Essential nutrients for improving male fertility

Zinc

Zinc supplementation improves sperm count, motility and morphology and improves testosterone concentration.  Zinc is important for the development of the gamete cells because several enzymes involved in DNA synthesis are zinc dependent.  Low zinc levels correlate with decreased fertility potential and men with lower sperm counts have lower levels of zinc compared to men with normal sperm counts.

In  ART studies of patients who presented with low plasma testosterone levels, treatment with zinc sulphate (60mg elemental zinc daily for 45-50 days) significantly increased testosterone and the average sperm count (from 8 million to 22 million).

In studies of infertile men taking 220mg oral zinc sulphate for four months, a significant improvement in sperm count, motility and morphology was noted.
Taking a zinc supplement can result in nausea, so is best taken before food or before bed. Increasing your consumption of seeds (for example pumpkin, pine, sesame and sunflower, and good quality nuts such as macadamias, almonds, brazil nuts, pecans, walnuts and hazelnuts), is also beneficial.

Selenium

A selenium deficiency is associated with reduced fertilityi.  Selenium is required for the formation and development of sperm.  Selenium protects developing sperm from oxidative stress and is important for sperm motility and DNA stability (Rayman 2000). ii

The recommended daily intake of selenium is 100-200 mcg. High doses (especially of the forms sodium selenite or selenate) can be toxic. Some forms of selenium are rendered ineffective if taken at the same time as zinc or vitamin C. Selenomethionine is the preferred, most effective, form which is stable and can be taken with other nutrients.

Food sources of selenium include garlic, onion, organic butter, wheat germ, Brazil nuts and seafood.  Unfortunately the soil in Australia is very low in selenium, a problem which is compounded by the fact that only small amounts of selenium are available in most non-prescription supplements.

Vitamin E

In a study on male fertility, vitamin E and selenium supplementation produced a significant improvement in sperm motility. The results confirm the protective and beneficial effects of vitamin E and selenium on semen quality and advocate their use in male infertility treatment. The study used vitamin E (400 mg) and selenium (225 mg) supplements for 3 months.iii

Food sources of vitamin E include wheat germ, seeds, cold-pressed vegetable oils, nuts, whole grains, avocadoes, egg yolk, whole milk and leafy vegetables.

Vitamin C

Vitamin C protects sperm cells by scavenging free radicals and also regenerating other antioxidants such as vitamin E.  Vitamin C protects DNA from oxidative damage that can result in genetic mutations.iv Vitamin C is also required for the synthesis of the amino acid Carnitine.

L-Carnitine

L-Carnitine is an important coenzyme in cellular energy production by utilizing fatty acids for energy. The L-Carnitine content of seminal fluid is directly related to sperm count and motility.  Supplementation of 2-3 grams of L-Carnitine a day for 3-4 months improves sperm quality, concentration and motility of sperm. L-Carnitine is an amino acid found in beef and milk.

Essential fatty acids

The cell membranes of sperm require fatty acids in the form of omega 3 for cell membrane fluidity. According to research, the presence of essential fatty acids in the plasma membrane of the cell, results in improved motility, and an improvement in the ability of sperm to fuse with the egg at conception.  For essential fatty acids to be metabolized and present in sperm, it is recommended that Omega 3 supplements are taken for a minimum of 3 months prior to conception. Food sources of Omega 3 include; deep sea fish (tuna, salmon and swordfish), sardines, mackerel and some seaweeds such as spirulina.

Folate or folic acid

Most people are aware that folic acid supplementation for women during pregnancy is required for prevention of neural tube defects.  However, not as widely publicized, is the fact that the folic acid levels in males  are just as important to prevent chromozomal abnormalities and that folic acid requirements must be contained within both gamete cells (sperm and ovum) at the time of fertilization.v

Daily folic acid supplementation of 5 mg to infertile men for 26 weeks resulted in a significant increase of folic acid concentrations in seminal plasma. One study found that men with high folate intake had lower overall frequencies of chromosomal problems caused by an extra or missing chromosome.

A note on homocystiene and folic acid intake

Homocysteine is an inflammatory bi-product of normal metabolism. In a healthy individual homocysteine levels are reduced by the presence of folic acid, B12 and B6. Elevated Homocysteine results in poor reproductive performance in both men and women. Homocysteine is increased by aging, low vitamin intake, smoking, coffee, some diseases and various drugs.  For men who have a semen analysis returned with lowered results, a blood test to measure homocystiene levels and folic acid levels can identify a deficiency in folic acid that can be rectified through supplements.

Coenzyme Q10

Coenzyme Q10 is an antioxidant that exists in mitochondria of cells.  The mitochondrion supplies all cells in the body with energy.  CoQ10 has an important role in resisting oxidative damage in sperm cells and providing the forward movement of sperm (progressive motility).

Supplementation of CoQ10 can also improves sperm qualityvi.  In a study of infertile men who had reduced sperm motility, taking 200 mg of CoQ10 twice daily for four months increased sperm forward motility from 9 percent at baseline to 16 percent after treatment. Six months after the CoQ10 treatment stopped, sperm forward motility was significantly reduced from 16 percent back to 9.5 percent.vii

L-Arginine

Arginine deficiency is associated with decreased sperm count and motility. Supplementation of up to 4g per day reverses these effects.

References

i Shalani S, Bansal MP; “Role of selenium in regulation of spermatogenesis: involvement of activator protein 1 Biofactors, 2005;23(3):151-62.
ii Rayman MP. The Importance of Selenium in Human Health. Lancet 2000, vol. 356, pp.233-241
iii Sperm oxidative stress and the effect of an oral vitamin E and selenium supplement on semen quality in infertile men. Archives of Andrology 2003 Mar-Apr;49(2):83-94.
iv Shils ME et al. Modern Nutrition in Health and Disease, 9th Edition. Lippincott Williams & Wilkins, USA, 1999.
v O’Neill C (1998) Endogenous Folic acid is essential for the normal development of preimplantation embryos. Hum Reprod 13, 1312-1316.
vi Li W, Li K, Huang YF. “Biological function of CoQ10 and its effect on the quality of spermatozoa: National Journal of Andrology: China. 2006 Dec;12(12):1119-22.
vii Coenzyme Q(10) supplementation in infertile men with idiopathic asthenozoospermia: an open, uncontrolled pilot study. Fertil Steril. 2004 Jan;81(1):93-8.