How can you increase sperm quality and quantity after the age of 40?

From the age of forty, sperm quality declines on multiple fronts: volume drops, total sperm count and motility decrease, and morphology (shape) worsens. At the same time, the proportion of sperm cells with damaged DNA rises. This makes conception harder and takes longer on average. The cells in the testes that support sperm production and produce testosterone function less effectively as you age, and oxidative stress plays a role in this.

The most concrete medical approach is correcting a varicocele, a varicose vein in the scrotum that raises the temperature of the testes. In men over forty, sperm quality improved in well over half of cases following such a procedure, though this was somewhat less than in younger men. Younger men benefited more from the intervention, but even in men older than forty there was a clear advantage. If you know you have a varicocele, a conversation with a urologist about this option is worthwhile.

Lifestyle also has a measurable effect. Quitting smoking, reaching a healthy weight, eating a varied diet, exercising, and avoiding unnecessary heat exposure to the testes (such as hot baths or laptops on the lap) are changes that can positively influence sperm quality. The quality of drinking water also plays a role: exposure to pesticides and industrial chemicals lowers testosterone and impairs sperm production. Whether this personally affects you depends on where you live and work.

A hypothetical idea in the literature is the administration of blood from young donors to improve sperm quality. This is purely a theoretical proposal with no clinical evidence in humans. It must be regarded as experimental and unsafe, and is not a realistic option.