If you’re trying to conceive – naturally or with ART support – here’s the simple truth: men’s health is half the story. In around 50% of infertility cases, a male factor is the main cause or part of the picture. That means there’s a lot men can do – starting today. [1]
Why talk about it now?
Because men’s sperm health and fertility has been sliding for decades. A major global review found average sperm concentration has dropped from roughly ~100 million/mL in the 1970s to ~50 million/mL by 2018, and the decline sped up after 2000. If that pace continued, straight-line projections nudge averages toward ~20 million/mL by mid-century. It’s a clear call to act. [2]
The heat piece
Testes work best when they run about 2-5 °C cooler than your core body temperature – that’s one reason they sit outside the body. When they overheat, the tiny “factories” inside slow down: testosterone output drops and new sperm production dips. Heat can also damage sperm already made, raising DNA fragmentation (tiny breaks in sperm DNA), so more sperm break down and get cleared. In short, heat is both a production and a quality problem. [3]
This isn’t just lab data. In human monitoring, scrotal temperature can rise by about ~3 °C in ~20 minutes on a conventional cushioned office chair. What does that mean? As a rule of thumb, each +1 °C rise is associated with roughly a 14% drop in sperm production; sustained +2–3 °C exposures in controlled human heating studies have driven counts down to contraceptive levels (and in some protocols, even temporary azoospermia). Repeated daily spikes matter. [4–6]
Clothing choices (yes, fabric matters)
Studies – including human textile-contact experiments – report that polyester against the scrotum can damage sperm cells: lower motility, more abnormal forms, and degenerative changes. The likely culprits are electrostatic effects and poorer cooling. Heat-stress studies in humans also show higher DNA fragmentation, meaning damaged sperm are more likely to break down and be cleared. The practical takeaway: prioritise breathability, airflow and smart design. [5–6]
Beyond conception: miscarriage risk & children’s health
This isn’t only about getting pregnant. Sperm quality matters for staying pregnant and for a child’s long-term health.
Miscarriage: Higher sperm DNA fragmentation is associated with increased miscarriage risk (including recurrent pregnancy loss in several analyses). Improving the testicular environment helps support better DNA integrity. [7–8]
Care pathways: IVF use is steadily rising; for example, ANZARD reported a 2.2% year-on-year increase in cycles from 2017 to 2018, with larger jumps in subsequent years. Wherever you are on the journey – natural or ART – male steps still matter. [9]
Quick definitions
Spermatogenesis → your sperm-making process. It runs like a production line that takes about ~74 days, plus a bit of transit time. Changes you make now usually show up in semen tests months, not days, later. [3]
Low testosterone (hypogonadism) → not enough testosterone from the testes. Common clues: low energy, low libido, mood shifts. A clinician needs to check and guide care.
Varicocele → enlarged scrotal veins. They can trap heat and reduce natural cooling; in selected men, repair has been linked with improvements (including testosterone). [3]
Where underwear design fits (and where Cool Beans helps)
Because position and airflow change the micro-climate, what you wear matters. Cool Beans is a TGA-registered testicular-cooling and support underwear designed to hold the scrotum gently forward – reducing thigh insulation and helping heat and sweat escape in everyday life. It’s not a cure or a replacement for medical care – it’s a practical, anatomy-aware base layer that plays nicely with nutrition, sleep, movement and clinician advice. Many men feel more comfortable within a week of reducing daily heat exposure. For bigger shifts in sperm health, think 3-4 months – long enough to influence the whole sperm lifecycle, plus a little buffer to get your body into a good rhythm.
(If this resonates, my book Cool Beans shares the science, stories and simple steps behind these changes-without the jargon stemming from my own infertility journey and how Cool Beans came to be.)
Four simple wins men can start this week
Cool: Break up sitting every 30–45 minutes; avoid pressing the scrotum against the thighs; choose breathable fabrics; pause long hot baths/saunas while trying to conceive. [4–6]
Nourish: Base meals on whole foods—plants, good fats, adequate protein. Less alcohol and no smoking lower oxidative stress that can harm sperm.
Rest: Guard your sleep—solid sleep patterns support hormone balance, including testosterone.
Unwind: Short, regular stress “down-shifts” (a walk, some breaths, a quick lift, a bit of sunlight) add up over weeks.
