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Despite the unclear picture of the causes of male infertility, unproven solutions are sold on social media.
Naturopath Lucas is one of the health influencers whose content includes warnings about fertility rates.
“We’re seeing an epidemic globally, with birth rates falling across the board,” he told the BBC.
But Lucas’s concern comes with some misleading claims — for example, he told his YouTube audience that men would become infertile within 33 years — which were not backed up by scientific evidence.
It sells online courses, offers 1:1 training and supplements for men who want to increase testosterone and fertility.
His social media content promoting some unproven fertility protocols went viral.
“I recommend that men apply an ice pack to their underwear two to three times a day for 10 to 15 minutes,” he says.
“This is more preliminary. I think it’s a good enough strategy to beat him,” he said.
Asked about the unproven nature of the recommendation, Lucas said he believes the test is a “promising intervention” but would like to see more research.
NHS guidance on low sperm count , ExternalIt says that tight underwear can increase the temperature of your testicles.
Lucas advises followers and clients on healthy eating, sleep and exercise – steps with strong evidence.
Professor Jayasena recommends lifestyle changes to improve fertility.
“If there are things you can change, like (quitting cigarettes), losing weight (losing weight) and increasing exercise, that’s the best thing you can ever do,” he said.