Male Fertility

Understanding the Importance, Options, and Entitlements

Around 40% of fertility cases are related to sperm issues—so how are they diagnosed, what treatments are available, and what can be done to improve quality? This comprehensive guide includes updated information on testing, treatment, and services available through Leumit.

Sperm and Fertility

It was once believed that fertility problems were mostly a female issue. Today we know that about 40% of fertility challenges originate with the male partner. That tiny sperm cell, which carries half the genetic material of the future child, plays a crucial role—and when pregnancy doesn’t occur, it's important to understand the male contribution.

Semen analysis looks at four key aspects:

  • Volume: Normal ejaculate volume is over 1.5 mL.
  • Concentration: A healthy sperm count is approximately 20 million sperm per mL of semen.
  • Motility (movement): It’s not just about how many sperm are present, but also how well they move. Sperm need to swim forward effectively to reach and fertilize the egg. Normal progressive motility is around 25% or more.
  • Morphology (shape): Sperm must have a normal shape to swim properly and penetrate the egg. At least 4% of sperm should be normally shaped for optimal fertility.

What Happens When There’s a Sperm Issue?

About 6% of men aged 15–50 experience infertility, such as low sperm count or poor motility. However, there are many available options—and even with low sperm counts, pregnancy is still possible.

Leumit offers access to expert care and a variety of treatments:

Semen Analysis and Evaluation

A key first step to assess sperm count, movement, and morphology.

High-Magnification Sperm Selection (MSOME/IMSI)

Used to select the best quality sperm, especially after recurrent miscarriage or failed IVF attempts.

Micromanipulation (ICSI)

Injection of a single sperm cell directly into an egg. This is part of IVF and is especially useful when sperm count is extremely low.

Surgical Sperm Retrieval (TESE/MESA)

For men who cannot ejaculate sperm naturally, due to blockages or extremely low sperm production.

Electrostimulation Sperm Retrieval

A solution for men who cannot ejaculate due to conditions like spinal cord injuries.

Leumit covers these treatments based on medical eligibility and the criteria set by Israel’s national health basket.

Lifestyle Changes

Lifestyle changes are within the couple’s control and can have a significant impact on sperm quality. Unlike medical interventions, these are simple adjustments that can lead to meaningful results.

Keep in mind: sperm production takes about 10 weeks (72 days). That’s why it’s recommended to begin lifestyle changes around three months before trying to conceive.

Lifestyle Changes to Consider Before Starting Fertility Treatments

Body weight affects levels of estrogen and testosterone, so it’s recommended to maintain a healthy weight.

Studies have shown that:

  • A diet rich in fruits and vegetables,
  • Omega-3 fatty acids, and
  • Vitamin C

can improve sperm motility, count, and quality.

In contrast, a diet high in saturated fats has been linked to reduced sperm count.

Studies have found that combining zinc and folic acid can help improve male fertility.

Smoking negatively affects both sperm count and motility. It is strongly recommended to stop smoking before trying to conceive.

Leumit offers free smoking cessation workshops to support you in the process.

Moderate exercise is an important part of a healthy lifestyle. It helps reduce stress and lowers levels of stress hormones that can impair fertility.

On the other hand, intense or excessive training has been linked to reduced sperm count and quality, and should be avoided.

Important to know: Regular use of steroids can cause testicular shrinkage and harm fertility.

Semen is a fluid—and it's mostly made up of water. Dehydration can impair sperm production and reduce their motility, so drinking plenty of water is essential for maintaining healthy fertility.

Heat negatively affects sperm production. It’s best to avoid prolonged hot baths, jacuzzis, and similar heat exposure. Additionally, avoid placing laptops or other electronic devices directly on your lap.

If you work in a kitchen or another high-temperature environment, it’s recommended to take appropriate safety measures to reduce heat exposure to the groin area.

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