When to see a clinician
If trying is taking longer than expected—or you notice a heavy/veiny feel in the scrotum, or persistent low energy/libido—book in with a qualified clinician. Ask about semen analysis timing, a check for varicocele, and broader health screens that influence fertility and hormones. [3]
References (numbered, in-text)
Lifestyle & fertility overview noting male factor ≈ 50%: Reprod Biol Endocrinol, 2018.
Levine H. et al., Human Reproduction Update, 2023/2022 (global sperm decline; faster post-2000).
Testicular thermoregulation reviews; spermatogenesis ≈ 74 days; 2–5 °C cooler: RBMO 2014; Int J Mol Sci 2024.
Human scrotal-temperature monitoring on chairs (~+3 °C in ~20 min): Koskelo R. et al., 2005.
Rule-of-thumb heat impact (≈ 14% per +1 °C); human heating studies showing strong suppression at +2–3 °C: Springer chapter on testicular heat stress (2013/2014); Mieusset/Bujan human thermal-contraception studies.
Polyester/contact evidence and human heat-stress studies affecting sperm/DNA integrity: Shafik A., Andrologia/Contraception 1992; human sauna/hyperthermia papers (Andrology/Hum Reprod).
Sperm DNA fragmentation (SDF) associated with miscarriage: Human Reproduction meta-analysis, 2012.
SDF & recurrent pregnancy loss: Fertility & Sterility meta-analysis, 2019 (plus subsequent updates).
ANZARD (Australia & NZ IVF registry) report: cycles +2.2% from 2017→2018; broader trend upward.
Coffee has long been celebrated as a daily ritual, but when it comes to hormones and fertility, caffeine isn’t always your best friend. For many women and couples on a fertility journey, one of the first recommendations from health professionals is to reduce or eliminate caffeine. But that’s often easier said than done—after all, coffee is more than a drink, it’s comfort, routine, and identity.
The good news? It’s possible to protect your hormones, support fertility, and still hold onto the ritual you love.
The Hormonal Impact of Caffeine
Caffeine is a stimulant that works on the central nervous system, but its effects go far beyond a morning energy boost. It influences the endocrine system, stress response, and reproductive hormones in ways that can affect fertility.
Cortisol & Stress: Caffeine stimulates cortisol, the body’s main stress hormone. Chronic high cortisol can disrupt ovulation and menstrual cycles, making conception more difficult.
Estrogen & Progesterone: Research suggests caffeine may affect estrogen metabolism, particularly in women, which can contribute to imbalances. Low or irregular progesterone levels, critical for supporting pregnancy, may also be impacted.
Insulin Sensitivity: For some women, caffeine reduces insulin sensitivity, which can aggravate conditions like PCOS—a common cause of fertility struggles.
Why Fertility Specialists Suggest Cutting Back
When couples are trying to conceive, health professionals often recommend limiting caffeine. Studies have linked high caffeine consumption (more than 200–300mg per day) with reduced fertility and increased risk of miscarriage. Even decaf isn’t truly caffeine-free, as it still contains small, unregulated amounts of caffeine.
For women navigating IVF or assisted reproductive treatments, the advice is even stricter. Eliminating caffeine entirely helps create the best environment for hormonal balance, embryo implantation, and early pregnancy.
Pregnancy, Postpartum & Beyond
It’s not just preconception where caffeine can cause challenges. During pregnancy, caffeine crosses the placenta, but a baby’s immature metabolism can’t process it effectively. High intake has been associated with low birth weight and pregnancy complications, which is why many practitioners recommend avoiding it altogether.
Postpartum, caffeine can contribute to heightened anxiety, jitters, and poor sleep—things new parents hardly need more of. For women experiencing hormonal shifts, breastfeeding, or simply trying to recover, cutting caffeine often provides a calmer foundation.
Keeping the Ritual Alive
Still, the advice to “just give up coffee” misses a vital point: coffee is not only about caffeine. It’s about ritual. For many, it’s the smell, the warm mug in hand, the shared moment, or the quiet pause before the day begins.
That’s where alternatives step in. Not Coffee was created as a 100% caffeine- and stimulant-free option for people who love the experience of coffee but can’t or don’t want to drink it anymore. Made from roasted chicory, organic carob, and chickpeas, it looks, brews, and tastes as close to coffee as possible—without the hormonal disruptions.
