About one in seven couples are unable to conceive after a year of trying, and roughly half of those cases involve a male contribution. Yet in a quarter to a third of them, the man is never properly evaluated. In this episode I sit down with Dr Michael Eisenberg, a urologist and Director of Male Reproductive Health at Stanford University, and Dr Natalie Crawford, a reproductive endocrinologist and co-founder of Fora Fertility in Austin, Texas. This is the comprehensive male fertility resource I went looking for and couldn't find, and I have a personal stake in it. What surprised me most is that sperm health appears to be about much more than conception. It tracks with metabolic health, immune health, pregnancy outcomes, and in one Danish cohort, with age of death decades later. What We Cover What a semen analysis measures, and why ejaculating normally tells you nothing Semen quality as a sixth vital sign, and the Danish study linking it to lifespan Testosterone therapy, why it functions as a contraceptive, and how long recovery takes Whether sperm counts are really declining, and the likely drivers Cannabis, alcohol, heat, cycling, sleep, and body weight Total motile sperm count, DNA fragmentation, and what to ask your lab for Paternal age, sperm freezing, and timing your decisions Sperm turn over roughly every three months, which makes this one of the most movable metrics in health. Whichever stage of life you're at, this conversation is worth your time. To connect with Dr Michael Eisenberg, find him on Instagram or LinkedIn. To connect with Dr Natalie Crawford, you can find her book The Fertility Formula at nataliecrawfordmd.com/book, listen to her podcast As a Woman, or follow her on Instagram, TikTok, YouTube, and LinkedIn. If this episode was useful, please leave a rating and review on Apple Podcasts. It genuinely helps more people find the show. Want to support the show? The best way to support the show is to use the products and services offered by our sponsors. To check them out and enjoy great savings, visit theproof.com/friends. You can also support the show by leaving a review on the Apple Podcast app and sharing your favourite episodes with friends and family. This episode is brought to you by: 38TERA Consider 38TERA's DMN prebiotic supplement a daily multivitamin for your gut. Formulated by yours truly and gastroenterologist Dr Will Bulsiewicz. Use code THEPROOF for a discount at checkout. 38Tera ships to the United States, Australia, and New Zealand. IM8 With 92 nutrients, including Vitamin B12, Iodine, Selenium and Vitamin D, in highly absorbable forms, IM8 Daily Essentials is the perfect all-in-one daily multi-vitamin to ensure you meet your daily micronutrient needs. IM8 is offering an exclusive 10% off your first order with a free welcome kit when you enter the promo code SIMON at checkout on im8health.com. IM8 ships to 27 countries including the U.S., Canada, the U.K., Australia, and many regions across Europe, Asia, and South America. Pique Pique’s Nandaka combines fermented Pu’er tea, full-spectrum Reishi, ceremonial cacao, and L-theanine for calm, sustained energy without the coffee crash. Unlock 20% off and establish your powerful foundation for sustained well-being at Piquelife.com/SIMON. Pique ships within the U.S. and to Australia, Canada, and select EU countries. Skylight Families are better when they’re working together. Right now, Skylight is offering our listeners $30 off their 15 inch Calendars by going to MySkylight.com/THEPROOF. Skylight ships within the U.S. and to Canada, Australia, and the United Kingdom. Function Health Take charge of your health with advanced blood testing and personalised insights. Function Health offers a practical way to track key health markers such as cholesterol, blood sugar, and more. Learn more and join at functionhealth.com/simonhill for a $25 credit toward your membership. Only available to those living in the United States. Function Health ships to 48 U.S. states, excluding Rhode Island, Hawai‘i, and Puerto Rico. WHOOP Whoop, the most advanced fitness and health wearable available. Your personalised fitness and health coach to recover faster, sleep better, and train smarter. Claim your first month free on join.whoop.com/simon. Whoop ships to 56+ international markets, including the US, Canada, most of Europe, Australia, New Zealand, UAE, Singapore, and parts of Asia. Simon Hill, MSc, BSc (Hons) Creator of theproof.com Host of The Proof with Simon Hill Author of The Proof is in the Plants Subscribe & Connect: YouTube Apple Podcasts Spotify Instagram: @simonhill Twitter: @theproof Facebook: The Proof with Simon Hill Nourish your gut with my Plant-Based Ferments Guide and download my Two-Week Meal Plan.