardiovascular health has been shown to result in favourable changes in quality and quantity of sperm and lead to a successful pregnancy. Whilst dependent on my client’s most urgent needs, the common themes that I find myself focusing on are achieving normal body composition, relieving obesity, inflammation, energy problem, regaining insulin sensitivity and normal glucose regulation. Gut issues, food sensitivities and resulting intestinal permeability are often the source of inflammation and autoimmunity, which all contribute to oxidative stress and impaired sperm DNA integrity.

Naturally, it is common that while male clients are properly treated, all their biomarkers, such as lipid profile and markers of inflammation show dramatic improvement as does their energy, appearance and sexual health. Fertility and vigour are indeed a gateway to longevity and the intervention should be aligned in this direction.


Effects of low sperm count go beyond fertility

Recent research published by Alberto Ferlin et al in European Urology Focus confirms this.

A total sperm count of less than 39 million per ejaculate may place men at increased risk for poorer metabolic, cardiovascular and bone health compared with men with higher total sperm counts.

This large study evaluated semen quality, reproductive function, and metabolic risk in men referred for fertility evaluation and showed that a man’s semen count is a marker of his general health. Men with low sperm counts are more likely than those with normal sperm counts to have greater body fat, higher blood pressure, higher “bad” (low-density lipoprotein) cholesterol and triglycerides, and lower “good” (high-density lipoprotein) cholesterol. They also have a higher frequency of metabolic syndrome and insulin resistance, a condition that can lead to diabetes. Men with low sperm counts had a 12-fold increased risk of hypogonadism or low testosterone levels, and half of them had osteoporosis or low bone mass. Fertility evaluation gives men a unique opportunity for health assessment and disease prevention. The study’s lead investigator, Alberto Ferlin, M.D., PhD said:

Our study clearly shows that low sperm count by itself is associated with metabolic alterations, cardiovascular risk and low bone mass.”

“Infertile men are likely to have important co-existing health problems or risk factors that can impair quality of life and shorten their lives.”

He cautioned that their study does not prove that low sperm counts cause metabolic derangements, but rather that sperm quality is a mirror of the general male health. Thus fertility evaluation gives men the unique opportunity for health assessment and disease prevention.

The bottom line, Ferlin stressed, is that treatment of male infertility should not focus only on having a child when diagnostic testing finds other health risks, such as overweight, high cholesterol or high blood pressure.



Ferlin A, Garolla A, Ghezzi M, et al. Sperm Count and Hypogonadism as Markers of General Male Health. Eur Urol Focus. 2019. doi:10.1016/j.euf.2019.08.001

Ferlin A, et al. OR15-5. Presented at: The Endocrine Society Annual Meeting; March 17-20, 2018; Chicago.



Agnes Ryu

Agnes Ryu

Dr. Ryu is a clinician and biochemist specializing in integrative medicine. Her clinical interests include fertility, hormones, metabolism, healthy ageing, menopause, and natural breast cancer care. As an integrative practitioner, Dr. Ryu aims to uncover the root causes of health issues and strives to empower patients with the knowledge and tools to take charge of their own health.

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