One day, as I sat weeping at the fertility clinic about my fourth miscarriage, my doctor referred to me in passing as a “geriatric mother.” Well, I was 38, so point taken. But he didn’t say anything about the guy sitting next to me: gruff, white-haired, and 29 years my senior. The doctor suggested my husband give a sperm sample. John was taken aback. I mean, he was only barely a senior citizen.
One viewing of Debbie Does Dallas later, we learned his swimmers were reasonably plentiful but slow and quirky and generally meh—pretty typical of his age. It was nothing I.V.F. couldn’t help with—and did. But in the family lore, the problem had to be me. It always was.
That was 1999. Fast-forward to 2025, and much has changed in fertility treatments, including the attitude of many couples trying to have kids. In the last year, there has been more public acknowledgment that infertility isn’t so much a Me Problem as a We Problem. Nobody knows exactly why, but sperm counts in the U.S. have dropped by almost half over the past 50 years—a crisis that reproductive epidemiologist Shanna Swann has dubbed “Spermageddon.” Obesity, drinking, drugs, environmental toxins, late starts to parenting: all these factors take a toll. And it’s not just the geriatric mothers and fathers who are feeling nervous. A 2023 study by HRC fertility clinics in California surveyed 1,200 millennials and Gen Z–ers and found that about 41 percent were fretting about their fertility and feeling like they didn’t know where to turn for accurate information.
And lo, this is how podcasts and TikTok trends are born. The conversation began late last year with a viral TikTok by Marcia Schaefer, a Wisconsin fertility chiropractor by training, who—even though she isn’t a medical doctor—treats couples looking to get pregnant and who has been studying the role that men play in infertility. “I was like, why is no one talking about the male component in infertility?” she tells me. “There’s a lot of research that talks about how DNA damage in sperm decreases the rate of live birth.” According to a relatively new—and not entirely substantiated—body of research, the quality of a man’s sperm may play a role in female miseries such as morning sickness and pre-eclampsia. While it’s not fully understood how or why, certain antigens in less-than-stellar sperm may have an inflammatory effect.
Traditionally the model for infertility, says Schaefer, is “disease management”—i.e., you have the “disease” of infertility, so let me give you these medications and pricey treatments to cure it. There are many couples for whom advanced fertility treatments like I.V.F. are an absolute necessity—and also nonmedical interventions that have proven effective. “I had an absurdly low sperm count,” says Eric Kreitzer, a digital-marketing manager in New York City. “There was no explanation offered, and it looked like nothing could be done. I had a course of acupuncture, which got the numbers up, at least to the point where we could do in vitro. He’s now at university.”
But Schaefer and an increasing number of her cohorts believe that fewer people would need high-tech interventions if we looked at infertility as an issue of health and wellness.
That’s not to say that if you’re a 45-year-old woman in great shape, it’s going to be easy peasy to have a baby. You really can’t get past the fact that every egg you have, you were born with, and your eggs (what’s left of them) have been sitting around for 45 years.
But sperm? It’s a little different. Yes, as men age their sperm becomes wonkier. But a man’s body is constantly making new sperm. What comes out today is a reflection of everything he was doing three months ago. “Whatever is good for your general health is good for your sperm quality,” says Stanton Honig, professor of urology and division chief of reproductive and sexual medicine at Yale. “So anything like smoking, smoking marijuana, using testosterone, any illicit drugs, they’re not going to be good for your health, and they’re not going to be good for your sperm.” The byword is “everything in moderation”: eat well (including protein), do cardio and weight training (cue the TikTok videos of tatted mesomorphs in the gym, covered in sweat, and saying things like “fertile men in their natural habitat”), lay off the Jacuzzi—intense heat and sperm aren’t friends—and nix the weed. (Oh, and the results on this one are truly iffy, but maybe keep your cell phone out of your front pocket. Even if it’s on vibrate.)
Fertility self-care seems to have captured the imagination of not just half the women on TikTok, but a surprising number of men too. It’s become something of a moral imperative. In one video that went viral, the guy is practically shouting at his wife, “Men should have to spend nine months getting in the best physical shape of their life before having a baby.... Fifty to sixty percent of the baby’s epigenetic makeup is because of the man. So if you’re going to spend nine months following all these rules while building a baby inside you then I can spend the nine months prior to that not drinking alcohol, limiting caffeine. I’ll get blood work, I’ll have three healthy meals a day, I’ll be in the best physical shape of my life.”
Now that’s a man who’s getting lucky tonight.
And where there’s a trend, products follow. Coenzyme Q10 (CoQ10), a nutrient that may improve sperm quality; pre-natal vitamins for men (WeNatal!); at-home IUI kits by the company Frida with a cup and syringe that “integrate,” as C.E.O. Chelsea Hirschhorn puts it, to catch every last drop of ejaculate (ladies, you can retire the turkey baster and “World’s Best Dog Dad” mug); a line of cooling underwear called (and I’m so sorry) Snowballs. I spent an hour watching YouTube videos on how to do at-home sperm tests. No money shots, alas, but plenty of swishing real samples in a dye solution and inserting them into a tiny machine that magically sends a photo of your boys to your phone. True, D.I.Y. kits are not a substitute for a lab, because they only test for the number of sperm and, sometimes, motility. But the lesson here is clear: if you want a man’s buy-in to fatherhood, hand him some lube and a new gadget.
I am waiting for the inevitable blowback, probably from the MAGAbros, arguing that to own your role in infertility issues is for pussies. Meanwhile … this new male concern for being accountable for fertility is actually kind of hot. “If you’re a man and plan on starting a family, your responsibility runs much deeper than just providing food, shelter, and water,” says yet another fertility-forward dreamboat. But maybe Antonio Vo on TikTok will speak to an even wider audience: “Dudes, we’re about to get blamed for everything, so check your health before you get her pregnant.”
Judith Newman is a New York–based writer and the author of To Siri with Love
