Male Infertility Diet & Nutrition Discussion
Male infertility may respond to diet and nutrition, according to research - many nutritional factors contribute to the problem.
Excessive alcohol consumption has been linked to lower percentages of normal sperm in men with poor sperm quality.1
Researchers evaluating the sperm counts of workers in Danish organic greenhouses had a sperm count more than twice as high as that of the controls who were general blue collar workers.2 These farmers grew produce without pesticides or synthetic fertilizers. Although these findings are not conclusive, they do suggest that the pesticides and/or chemical fertilizer traces that remain in food may damage fertility.
Vitamin C protects sperm from oxidative damage.6 Supplementing with vitamin C has been found to improve the quality of sperm in men who smoke.7 Men with low sperm quality sometimes have a condition called agglutination, which is when sperm stick together in clumps. Agglutination reduces fertility. Vitamin C has been found to reduce agglutination of sperm, 8 and supplementing with 200-1,000mg daily reduced men's infertility due to such clumping.9, 10 Many medical professionals recommend 1gm of vitamin C daily for infertile men, particularly if they have been determined to have sperm agglutination. A double-blind trial, however, evaluating the effects of vitamins C and E combined, found no such improvements.11
Deficiency of zinc is known to lead to reduced sperm numbers as well as men's impotence.12 However, the relationship between semen zinc levels and quality of sperm is controversial. Research has demonstrated that men with weak fertility have lower semen zinc levels than men with normal fertility.13 Likewise, men with higher amounts of semen zinc levels have more normal counts.14 At the same time however, other research demonstrates that high levels of semen zinc are tied to lower sperm motility.15 16 Some research has suggested that oral zinc supplementation helps sperm count,17, 18 motility,17, 20 and sperm shape for some infertile men.21 A small trial of volunteers found that zinc supplements of 240mg daily helped sperm counts and may have contributed to successful pregnancy in 1/3 of the infertile men.22 One controlled trial found that in 100 men who had poor sperm motility and who received either 57mg of zinc twice a day or a placebo23 there was marked improvement in quality, motility, count of sperm and fertilizing functioning of the sperm. This data was substantiated by later 2009 research.52 The ideal supplementation amount is not known but some medical professionals recommend 30 mg twice a day. Note: supplementing with zinc over the long-term requires 1-2mg of copper daily to prevent copper deficiency (preferably a 15:1 ratio of zinc to copper)..
Arginine is an amino acid that is found in many foods and is needed for sperm production. Preliminary research demonstrates that several months of supplementing with L-arginine can increase sperm quality, count,24 25 26 and fertility.27 28 But if the base level of sperm count was very low, ie, less than 10 million per ml, then this supplementation brought very little or no improvement.29 30 Some pregnancies have been connected supplementing with arginine in preliminary trials31 but there has not been sufficient controlled research to substantiate the finding. For male infertility where sperm counts are greater than 10 million per ml, many health professionals recommend up to 4gm of L-arginine daily over several months.
One double-blind trial of infertile men who had low sperm motility found that supplementing with selenium (100mcg daily for 3 months) markedly improved sperm motility but did not improve sperm count. Pregnancy was achieved in 11% of 46 men who supplemented with selenium compared with none of the 18 men who were given a32 Also see 2011 research on the combination of selenium and vitamin E.
Vitamin B12 is necessary for maintained fertility and research has found that vitamin B12 received as injection has improved sperm counts for infertile men in several studies.33, 34 Other research that evaluated infertile men receiving oral vitamin B12 supplements (1,500mcg daily methylcobalamin for 2-13 months) found that 60% of the subjects had increased sperm counts.35 Controlled trials are needed to confirm this finding.
L-carnitine is a compound biosynthesized in the liver and kidneys by several amino acids and may be found in in all cells of the body. It has been shown to be required for normal sperm cell functioning. In trials supplementing with 3-4gm daily for 4 months, it has been helpful in improving sperm motility in men who have poor sperm quality.36, 37 In addition, a preliminary study reported that acetylcarnitine (4gm daily) may be helpful to improve sperm motility.38
CoEnzyme Q10 (CoQ10)
The nutrient coenzyme Q10 exists in the mitochondria, the energy producing part of a cell. Althought its precise function in forming sperm is not known, it has been found that as little as 10mg daily for two weeks can help improve sperm motility and sperm count.39 In one trial, men who had a poor sperm count received given CoQ10 (60mg daily for three months). While no great change was found for most aspects of sperm condition, there was a marked improvement in the success of in-vitro fertilization rates.40
Animal infertility results from vitamin E deficiency.41 In one early trial couples received 100-200IU vitamin E daily resulted in a marked increase in
fertility.42 It is thought that vitamin E may support fertility by reducing sperm cell damage from free-radicals. Another early trial found that men who had experienced low fertilization rates in previous in-vitro fertilization attempts and who were given 200IU vitamin E daily for 3 months found significant improvement after a
month.43 It was also noted that the amount of oxidative stress on sperm cells was reduced.
