Is sugar consumption negatively associated with semen quality? Original paper

In this cohort study, increased sugar consumption from sugar-sweetened beverages and added sugars in foods negatively affected sperm concentration and total sperm counts. However, it is unclear whether a relationship exists between sugar consumption and other important parameters of male fertility.

This Study Summary was published on June 28 2022.

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Male fertility has declined over the past few decades, as illustrated by certain fertility markers such as sperm count and quality[1] and total testosterone levels.[2] This problem in men’s health has been occurring in parallel with the rise in the global obesity epidemic, which is strongly associated with high sugar consumption.[3]

Consumption of high-sugar foods — particularly sugar-sweetened beverages — increases reactive oxygen species (ROS),[4] which negatively affect semen quality through various mechanisms.[5] [6] [7] Therefore, it has been hypothesized that reducing sugar consumption may lead to improvements in semen quality, among other male fertility-related parameters.

The study

This cross-sectional cohort study recruited 280 men (ages 18–55) who attended routine semen analysis at a sperm bank over a 3-year period (2012–2015). The investigators collected semen samples and measured parameters such as volume, sperm concentration, total sperm count, percentage total motility (movement), and percentage normal morphology (size/shape).

The participants were required to complete Food Frequency Questionnaires (FFQ). They also completed lifestyle questionnaires to assess variables other than sugar consumption that may affect semen quality (e.g., age, ethnicity, smoking, physical activity level).

Sugar consumption was divided into two subcategories: (i) soft drink consumption (SoftD) and (ii) added sugar to products (SugProd). The participants were further divided into three subgroups, or tertiles, for each of these two subcategories. The tertiles (T1, T2, T3) were based on the median consumption of SoftD (drinks/day) and SugProd (teaspoons of added sugar/day).

  • Sugar-sweetened beverage (SoftD) tertiles: (T1) 0 drinks/day, (T2) 0.2 drinks/day, and (T3) 1 drink per day
  • Added sugar to products (SugProd) tertiles: (T1) 3.0 teaspoons of added sugar/day, (T2) 11.2 teaspoons of added sugar/day, and (T3) 25 teaspoons of added sugar/day

The results

Total sperm count and concentration were significantly lower in the participants who consumed more sugar-sweetened beverages per day. A similar trend was observed in the SugProd category (which represented all the added sugar in the participants’ diets).

The other sperm parameters (i.e., morphology, motility, volume) did not demonstrate any statistically significant differences between the tertiles of either the SoftD or SugProd dietary subcategories.


The cross-sectional design of this study and the multifaceted nature surrounding these health concerns — particularly sugar consumption — present limitations that should be considered. Future research should explore variables associated with these complexities, such as the effects of different sugars (e.g., fructose, glucose, sucrose) on sperm parameters.

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This Study Summary was published on June 28 2022.