It comes in two forms:
Instant: Works just like instant coffee for quick, easy preparation.
Ground: Brews in espresso machines, stovetops, and plungers.
And with flavours like Vanilla, Hazelnut, and Caramel, it brings variety and joy back into the cup.
A Supportive Choice for Fertility & Wellness
Thousands of women across Australia have already made the switch, particularly those on fertility journeys, during pregnancy, or postpartum recovery. Feedback has been consistent: they feel calmer, more balanced, and grateful that they can keep their coffee ritual alive without compromising their health goals.
For many, Not Coffee has become more than a beverage. It’s a symbol of choice, empowerment, and comfort in times when so much feels out of their control.
Finding Balance
Caffeine isn’t inherently bad—it can be enjoyed in moderation by many. But for those focused on fertility, hormones, and long-term wellness, cutting back or eliminating it can make a profound difference. The key is finding balance: protecting your body while still holding onto the moments that matter.
And that’s exactly what Not Coffee offers. It proves that giving up caffeine doesn’t mean giving up your ritual. Instead, it’s about rewriting it in a way that supports health, hormones, and healing.
When it comes to fertility and hormones, the advice to reduce caffeine is rooted in protecting your body’s delicate balance. But rather than viewing this as a loss, it can be seen as an opportunity—to nourish yourself differently, to honour your wellbeing, and to redefine your ritual.
With thoughtful alternatives like Not Coffee, balance becomes possible. You can protect your hormones, support your fertility, and still enjoy that treasured moment with a cup in hand.
When you’re on a fertility journey, it can sometimes feel like a roller coaster of highs and lows or that you’ve handed over the steering wheel to doctors, clinics, and endless appointments. You’re told what tests you need, when to come in, and what the “next step” should be. But here’s the truth: this is your body, your journey, and your future family, so your voice matters too.
Advocating for yourself doesn’t mean being confrontational or disagreeing with medical advice. It means making sure you’re heard, informed, and involved in every decision about your care. And while that can feel intimidating in a medical system that often feels rushed or overwhelming at times, it’s one of the most powerful things you can do for yourself, so don’t be afraid to speak up.
Why Self Advocacy Matters in Your Fertility Journey
- Fertility is personal: No two journeys are the same, which means the standard “one-size-fits-all” approach doesn’t work.
- You deserve clarity: Medical jargon, rushed or brief explanations, and unexplained decisions can leave you feeling confused. Asking questions and seeking clarity is your right.
- You’re the constant in your journey: Doctors, nurses, and specialists may come and go, but you are the person experiencing this from start to finish.
Advocating for yourself ensures you feel more in control, less overwhelmed, and fully involved in your care.
Practical Ways to Advocate for Yourself
Learn About Your Body and Menstrual Cycle
This is empowering in itself, but understanding your body means you can speak to doctors, go to appointments armed with information and data that you can discuss in more detail. Tracking your cycle (and I don’t mean via an app, by all means you can use an app to enter your data but knowing how to identify patterns, problems and clues yourself is key) can help you know information like the length of your menstrual cycle, how long you bleed for, your follicular and luteal phase, likely day of ovulation, and document any unusual signs and symptoms that come up over the cycle.
Ask Questions (and Keep Asking Until It Makes Sense)
If you don’t understand a test, treatment, procedure or recommendation, ask:
- Why is this being recommended?
- Do we need this in order to conceive?
- What are the alternatives?
- What are the risks and benefits?
- How does this apply to my situation?
- And what will happen if we decide not to go ahead with this recommendation?
It’s okay to keep asking until you feel confident in the answer.
Bring a Support Person
Appointments can feel overwhelming and information-heavy. Bringing a partner, friend, or even a fertility nurse can help you feel supported and ensure nothing is missed and be able to debrief following the appointment to ensuring you have time to process and understand clearly what was discussed.
Keep Records
Maintain a folder (digital or physical) with test results, cycle notes, medications and treatment plans. Being organised not only helps you feel in control, but it also makes it easier to spot patterns or ask informed questions. You can also keep in the same place all your questions you wanted answered and add the answers as you go through your journey.
