Dear Dr G,

I am a 30-year-old man who is really stressed about parenthood.

My wife and I have been married for the last three years and we have been trying for a baby since day one.

During the last three years of festivities during balik kampung, I have been seeing my wife interrogated by well-meaning uncles and aunties about babies.

In truth, we have a dark secret that nobody in the family knows.

My wife had actually undergone medical examinations and was given an all-clear.

My semen analysis revealed my sperm quality being suboptimal is the real reason behind the delay in conceiving.

My approach in the last few years has been avoiding conversation.

However, I have decided to face the issues and hope to enhance my sperm quality in the years to come.

I have done some online searches and was horrified by how many recommendations for fertility enhancement in men.

I am somewhat confused and hope to put Dr G on the spot to debunk the myths.

First of all, can you confirm whether the type of clothing will influence the quality of sperms?

Will frequent ejaculations also cause male infertility?

Will a certain diet influence the sperm quality? What about alcohol intakes?

Lastly, I hear stress can reduce sperm counts? How is that possible?

Please help.

Yours truly,

Stressed Saiful

Male fertility is influenced by a wide range of biological, environmental, and lifestyle factors. In recent years, increased awareness about declining sperm quality has led to the spread of both scientifically supported information and widespread myths. Misunderstanding these factors can create unnecessary anxiety or cause men to overlook important habits that genuinely affect reproductive health.

One common myth is that wearing tight underwear or certain clothing completely destroys sperm production. In reality, the testes require a slightly cooler temperature than the rest of the body for optimal sperm development, and prolonged heat exposure can reduce sperm quality.

However, clothing alone is rarely a major cause of infertility. More significant contributors include frequent use of hot tubs or saunas, placing laptops directly on the lap for long periods, and extended sitting without movement. Addressing these habits can help maintain a healthier environment for sperm production.

There is also a belief that frequent sexual activity significantly lowers sperm quality. While very frequent ejaculation may temporarily reduce sperm concentration, the body continuously produces new sperm. For most healthy men, regular sexual activity does not harm fertility.

In fact, moderate ejaculation frequency may help reduce the accumulation of damaged sperm cells. Problems arise only when underlying health conditions or hormonal imbalances interfere with normal sperm production. Dietary myths are particularly common.

Some people assume that consuming specific “superfoods” or supplements can rapidly restore fertility. While nutrients such as zinc, selenium, omega-3 fatty acids, and antioxidant vitamins play important roles in sperm health, no single food or supplement can reverse fertility problems on its own. Sustainable improvement usually depends on long-term dietary patterns that support overall metabolic and hormonal health.

A balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats provides the foundation for better reproductive function. Alcohol consumption is another area where misconceptions exist.

Moderate intake may not significantly impair fertility in otherwise healthy individuals, but chronic heavy drinking can reduce testosterone levels and interfere with sperm production.

Similarly, smoking is sometimes underestimated as a fertility risk. Scientific studies consistently link tobacco use to reduced sperm count, impaired motility, and increased oxidative damage. Quitting smoking can lead to gradual improvements in sperm quality over several months, as sperm production cycles renew.

Stress and sleep are often overlooked lifestyle factors. Many men believe psychological stress has little physical impact on fertility.

However, chronic stress can disrupt hormonal balance, particularly by increasing cortisol levels that may suppress testosterone production. Poor sleep further compounds this problem by affecting metabolic health, immune function, and cellular repair processes. Together, these factors can reduce the efficiency of sperm development and contribute to reduced fertility potential.

Physical activity is generally beneficial for reproductive health, but another myth suggests that more exercise is always better. Moderate exercise supports hormonal regulation, improves circulation, and helps maintain a healthy body weight. Excessive or extreme endurance training, however, can lead to hormonal suppression and increased oxidative stress.

Striking a balance between activity and recovery is therefore important for maintaining optimal sperm quality. Medical evaluation can play a critical role when lifestyle changes alone are insufficient. Conditions such as hormonal disorders, infections, or varicocele may require targeted treatment. Fertility specialists can provide semen analysis and personalised guidance based on individual health status.

Early intervention often improves outcomes and reduces the emotional burden associated with fertility challenges. Many myths about male fertility persist despite growing scientific knowledge about sperm health. While certain lifestyle factors do influence sperm quality, the effects are usually gradual and modifiable. By understanding the difference between misconceptions and evidence-based facts, men can take proactive steps to improve their reproductive health.

Sustainable lifestyle improvements, combined with appropriate medical care when needed, offer the best chance of overcoming obstacles and supporting fertility. The philosopher George Santayana once said: “Myth is the truth which is imagined”.

As far as the causes of male infertility, the myths are certainly widely imagined. Men who are ready to face both myths and truths about problematic male fertility often put Dr G on the spot for advice. His view is: “Healthy living is the only truth that is imaginable for healthy sperms.”