Is Sperm Quality A Vital Sign For Men? (Episode 617)

Full Transcript: Episode 617

Lisa Hendrickson-Jack:

This is the Fertility Friday podcast, episode number 617. In today’s episode, we are diving into some really interesting research that links sperm quality to life expectancy in men. It gives us some insight into a really interesting question: can sperm quality be an indication — a health indication in men, kind of like a vital sign for them — in the same way that the menstrual cycle can be for women?

While we won’t be able to completely delve into that question in one episode, I think you’ll really enjoy today’s episode. I think you’ll find this research really fascinating. Without further ado, let’s go ahead and jump right in.

The title of the study that we are diving into today: semen quality and lifespan, a study of 78,284 men followed for up to 50 years. This study is a newer study. It’s the biggest of its kind. It’s certainly something that we should be paying attention to — it’s not every day that you get a research study that’s looking at such a large population size over that many years.

In 2025, Danish researchers published results from the largest semen quality and mortality follow-up study ever conducted. Nearly 80,000 men were followed for up to 50 years. The headline finding of this study was that the men with the highest total motile sperm counts — meaning the men who had the most sperm that were actually moving and swimming in their total count — could expect to live an average of about 2.7 years longer than men who had the lowest total motile sperm count.

That’s really interesting because, across such a large data set and across that many years, it really has implications that there could be a link between semen parameters and overall health. This isn’t a completely surprising result. We do know that a man’s semen analysis provides some insights into health. If the analysis is really low, it could be related to a physical issue or genetic issue, but it can also be related to various health issues.

We know that there’s a connection between semen quality and metabolic conditions. We know that semen quality varies with age and nutritional status. There are a lot of links there between men’s semen quality and overall health — and that is evidenced by the fact that men who improve their nutritional inputs, improve their overall health, improve those metabolic factors, tend to improve their semen parameters as well.

We do know that there is a link, but this study gives us a whole different ballgame because it’s not only looking at the parameters themselves, but this potential link to longevity. What I’m going to share with you are my top five takeaways from this study. With every study there’s a lot of data we can dig into, but these are the highlights I want to focus on.

The first one is that headline finding — there is a connection between semen quality and lifespan. It’s no longer speculation. The researchers confirmed that men who had the highest motile sperm counts also had the longest lifespan. The study was nearly 80,000 men — just under 80,000. Over the course of 50 years, they followed this group. Over that time, about 8,600 of those men passed away, representing a smaller percentage of the overall study. That’s how they were able to gather this data — they looked at all of the men who had passed away over the course of the study and looked for any correlation between sperm quality and lifespan.

What the researchers found was that the men who had the highest total motile sperm count — specifically men whose total motile count was above 120 million — could expect to live about 80 years on average, compared to about 77 years for men who had the lowest numbers. Those were men whose counts were between zero and five million. Again, this isn’t the total sperm count, but the count of the sperm that are actually moving.

In case you’re wondering why they’re looking at that number in particular: when we look at fertility research, the number most closely linked to fertility — the sperm parameter most highly correlated with successful conception — is actually that same number, the total motile sperm count. The higher the total motile sperm count of the male partner, the more highly correlated it is with her chance of successfully conceiving. It is a very significant parameter in fertility research, and interestingly, this is one of the parameters that was so significantly linked to longevity.

My second biggest takeaway: what was interesting about the findings is that the men with the highest total motile sperm count were associated with the highest longevity. But it didn’t end there. When they actually broke it down based on different parameters — semen volume, sperm concentration, and total sperm count — all of these different parameters followed the same pattern. The highest number correlated with the longest lifespan, and as they moved down to lower and lower numbers, those parameters gradually decreased as well.

It was consistent across these samples. For example, men who had counts of 40 to 80 million had a 16% higher risk of dying. Men with 10 to 40 million total motile sperm count had a 27% higher risk. Men in the 5 to 10 million category had a 38% higher risk. And then men in the lowest category — the 0 to 5 million total motile sperm count — had a 61% higher risk.

I know that I’m throwing a bunch of numbers out there, but basically it was a progressive decline. It wasn’t like one number was off by itself and the rest were mixed. There was this gradual decline in longevity depending on the sperm parameters.

Now I want to move on to the third takeaway. You might be thinking — well, how do we know if the men were healthy? Maybe the men who had the lower parameters had existing illnesses, so maybe there were some different confounding factors playing a role in these findings. What was interesting — and again, I think because the sample size was so massive — they were able to account for a variety of different factors.

They had a subsample within the sample. The sample was almost 80,000 men. There was a subsample of about 60,000 men within that, and they actually had access to 10 years of hospital records before the sample was taken. They were able to go in and look at the medical records of these 60,000 men for the 10 years leading up to when the samples were taken. They also had other factors they were able to take into consideration, including educational background and a few different lifestyle and socioeconomic factors.

When they adjusted this sample based on the prior health information, the sperm quality and mortality correlation persisted with only a slight reduction. Basically, you wouldn’t be able to say those men had really poor health before — and that was why they had the low sperm — and that was the reason why. When they actually took that into consideration, that correlation between total motile sperm count and longevity still did persist.

The researchers speculate as to what this could mean — what is the actual mechanism behind this? Although we don’t know for certain, it’s certainly possible that these sperm parameters are indicating some sort of biological signal, something about the underlying health of these men — potentially at the cellular level, maybe at the mitochondrial level, maybe at the metabolic level — that is showing up subclinically in the sperm parameters before it’s showing up in other places.

The fourth takeaway is due to another interesting finding. Based on everything I’ve told you, you might assume that the group of men with no sperm at all — that’s called azoospermia — would have the lowest life expectancy. But interestingly, that’s not what they found, and there’s a reason for that.