Know Your Rights
You have the right to:
Request further investigations (just be aware based on Medicare requirements, doctors need to have a reason to request testing, so if there is no clinical indication some doctors can may say no. But know that there are private providers eg places like i-screen that you can pay privately to have certain tests completed)
Ask for a second opinion
Decline treatments you don’t feel ready for
Access your medical records
Trust Your Instincts
You know your body best. If something doesn’t feel right, whether it’s a symptom being dismissed or a plan that doesn’t sit well, say something and speak up.
Control What You Can
Nutrition, movement, sleep, stress, gut health, endocrine disrupting chemicals are all things that you can action and take control of. Now you don’t need to be harsh on yourself and be perfect in all these areas. But focusing on key areas that could use some love and making small changes can go along way to reducing inflammation, helping your hormones function effectively and improving your fertility and chances of conception.
Find Your Team
Surround yourself with people or a team that lift you up and that you can talk to and vent to openly and honestly during this time. It could be friends, family, a community, doctor, counsellor, dietician, a fertility nurse (like me) or all of the above!
When Self-Advocacy Feels Hard
Many of my clients tell me they feel intimidated in medical settings or worry about “bothering” their doctor with questions. Please know: you are not a burden. You are a patient with the right to understand your care and make informed choices.
If speaking up feels difficult, try phrases like:
- “Can you explain that in simpler terms?”
- “I’d like to take some time to think before deciding.”
- “Can you give me more information regarding this to take home?”
These simple questions can shift the conversation and give you back your voice. Or if you want more time to consider your options, ask for information, documentation or research that you can take home, review and read in your own time.
Fertility journeys are often described as a rollercoaster, and while you can’t control every twist and turn, you can control how informed and empowered you feel along the way. Advocating for yourself isn’t about being difficult, it’s about making sure you’re an active participant in your care. And when you combine your voice with the right support, you’re no longer just a passenger, you’re back in the driver’s seat. And if you re considering having support with your own private fertility coach, know that it can give you 24/7 access to guidance, advocacy, and someone who knows how the system works. We can help you prepare questions, explain test results, and support you in making decisions that align with your goals and values. So keep My Fertility Nurse in mind.
What if I told you that half the people who start IVF never complete their planned treatment cycles? Most would guess the main reasons are cost, medical complications, or side effects. The reality is far more surprising and entirely preventable.
Psychology has now overtaken financial barriers as the #1 reason people discontinue IVF. In Australia, where we have public funding support, the psychological burden is literally heavier than the financial load. 47.5% of patients report being “too stressed to continue,” while 76% of women experience clinical-level anxiety symptoms during treatment.
When Sarah walked into her first IVF consultation, she thought her biggest challenge would be the medical procedures. By her second cycle, she was having panic attacks in the car before appointments and dissociating during internal scans. By the time she was meant to start her third cycle, Sarah cancelled, telling me: “I can’t handle feeling this broken anymore.”
Sarah wasn’t weak. She was having a completely normal psychological response to abnormal levels of stress. More importantly, her distress was entirely treatable.
The Perfect Storm: Why IVF Overwhelms Even Strong Coping Skills
Our research reveals that 90% of patients show patterns of thinking, processing, and responding that they hadn’t recognised before – patterns that significantly impact how they experience fertility treatment. These aren’t people with diagnosed conditions – they’re individuals whose successful life strategies become insufficient when facing IVF’s extraordinary demands.
IVF creates a “perfect storm”: daily hormone injections requiring precise timing, frequent blood draws and ultrasounds in bright, noisy medical environments, complex medication protocols, and the emotional rollercoaster of hope and disappointment often repeated across multiple cycles.
For someone who has unknowingly developed workarounds for sensory sensitivities or information processing differences, IVF can feel completely overwhelming. What looks like “being difficult” may actually be sensory overwhelm. What seems like “non-compliance” may be executive functioning challenges with complex protocols.
The Trauma Connection
With approximately 70% of people having encountered trauma at some point in their lives, many entering fertility treatment carry pre-existing vulnerabilities that medical environments can trigger. Medical trauma can develop from invasive procedures, loss of control, feeling dismissed by healthcare providers, or experiencing your body as unreliable when treatments fail.