A 2011 study of 690 infertile men found that vitamin E in combination with selenium, given for at least 100 days, resulted in a 52.6% improvement in sperm motility, shape (or both), and there was a 10.8% increase in reports of spontaneous pregnancy compared to no treatment51 Their conclusion was that these nutrients combined might improve semen quality and have protective and beneficial effects, particularly on motility. The researchers recommended the combination's use for the treatment of idiopathic male infertility which was identified as asthenoteratospermia or asthenospermia in analysis of the semen.
A small early trial suggested that that oral S-adenosyl-L-methionine (SAMe), at the rate of 800mg daily, might increase sperm activity in infertile men.45 More research is needed.
One of the roles of calcium is that it regulates human sperm functioning.46 The degree of calcium concentration in semen is tied to sperm motility.47 48 A 2012 study found that calcium ionophore improves outcomes in patients with severe male factor infertility.53
Some healthcare professionals feel that Asian ginseng may be helpful for male infertility. One trial involving 66 infertile men found that 4gm of Asian ginseng daily for three months resulted to an improvement in sperm count and motility.49 This research needs to be substantiated.
Related Health Condition: Male Infertility.
See other research on male infertility.
1. Goverde HJM, Dekker HS, Janssen HJG, et al. Semen quality and frequency of smoking and alcohol consumption - an explorative study. International Journal of Fertility, 1995;40:135-8.
2. Abell A, Ernst E, Bonde JP. High sperm density among members of organic farmers' association. Lancet 1994;343:1498.
6. Fraga CG, Motchnik PA, Shigenaga MK, et al. Ascorbic acid protects against endogenous oxidative DNA damage in human sperm. Proceedings of the National Academy of Science 1991;88:11003-6.
7. Dawson EB, Harris WA, Teter MC, Powell LC. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertility and Sterility 1992;58:1034-9.
8. Dawson EB, Harris WA, McGanity WJ. Effect of ascorbic acid on sperm fertility. Federal Proceedings 1983;42:531 [abstr 31403].
9. Dawson EB, Harris WA, Powell LC. Relationship between ascorbic acid and male fertility. In: Aspects of Some Vitamins, Minerals and Enzymes in Health and Disease, ed. GH Bourne. World Revview Nutrition and Diet 1990;62:1-26 [review].
10. Dawson EB, Harris WA, Rankin WE, et al. Effect of ascorbic acid on male fertility. Annals of the New York Academy of Science 1987;498:312-23.
11. Rolf C, Cooper TG, Yeung CH, Nieschlag E. Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study. Hum Reprod 1999;14:1028-33.
12. Prasad AS, Cossack ZT. Zinc supplementation and growth in sickle cell disease. Annals of Internal Medicine 1984;100:367-71.
13. Kvist U, Kjellberg S, Bjorndahl L, et al. Seminal fluid from men with agenesis of the Wolffian ducts: zinc-binding properties and effects on sperm chromatin stability. International Journal of Andrology, 1990;13:245-52.
14. Saaranen M, Suistomaa U, Kantola M, et al. Lead, magnesium, selenium and zinc in human seminal fluid: comparison with semen parameters and fertility. Human Reprodduction, 1987;2:475-9.
15. Danscher G, Hammen R, Fjerdingstad E, Rebbe H. Zinc content of human ejaculate and motility of sperm cells. International Journal of Andrology, 1978;1:576-81.
16. Carpino A, Siciliano L, Petroni MF, et al. Low seminal zinc bound to high molecular weight proteins in asthenozoospermic patients: evidence of increased sperm zinc content in oligoasthenozoospermic patients. Human Reproduction, 1998;13:111-4.
17. Stankovic H, Mikac-Devic D. Zinc and copper in human semen. Clinica Chimica Acta, 1976;70:123-6.
18. Hartoma TR, Nahoul K, Netter A. Zinc, plasma androgens and male sterility. Lancet 1977;2:1125-6.
20. Kynaston HG, Lewis-Jones DI, Lynch RV, Desmond AD. Changes in seminal quality following oral zinc therapy. Andrologia 1988;20:21-2.
21. Tikkiwal M, Ajmera RL, Mathur NK. Effect of zinc administration on seminal zinc and fertility of oligospermic males. Indian Journal Physiology Pharmacology, 1987;31:30-4.
22. Marmar JL, Katz S, Praiss DE, DeBenedictis TJ. Semen zinc levels in infertile and postvasectomy patients and patients with prostatitis. Fertility and Sterility, 1975:26:1057-63.
