In Hungary, 15–20% of couples who wish to have a child experience difficulty conceiving, and this proportion is continuously increasing [1]. Female infertility receives increasing attention, yet it is less well known that in nearly half of cases, a male factor is present, affecting both sperm quality and quantity. Fertility decline is not caused only by diseases or delayed parenthood; many other factors can be influenced by changing individual habits. With optimal body weight, appropriate nutrition, moderate alcohol intake, avoidance of smoking, regular physical activity, and reduction of psychological stress, not only general health but also reproductive health can be supported [2,3].

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NUTRITION

Food provides the energy and micronutrients required for life processes, including reproduction. Nutrients are essential throughout all stages of human development—from fetal life through puberty and reproduction into old age. A balanced, varied diet helps preserve or improve health.

Body weight and fertility

Excess body weight negatively affects fertility. In Hungary, 65% of men are overweight or obese [4]. According to a recent survey by the Pannon Reproduction Institute, 79.2% of their male patients fall into these categories—well above the national average.
Overweight leads to lower testosterone, higher estrogen, and increased oxidative stress, all of which contribute to infertility [2]. Research shows that as BMI and waist circumference increase, ejaculate volume, sperm concentration, and total sperm count decrease. Obese men also have a higher proportion of abnormally shaped and DNA-damaged sperm compared to men with normal BMI [5]. Excess weight may lead to insulin resistance, which also increases oxidative stress and worsens sperm quality [6]. Weight reduction can improve semen parameters [5].

Mediterranean diet

Research on male fertility parallels findings on general health: the traditional Mediterranean diet significantly supports health. It includes large amounts of vegetables, fruits, whole grains, fish and seafood, and lean white meats, while avoiding fatty red meat and processed meats. This pattern improves sperm quality and partner pregnancy rates [6].

Vegetables, fruits, and antioxidants

Daily intake of vegetables and fruits helps reduce body weight due to their high fiber content and provides vitamins E, C, and D.
Leafy greens (spinach, kale, chard) provide folate, which is essential for male as well as female fertility.
To counteract oxidative stress, antioxidant-rich foods should be consumed, including carotenoids such as beta-carotene, cryptoxanthin, and lycopene, found in carrots, pumpkin, tomatoes, and melon.
Red and dark-purple fruits and vegetables (e.g., red cabbage, beetroot, blackcurrant, blueberry, aronia, pomegranate, rosehip, watermelon) are particularly rich in antioxidants and should be eaten several times per week [6,7].

Fats and animal products

Saturated and trans fats should be avoided; unsaturated and essential fatty acids are recommended.
Red meat, processed meats, and full-fat dairy are associated with reduced sperm quality, while lean meats, low-fat dairy, and omega-3-rich fish support better semen quality [6].

Alcohol and caffeine

WHO recommends avoiding alcohol due to its harmful health effects [8]. While no strict threshold exists for infertility, daily alcohol consumption reduces sperm quality, and higher intake further suppresses spermatogenesis [5,6].

Caffeinated drinks (coffee, tea) negatively affect sperm quality and reduce partner conception rates [5,6,9].

Sugar and insulin resistance

Sugary foods and soft drinks increase the risk of insulin resistance, which through oxidative stress impairs sperm quality [6].

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LIFESTYLE

To maintain or restore health, achieve normal body weight, and reduce oxidative and psychological stress, regular physical activity is essential. Sedentary work, especially when combined with tight clothing, causes testicular heat stress, reducing sperm quality. Frequent sauna use and intensive cycling also cause heat stress [5] and should be avoided during fertility problems.

Psychological stress lowers testosterone, reduces spermatogenesis, decreases sperm concentration and motility, and increases abnormal sperm morphology [5]. These effects can be counteracted by exercise, relaxation techniques, and time in nature.

Smoking

About one-third of Hungarian men smoke [10]. Cigarette smoke contains over 7,000 chemicals, many carcinogenic and oxidative. Smoking reduces spermatogenesis, sperm count, and motility, and damages sperm morphology and DNA. Smoking also causes epigenetic changes, affecting not only the smoker but also future offspring [5,11].

Cannabis

Although increasingly legal internationally, cannabis harms reproduction. Men using it more than once weekly have lower sperm count and concentration [5].

Anabolic steroids

These suppress spermatogenesis, cause testicular atrophy and infertility, reduce libido, and cause erectile dysfunction. Recovery may take up to two years [5].

Mobile phones

Electromagnetic radiation may reduce sperm motility; therefore phones should be kept away from the testes [5].

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Many factors contribute to male infertility: diet, obesity, inactivity, alcohol, smoking, drug use, psychological stress, and their combinations. Early recognition and lifestyle change can significantly improve fertility.

Bibliography:

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World Health Organization, "Alcohol," 2024. [Online]. Available: https://www.who.int/news-room/fact-sheets/detail/alcohol.

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T. L. T. Y.-H. C. A. J. G. C. T. D. L. W. R. H. J. E. C. A. E. Karmon, "Male caffeine and alcohol intake in relation to semen parameters and in vitro fertilization outcomes among fertility patients," Andrology, %1. kötet5, %1. szám2, pp. 199-398, 2017.

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Központi Statisztikai Hivatal, "Dohányzás," 2019. [Online]. Available: https://www.ksh.hu/docs/hun/xftp/idoszaki/elef/dohanyzas_2019/index.html.

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