The fertility check men aren’t getting—but may desperately need
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Making men intimately aware of their own sperm health may make them more motivated to push for certain policy changes that could help fix male infertility and improve health on a larger scale.
—Lucky Sekhon, MD, reproductive endocrinologist and infertility specialist
When it comes to infertility, the cultural reflex is still to focus on women. The “biological clock” looms large, and patients often assume delayed childbearing is the culprit when couples struggle to conceive.
But as reproductive endocrinologist and infertility specialist Lucky Sekhon, MD, pointed out in a recent video, that narrative leaves out half the picture.
"Fifty percent of cases of infertility are due to a male factor," she emphasized. Yet the imbalance in blame persists, and men are rarely counseled with the same urgency around fertility as women.
Dr. Sekhon references a large-scale study that made national headlines: Sperm counts worldwide have dropped by more than 50% over the past few decades. This decline doesn’t appear to be slowing.
While women undergo annual gynecologic assessments that often include fertility considerations, men have no equivalent touchpoint—and physicians may not be raising the issue early enough.
The drivers are multifactorial, according to Dr. Sekhon. Environmental exposures play a major role: Endocrine-disrupting chemicals (like BPA, phthalates, pesticides, and industrial pollutants) interfere with testosterone production and can damage sperm-producing cells.
Alarmingly, some of these exposures begin in utero, with links between prenatal chemical exposure and reduced adult sperm counts.
Lifestyle factors compound the problem. Rising rates of obesity lower testosterone and worsen oxidative stress, according to Dr. Sekhon, directly impairing sperm quality.
Add in chronic stress, highly processed diets, vaping or smoking, and heavy alcohol use, and you may have a recipe for widespread DNA damage in sperm.
Related: Supplements to improve male fertilityWhy sperm quality matters
Poor sperm health isn’t only about achieving pregnancy, of course.
"We know that poor sperm quality can affect the health of future generations," Dr. Sekhon said. "DNA damage in sperm, epigenetic changes often triggered by chemical exposures, or unhealthy lifestyle and chronic medical conditions can actually influence the long-term health of children, causing problems with their metabolism or reproductive problems of their own."
In other words, the quality of today’s sperm could shape tomorrow’s public health burden.
What physicians can do now
The takeaway for clinicians is straightforward: Infertility isn’t just a woman’s problem. Physicians across specialties—not just reproductive endocrinologists—can play a role by:
Normalizing male fertility discussions: Encourage male patients, especially those in their 20s and 30s, to consider fertility as a marker of overall health.
Promoting modifiable changes: Counsel on reducing chemical exposures (e.g., using glass or stainless steel instead of plastics), maintaining a healthy weight, staying active, and avoiding smoking and heavy alcohol use.
Screening early: When couples present with fertility concerns, order a semen analysis up front rather than defaulting to female-focused evaluations.
Framing fertility as preventive care: When relevant, considering positioning sperm health as part of routine men’s health—akin to cholesterol or blood pressure monitoring.
"Making men intimately aware of their own sperm health may make them more motivated to push for certain policy changes that could help fix male infertility and improve health on a larger scale," Dr. Sekhon said.