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We take a deep dive and talk to traditional Doctors and alternative Practitioners to find out how men can support their own fertility.

Thanks partly to lifestyle choices and the fact many couples are starting families later, male fertility in Australia, like the rest of the western world, is at an all-time low.

Dr Alex Polyakov, a clinical senior lecturer at University of Melbourne and Clinical Director of Melbourne IVF says, “There have been a number of studies looking at [places like] Europe, America, China, and Australia, which clearly demonstrate the average number of sperm in men, as well as the quality of sperm, has declined over the past 30 years.”

“There are multiple theories as to why the number and quality of sperm is declining,” says Dr Polyakov. “People now talk about various environmental factors, such as plastics or other pollutants, often called endocrine disruptors, that mimic hormones if you [absorb or] ingest them. It’s a big area of research. You can’t easily control your environmental exposure to plastics, but you can try to improve the quality and the number by doing the right things in terms of not wearing tight underwear, not smoking, drinking, or taking drugs, trying to ejaculate at regular intervals.”

Sydney-based natural fertility expert and doctor of Chinese Medicine, Kim Gatenby, concurs. “I’m definitely seeing a larger proportion of male patients in my clinic who are seemingly healthy young men, yet they have extremely poor sperm that is unable to result in a pregnancy without intervention. Sperm counts may be at an all-time low.” If you’re looking for simple ways to improve your chances of starting a family naturally, either now or in the future, here are some expert tips to consider.

We’ve distilled some tips for you to take into your everyday life to help support your journey to healthy sperm:

TIP 1: Rethink your what you eat, drink, and take. 

“Diet and lifestyle changes [such as reducing alcohol and avoiding recreational drugs] fall into the category of modifiable factors,” says Dr Polyakov. “Patients like to focus on these areas as they have some control and can make beneficial choices. There are specific combination of vitamins and minerals with scientific backing that we often recommended, includes zinc. Men who are trying to achieve natural pregnancy should probably take a [men’s health] supplement with zinc in it.” 

TIP 2: Lose some weight if you’re carrying excess kilos.

“Having a healthy weight is very important for men’s fertility but often under-appreciated,” says Dr Polyakov. “Some men try supplements make various other [lifestyle] changes, when in actual fact the best thing they could do is just lose some weight. Excess fat cells can increase the amount of estrogen in the system and that can have a detrimental effect on sperm quality. We know that for men who are overweight, sperm number and quality is less than men who have a normal body mass index (BMI).”

TIP 3: Edit your undies drawer.

 A highly regarded 2018 study* of 656 male partners in couples seeking infertility treatment at Massachusetts General Hospital, Boston, from 2000 to 2017 found men who most frequently wore boxers had a 25 percent higher sperm concentration than those who wore fitted briefs. “Underwear is important in the sense that testicles are situated outside the main body because they function better at lower temperatures,” says Dr Polyakov. “If men wear tight underwear, the temperature around the testicles is increased, and that can have detrimental effects on the quality and the number of sperm. So, the advice we always give men trying to get pregnant is to wear cotton boxers to improve the temp regulation of the testes,” he states.

“We recommend cotton [underwear]… because it allows heat to escape, while synthetic materials trap the heat in, meaning the temperature surrounding the testes may be higher if someone wears tight polyester underwear as opposed to cotton boxers.” Cotton also wicks moisture, adds Ms Gatenby, and “discourages growth of bacteria and yeast in an environment that relies on a delicate balance of good flora to maintain health. It’s important to always wear breathable underwear for three months prior to trying to conceive in order to maximise sperm health.” Anecdotal evidence suggests tight jeans, long hot baths and working with a computer on your lap might have the same overheating effect.

TIP 4: Make sure your cotton underwear is organic.

We all think of cotton as natural, but conventional cotton is one of the most polluting textile fibres produced, primarily because it accounts for more than 25 percent of the world’s pesticide use.

Many of the compounds found in these pesticides are either known and highly likely to be carcinogens, according to the World Health Organisation. Given your skin is the largest and most exposed organ on your body, it makes sense that reduced exposure to fabrics grown, processed, and dyed using chemicals – which remain even after washing and include endocrine disruptors – is common sense. “Organic fabrics are preferable to cotton grown with pesticides [and synthetic fertilisers], which may remain in the fabrics,” says Ms Gatenby. “Given we know chemicals are reducing fertility rates, it’s important to use organic clothing and eat organic food where possible to support reproductive health. I advocate that all my fertility patients reduce their exposure to chemicals and have seen significant improvements in fertility potential in a matter of months from making those changes.” As a bonus, organic cotton is generally more breathable than chemical-affected commercial cotton, better at wicking sweat (especially during exercise), and there’s also evidence to suggest it’s softer and more durable than commercial cottons damaged by chemicals and stripped of natural waxes.

TIP: In a nutshell, go au naturale all-round if you can.

“My best advice for men wanting to improve their sperm quality is to focus on improving their lifestyle and living as chemical-free as possible,” says Ms Gatenby. “This includes eating fresh organic foods, avoiding chemicals in personal care products, avoiding plastics in food and drink containers, and wearing breathable organic cotton underwear to keep their sperm at the correct temperature and away from chemicals.” Of course, for some men, there are more serious factors at play, especially if infertility is the result of testicular injury, medication use such as chemotherapy, hormonal problems, genetic factors, or other medical disorders. In these cases, and for any ongoing fertility concerns, seeking expert advice from a CREI-trained specialist doctor (meaning they hold a Certificate in Reproductive Endocrinology and Infertility qualification) is always advised. 

Key facts about Conventional v Organic Cotton

  1. Regular cotton is grown with harmful pesticides declared carcinogenic by the World Health Organisation.
  2. All-natural and biodegradable, organic cotton production uses 91 percent less water, 46 percent less CO2, and 61 percent less energy than standard cotton.
  3. Regular cotton can cause skin irritation and allergies, but organic cotton is hypoallergenic.
  4. Organic cotton fibres are longer and stronger than conventional cotton fibres.
  5. A majority of fair-trade cotton is also certified organic, with number is growing every year.



  • Dr Alex Polyakov is an obstetrician, gynaecologist, and fertility expert based at Melbourne Royal Women’s Hospital. He is Clinical Director of Melbourne IVF and a Clinical Senior Lecturer at the University of Melbourne.
  • Kim Gatenby is a natural fertility expert with over 15 years of experience as an acupuncturist and Doctor of Chinese Medicine and holds a master’s degree in Reproductive Medicine from the University of New South Wales. 

Journal References:

* Type of underwear worn and markers of testicular function among men attending a fertility center.

Human Reproduction, Volume 33, Issue 9, September 2018: p1749–1756.