Azoospermia is the word for zero sperm — when you’re doing a test and there’s nothing there at all. I think one of the reasons for this finding is that there’s more than one reason why a man might not have sperm in his semen sample. One reason could be a health issue or physical issue — it could be that sperm is so poor that there’s nothing there. But there are other conditions that can contribute to azoospermia. For example, sometimes a man actually does have sperm — he has a fairly normal sperm count — but there’s a physical obstruction that is preventing the sperm from making it through into the semen analysis.

The researchers theorized that the group of men with azoospermia probably contains some men who really do have really poor semen samples, and others who might have what they call obstructive azoospermia — meaning they do have sperm, but it’s just not getting out. That’s one of the reasons why the finding wasn’t black and white in men with zero sperm.

When we look back at the results, the men with the highest longevity were the men with the most sperm — 120 million or higher total motile sperm count. The men with the lowest longevity were not the ones with zero sperm, but the ones with zero to five million. The men with zero sperm were in a different category because there could be multiple different factors for why that’s happening.

The fifth takeaway is what I was alluding to at the beginning of this episode — could a man’s semen parameters be an indication of health, kind of like the menstrual cycle is in women? I think this study is an important one. It raises a lot of important questions. It doesn’t provide a smoking gun — like, okay, this is definitely going to mean that you’re going to die sooner. But the results are significant. Finding a persistent change in longevity that was correlated to a man’s semen parameters opens the door for future research, so we can find out: why is that? What are the implications? And is this something we should be looking at as a marker of health, to give men an opportunity to improve it?

From our perspective here on the Fertility Friday podcast, we certainly look at menstrual cycle disruptions and menstrual cycle parameters as an opportunity to look deeper. When you resolve those parameters, you tend to have a better quality of life, fewer symptoms, and more balanced hormones, because the menstrual cycle is really reflecting what’s happening hormonally. While it’s a bit of a different concept, it is something interesting to really consider.

For example, men who seem to be totally healthy but then have a semen analysis that’s suboptimal — that could be a really significant clue that we shouldn’t be ignoring. While today’s podcast isn’t for going into all of the weeds about sperm parameters, in the sperm chapter of Real Food for Fertility, we went into a whole lot of detail about how the WHO’s parameters were established. We have an entire podcast episode on that as well — the study that is the basis for our WHO parameters that were established in 2010.

This study also provides more weight to the idea that just because a man passes a semen analysis doesn’t mean that his sperm is optimal. It doesn’t mean that the conversation is over and he gets a free pass. I think it provides more credence to one of the things that I often say when it comes to semen analysis: there’s no man alive whose sperm is so amazing that he can’t improve his diet, improve his nutritional inputs, potentially take a multivitamin, or look at some key nutrients to support sperm health.

One thing that we always want to think about is that when it comes to sperm quality — similar to egg quality, but in particular sperm quality — we are always looking at a window. Whatever semen analysis happens, if your partner has a semen analysis today, that is a printout of what was happening approximately three months ago, because it takes about 74 days for the process of spermatogenesis to take place and complete. The changes that he makes today are going to show up in his semen analysis three to four months down the road.

I’ve worked with clients who start to see changes at three to four months, but the full coming to fruition of the changes he’s making can really come into play several months down the road — six months later, nine months later — because it’s not like that three-month window is all the change that can happen and then it just stops. It’s certainly the beginning of whatever results you’re going to see from the changes that he makes.

To conclude: this study shows us that there is a link between semen quality and lifespan. Men who had the highest total motile sperm counts — over 120 million — lived an average of about 2.7 years longer than men with the lowest counts, men with 0 to 5 million total motile sperm count. This association, while most prominently linked to the total motile sperm count, still ran across every sperm parameter. There was a gradual increase in longevity as the sperm parameters increased.

Pre-existing illnesses did not explain this away. This was not a situation where we could just say those men previously had an illness — the researchers had the data, they were able to sift through it, and the correlation persisted even when they accounted for potentially pre-existing conditions.

The men with zero sperm — azoospermia — fell into a category of their own. The researchers theorized that’s because there’s more than one reason why a man may have zero sperm. Sometimes men with zero sperm actually have decent parameters, but there’s a physical blockage.

Lastly, this study certainly does spark an important conversation about the link between a man’s semen parameters and his overall health. I hope to see more studies looking deeper into this. After this landmark study — with such a big sample size, looking over such a long period of time, finding such a significant correlation between sperm health and longevity — I feel like this is just the beginning of a new era of research. Hopefully we can learn more and put more of a spotlight on that, so that we can have both parties really examined, especially when we’re looking at matters of fertility challenges and infertility.

This is a topic that I go into a significant amount of detail on in Real Food for Fertility in our sperm chapter. Funny story — there was a time when I wanted to write an entire book about sperm quality. I actually had a cover made and everything. But what I decided to do was put that research into a really thorough, meaty sperm quality chapter.

You’ll find more details about Real Food for Fertility at realfoodforfertility.com — grab the first chapter for free. You can also head over to Amazon if you want to grab a copy, and the book is available in audio format if you prefer audio. For those of you who don’t yet have a subscription to Audible, you can actually read Real Food for Fertility for free — head over to fertilityfriday.com/realfood. If you are in the United States, you will get a link to read Real Food for Fertility for free.

I hope that you enjoyed today’s show. If you can think of someone who could benefit from hearing it, head over to fertilityfriday.com to share today’s episode. You can also share it from the app that you’re listening to in your podcast player. Until next time, be well and happy charting.