Alcohol
In a study of men with poor sperm quality, excessive alcohol consumption was associated with a decrease in the
percentage of normal sperm.1
Organic food
In a study of Danish greenhouse workers, an unexpectedly high sperm count was found among organic farmers, who grew
their products without the use pesticides or chemical fertilizers. The sperm count was more than twice as high in these
men as in a control group of blue-collar workers.2 Although these findings are not
definitive, they suggest that consuming organically grown foods may enhance fertility.
Vitamin C
Vitamin C protects sperm from oxidative damage.6 Supplementing vitamin C improves the
quality of sperm in smokers.7 When sperm stick together (a condition called agglutination),
fertility is reduced. Vitamin C reduces sperm agglutination,8 and supplementation with
200-1,000 mg per day increased the fertility of men with this condition in a controlled study.9
10 Many doctors recommend 1 gram of vitamin C per day for infertile men, particularly those diagnosed with sperm
agglutination. However, a double-blind trial studying the effects of combined vitamin C and vitamin E supplementation
found no improvements in semen quality among men with low sperm motility.11
Zinc
Zinc deficiency leads to reduced numbers of sperm and impotence in men.12 The correlation
between blood levels of zinc and sperm quality remains controversial. Infertile men have been reported to have lower
levels of zinc in their semen, than do men with normal fertility.13 Similarly, men with
normal sperm density tend to have higher amounts of zinc in their semen, than do men with low sperm counts.14 However, other studies have found that a high concentration of zinc in the semen is related to
decreased sperm motility in infertile men.15 16 A few studies have shown that oral zinc
supplementation improves both sperm count17 18 motility,19 20
and the physical characteristics of sperm in some groups of infertile men.21 For infertile
men with low semen zinc levels, a preliminary trial found that zinc supplements (240 mg per day) increased sperm counts
and possibly contributed to successful impregnation by 3 of the 11 men.22 However, these
studies all included small numbers of volunteers, and thus the impact of their conclusions is limited. In a controlled
trial, 100 men with low sperm motility received either 57 mg of zinc BID or a placebo.23
After three months, there was significant improvement in sperm quality, sperm count, sperm motility, and fertilizing
capacity of the sperm. The ideal amount of supplemental zinc remains unknown, but some doctors recommend 30 mg BID.
Long-term zinc supplementation requires 1-2 mg of copper per day to prevent copper deficiency.
Arginine
Arginine, an amino acid found in many foods, is needed to produce sperm. Research, most of which is preliminary shows
that several months of L-arginine supplementation increases sperm count, quality,24 25 26
and fertility.27 28 However, when the initial sperm count was extremely low (such as less
than 10 million per ml), L-arginine supplementation produced little or no benefit.29 30
While some pregnancies have been attributed to arginine supplementation in preliminary reports,31 no controlled research has confirmed these claims. For infertile men with sperm counts greater
than 10 million per milliliter, many doctors recommend up to 4 grams of L-arginine per day for several months.
Selenium
In a double-blind study of infertile men with reduced sperm motility, supplementation with selenium (100 mcg per day
for three months) significantly increased sperm motility, but had no effect on sperm count. Eleven percent of 46 men
receiving selenium achieved paternity, compared with none of 18 men receiving a placebo.32
Vitamin B12
Vitamin B12 is needed to maintain fertility. Vitamin B12 injections have increased sperm counts for men with low
numbers of sperm.33 These results have been duplicated in double-blind research.34 In one study, a group of infertile men were given oral vitamin B12 supplements (1,500 mcg per
day of methylcobalamin) for 2 to 13 months. Approximately 60% of those taking the supplement experienced improved sperm
counts.35 However, controlled trials are needed to confirm these preliminary results. Men
seeking vitamin B12 injections should consult a physician.
L-Carnitine
L-carnitine is a substance made in the body and also found in supplements and some foods (such as meat). It appears to
be necessary for normal functioning of sperm cells. In preliminary studies, supplementing with 3-4 grams per day for
four months helped to normalize sperm motility in men with low sperm quality.36 37 While
the majority of clinical trials have used L-carnitine, one preliminary trial found that acetylcarnitine (4 grams per
day) may also prove useful for treatment of male infertility caused by low quantities of immobile sperm.38
CoEnzyme Q10
Coenzyme Q10 (CoQ10) is a nutrient used by the body in the production of energy. While its exact role in the formation
of sperm is unknown, there is evidence that as little as 10 mg per day (over a two-week period) will increase sperm
count and motility.39 In one study, men with low sperm counts were given CoQ10 (60 mg per
day for about three months). No significant change was noted in most sperm parameters, but a significant improvement
was noted in in-vitro fertilization rates.40
Vitamin E
Vitamin E deficiency in animals leads to infertility.41 In a preliminary human trial,
100-200 IU of vitamin E given daily to both partners of infertile couples led to a significant increase in
fertility.42 Vitamin E supplementation may enhance fertility by decreasing free-radical
damage to sperm cells. In another preliminary study, men with low fertilization rates in previous attempts at in vitro
fertilization were given 200 IU of vitamin E per day for three months.43 After one month of
supplementation, fertilization rates increased significantly, and the amount of oxidative stress on sperm cells
decreased. However, the evidence in favor of vitamin E remains preliminary. A review of research on vitamin E for male
infertility concluded that there is no justification for its use in treating this condition.44 Controlled trials are needed to validate these promising preliminary findings.
SAMe
Preliminary research suggests that oral SAMe (S-adenosyl-L-methionine), in amounts of 800 mg per day, may also increase
sperm activity in infertile men.
45
Calcium is a key regulator of human sperm function.46
Calcium
The concentration of calcium in semen determines sperm motility (i.e., the ability of sperm to move
spontaneously).47 48 However, calcium deficiency has not been confirmed as a cause of male
infertility nor is there any evidence that calcium supplementation improves male infertility.
Asian ginseng
Asian ginseng may prove useful for male infertility. One preliminary study with 66 men found that 4 grams of Asian
ginseng per day for three months led to an improvement in sperm count and sperm motility.49
Discussion: Lifestyle
Medications
Some conventional medications can interfere with fertility. If in doubt, men taking prescription drugs should consult
their physician.
Temperature
The optimal temperature of the testes for sperm production is slightly lower than body temperature, which is why the
testes hang away from the body in the scrotum. Men with low sperm counts are frequently advised to minimize lifestyle
factors that may overheat the testes, such as wearing tight (e.g., “bikini-style”) underwear or frequently using spas
and hot baths.
Air quality
Environmental exposures (e.g., formaldehyde), smoking, and use of recreational drugs (e.g., marijuana, cocaine,
hashish) may reduce sperm count or cause abnormal sperm morphology (shape).3 4 Smoking
adversely affects the semen quality of infertile men.5
Other Integrative Options
Acupuncture
Acupuncture may be helpful in the treatment of some cases of male infertility due to impairment of sperm function. A
controlled study of men with reduced sperm function found that one measure of sperm function significantly improved in
the men treated with acupuncture (two times per week for five weeks) compared to controls.50 Similar results have been reported in other studies.51 52
Nevertheless, double-blind trials are needed to determine conclusively whether acupuncture is a useful treatment for
male infertility.
Studies:
