What lifestyle interventions are most effective for improving male fertility?

Effective lifestyle interventions for improving male fertility include:

• Smoking cessation: Men should be informed that smoking is associated with reduced semen quality, and stopping smoking will improve their general health, although the direct impact on fertility is uncertain.
• Weight management: Men with a body mass index (BMI) of 30 or over should be informed that they are likely to have reduced fertility, so losing weight may improve fertility.
• Alcohol moderation: Men should be advised that excessive alcohol intake is detrimental to semen quality, but consumption within recommended limits (3 to 4 units per day) is unlikely to affect semen quality.
• Occupational and drug exposure: Men should be asked about occupational hazards and use of prescription, over-the-counter, and recreational drugs that may interfere with fertility, with appropriate advice or referral offered.
• Sexual intercourse frequency: Regular vaginal sexual intercourse every 2 to 3 days optimizes the chance of pregnancy.
• Loose-fitting underwear: Men should be informed that elevated scrotal temperature is associated with reduced semen quality, but it is uncertain whether wearing loose-fitting underwear improves fertility.

Overall, lifestyle changes focusing on smoking cessation, weight control, alcohol moderation, and avoidance of harmful exposures are the most effective interventions to improve male fertility.

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