The intersection is significant: chronic stress affects hormone profiles and treatment response. Elevated cortisol levels can impact egg quality and implantation success. Recent research shows that women with lower stress levels before egg collection had significantly higher pregnancy rates – meaning emotional wellbeing directly affects treatment outcomes.
Prevention AND Intervention: A New Model of Care
Rather than waiting for crisis to develop, the Hope Affirm Thrive program provides both preventive support and targeted intervention. Every participant receives evidence-based accommodations as standard practice: visual medication schedules, written summaries of verbal instructions, sensory comfort strategies, and preparation scripts for medical procedures.
For those needing deeper intervention, we integrate trauma-informed approaches including EMDR protocols specifically adapted for fertility populations, combined with nervous system regulation techniques.
Practical Tools You Can Use Today
Whether you need prevention or intervention, there are specific techniques that can transform your fertility treatment experience:
The 4-4-8 Reset Breath for immediate nervous system calming – inhale for 4 counts, hold for 4, exhale for 8. Use this before appointments or anytime anxiety peaks.
5-4-3-2-1 grounding anchors you in the present moment when panic strikes: identify 5 things you can see, 4 you can touch, 3 you can hear, 2 you can smell, and 1 you can taste (sour gummies make for the perfect nervous system disrupter!).
Know When You Need More Support
These tools work well for general fertility stress and mild-to-moderate anxiety. Seek professional support if you’re experiencing frequent panic attacks, avoiding necessary medical care, or if past trauma is being triggered by medical procedures. Needing additional support isn’t failure – it’s wisdom.
Sarah’s Different Ending
Sarah accessed trauma-informed support that identified her distress wasn’t just “IVF anxiety” – it was medical trauma from painful procedures and childhood experiences of feeling powerless in medical settings.
Sarah learned nervous system regulation techniques she could use before, during, and after procedures. We used EMDR to process specific trauma memories being triggered by fertility treatment. She developed self-advocacy skills and connected with others going through similar experiences.
Sarah completed her treatment feeling confident and calm. She said, “I finally felt like an active participant in my care instead of something being done to me.”
Looking Forward: Prevention as Essential Healthcare
At Melbourne Fertility Expo 2025, I’ll be sharing specific tools you can use immediately to manage fertility treatment stress, along with evidence about how early psychological support prevents treatment discontinuation and improves outcomes.
My main talk, “Why 50% of IVF Patients Stop Treatment – And How Emotional Readiness Can Change Everything,” reveals the research behind treatment discontinuation and provides a framework for assessing your psychological readiness. The hands-on workshop, “Your Emotional Toolkit,” teaches four practical nervous system regulation techniques you can use immediately.
That 50% discontinuation rate is largely preventable with the right support at the right time. Don’t let psychology be the reason you stop treatment. It doesn’t have to be.
Elizabeth Bancroft will be speaking at Melbourne Fertility Expo 2025, sharing insights from the Hope Affirm Thrive program and teaching practical techniques for managing fertility treatment stress. Her sessions provide evidence-based tools for both preventing psychological distress and addressing it when it occurs, helping patients complete their treatment with confidence.
About the Author:
Elizabeth (Liz) Bancroft is an AHPRA-registered Clinical and Counselling Psychologist with over 14 years of experience supporting individuals through complex trauma, infertility, and neurodiverse mental health needs. She is the founder of Hope Affirm Thrive, an evidence-based support program designed to help women navigate the emotional challenges of IVF.
Support Your IVF Journey:
If you’re navigating fertility treatment and need emotional support, visit www.hopeaffirmthrive.com.au to learn more about the Roadmap Through IVF program—a comprehensive online 8-week program offering trauma-informed, neurodiversity-affirming support for every stage of your fertility journey.
Free Resources – Start Here:
Contemplating Treatment?
Starting Your Journey?
- Evidence-Based Strategies Webinar ($29) – A low-cost webinar covering stress management, emotion regulation, advocacy tips, and building resilience for your IVF journey. Access here – https://hopeaffirmthrive.com.au/webinar-evergreen
- IVF Mental Health Survival Kit – Evidence-based tools, advocacy scripts, and grounding techniques to help you stay steady through every stage of treatment. Download here https://hopeaffirmthrive.com.au/guide