23. Omu AE, Dashti H, Al-Othman S. Treatment of asthenozoospermia with zinc sulphate: andrological, immunological and obstetric outcome. European Journal of Obstetrics, Gynecology and Reproductive Biology, 1998;79:179-84.
24. De Aloysio D, Mantuano R, Mauloni M, Nicoletti G. The clinical use of arginine aspartate in male infertility. Acta Eur Fertil 1982;13:133-67.
25. Tanimura J. Studies on arginine in human semen. Part II. The effects of medication with L-arginine-HCl on male infertility. Bull Osaka Med School 1967;13:84-9.
26. Scibona M, Meschini P, Capparelli S, et al. L-arginine and male infertility. Minerva Urol Nefrol 1994;46:251-3.
27. Schacter A, Goldman JA, Zukerman Z. Treatment of oligospermia with the amino acid arginine. Journal of Urology, 1973;110:311-3.
28. Schacter A, Friedman S, Goldman JA, Eckerling B. Treatment of oligospermia with the amino acid arginine. Int J Gynaecol Obstet 1973;11:206-9.
29. Mroueh A. Effect of arginine on oligospermia. Fertility and Sterility, 1970:21:217-9.
30. Pryor JP, Blandy JP, Evans P, et al. Controlled clinical trial of arginine for infertile men with oligozoospermia. British Journal of Urology, 1978;50:47-50.
31. Aydin S, Inci O, Alagol B. The role of arginine, indomethacin and kallikrein in the treatment of oligoasthenospermia. Int Urol Nephrol 1995;27:199-202.
32. Scott R , MacPherson A, Yates RWS, et al. The effect of oral selenium supplementation on human sperm motility. British Journal of Urology, 1998;82:76-80.
33. Sandler B, Faragher B. Treatment of oligospermia with vitamin B12. Infertility 1984;7:133-8.
34. Kumamoto Y, et al. Clinical efficacy of mecobalamin in treatment of oligozoospermia. Acta Urology Japan 1988;34:1109-32.
35. Isoyama R, et al. Clinical experience of methyl-cobalamin (CH3-B12)-clomiphene citrate combined treatment in male infertility. Hinyokika Kiyo 1986;32:1177-83 [in Japanese].
36. Costa M, et al. L-carnitine in idiopathic asthenozoospermia. Andrologia 1994;26:155-9.
37. Vitali G, Parente R, Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clinical Res 1995;21:157-9.
38. Moncada ML, et al. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Europaea Fertilitatis 1992;23:221-4
39. Tanimura J. Studies on arginine in human semen. Part III. The influences of several drugs on male infertility. Bulletin Osaka Medical School 1967;13:90-100.
40. Lewin A, et al The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Medicine 1997;18 Suppl:S213-9.
41. Thiessen DD, et al. Vitamin E and sex behavior in mice. Nutritional Metabolism 1975;18:116-9.
42. Bayer R. Treatment of infertility with vitamin E. Int Journal Fertility 1960;5:70-8.
43. Geva E, Bartoov B, et al. The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program. Fertility and Sterility, 1996;66:430-4.
45. Piacentino R, et al. Preliminary study of the use of s. adenosyl methionine in the management of male sterility. Minerva Ginecologica 1991;43:191-3 [in Italian].
46. Hong CY, et al Calcium ion is the key regulator of human sperm function. Lancet 1984;2:1449-51.
47. Kilic S, et al. Effect of total and ionized calcium levels of seminal fluid on sperm motility. Urology Int 1996;56:215-8.
48. Prien SD, et al. Seminal concentrations of total and ionized calcium from men with normal and decreased motility. Fertility and Sterility, 1990;54:171-2.
49. Salvati G, et al. Effects of Panax ginseng C.A. Meyer saponins on male fertility. Panmineva Med 1996;38:249-54.
50. Lenzi A, Lombardo F, Sgro P, Salacone P, Caponecchia L, Dondero F, Gandini L (2003). Use of carnitine therapy in selected cases of male factor infertility,. Fertility and Sterility 79 (2): 292-300
51. Mohammad K Moslemi1, and Samaneh Tavanbakhsh, Selenium-vitamin E supplementation in infertile men: effects on semen parameters and pregnancy rate, Int Journal Gen Med. 2011; 4: 99-104.
52. Colagar AH, Marzony ET, Chaichi MJ., Zinc levels in seminal plasma are associated with sperm quality in fertile and infertile men, Nutritional Res. 2009 Feb;29(2):82-8
53. Ebner T, Koster M, Shebl O, Moser M, Van der Ven H, Tews G, Montag M., Application of a ready-to-use calcium ionophore increases rates of fertilization and pregnancy in severe male factor infertility, Fertility Sterility. 2012 Aug 23