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Concerned about reproductive health rumours? Urologist debunks 5 myths on male fertility and sperm health
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Dr Sanjay Prakash J debunks five common myths on male fertility, explaining why the subject is more complex than simply considering sperm count.
Reproductive health can sometimes be a subject of gossip among friends, but not many individuals get their doubts cleared by a medical practitioner. As such, there are many rumours on the subject that freely float among individuals.
“Male fertility is often reduced to one factor: the sperm count,” shared urologist and andrologist Dr Sanjay Prakash J with HT Lifestyle. “But reproductive health is far more complex than that. Several popular beliefs about semen and fertility can create unnecessary anxiety, or worse, delay the right evaluation.”
He went to debunk five myths about men’s reproductive health, which are presented as follows.
Myth 1: More ejaculation can lead to permanent depletion of sperm
Dr Prakash J noted that while frequent ejaculation may temporarily reduce the sperm concentration in an individual’s ejaculate, it does not permanently exhaust the body’s sperm supply.
“Sperm are continuously produced in the testes,” stated the urologist. “In fact, prolonged abstinence is not necessarily better either, as very long intervals may increase the proportion of older sperm and potentially affect motility and DNA quality.”
For couples trying to conceive, the doctor stated that regular intercourse is generally a more practical approach than trying to save up. Frequent ejaculation is also a treatment for seminal infections and high DFI (DNA Fragmentation Index), he shared.
Myth 2: Presence of sperm guarantees the success of IVF/ICSI
Assisted reproduction can overcome several sperm-related barriers, but it is not a universal solution, highlighted Dr Prakash J.
“Severe male-factor infertility may sometimes reflect an underlying hormonal, genetic, anatomical or testicular problem that deserves diagnosis and treatment. However, if the quality of sperm is poor, IVF-ICSI cannot solve the problem either,” noted the urologist.
Myth 3: Sperm boosters can guarantee better fertility
In the words of the urologist, “There is no magic pill or food that can guarantee improved fertility. Antioxidants, vitamins and other nutraceutical combinations are widely marketed as 'sperm boosters,' but their benefits are variable and depend on the underlying cause of infertility.”
The urologist explained that supplements may have a role in selected men, particularly when nutritional deficiencies or specific clinical indications exist. However, they should not replace evaluation for conditions such as varicocele, hormonal abnormalities, infections, obstruction or genetic disorders.
“A better sperm report should come from treating the cause, not simply taking more supplements,” stated Dr Prakash J.
Myth 4: Testosterone injections improve male fertility in hypogonadism
“Exogenous testosterone can actually suppress sperm production,” cautioned Dr Prakash J. “When testosterone is administered from outside, the brain reduces the hormonal signals, LH and FSH, that normally stimulate the testes to produce testosterone and sperm. Sperm production can therefore fall dramatically and, in some men, disappear completely from the semen.”
The urologist warned that men who want to preserve fertility should not start testosterone therapy without discussing its reproductive consequences with a specialist, especially when appropriate, fertility-preserving hormonal strategies may be considered instead.
Myth 5: Zero sperm in the semen means a man can never have a biological child
While the statement may seem logical, that may not necessarily be the case with modern medical advancements, shared Dr Prakash J.
“The complete absence of sperm in the ejaculate is called azoospermia, but it is not a single disease,” he explained. “Broadly, it can occur because sperm are being produced but are unable to reach the semen (obstructive azoospermia) or because sperm production within the testes is severely impaired (non-obstructive azoospermia). This distinction is crucial.”
In some men with obstruction, the testes may continue to produce sperm normally. In such cases, sperm can often be retrieved directly from the epididymis or testis and used for assisted reproduction. Fertility can also be restored by microsurgical reconstructions.
“Even in selected men with non-obstructive azoospermia, advanced sperm-retrieval techniques can sometimes identify and retrieve these sperm for use with IVF-ICSI. Therefore, an azoospermia report should not immediately be interpreted as no chance of biological fatherhood,” shared the urologist.
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Dr Sanjay Prakash J, MS(GS), DrNB(Uro), FMAS, FIAGES, FAMH, FECSM, is a Consultant Urologist and Microsurgical & Cosmetic Andrologist specialising in male infertility, male sexual disorders, and microsurgical procedures at the Asian Institute of Nephrology and Urology, Chennai.
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