How to Increase Male Fertility
Traits associated with reduced male fertility
- Alcohol consumption (reduces morphology and sperm count)
- High BMI (reduces sperm count and motility)
- Red meat consumption (reduces implantation and pregnancy rate)
- Being on a weight loss diet (reduces implantation and pregnancy rate)
- Smoking (reduces motility and fluid quality)
- Having low or average self-rated health (26.9% lower sperm count and 1.4% fewer normal sperm than high health)
Traits associated with improved male fertility
- Cereal consumption (improves sperm count and motility)
- Fruit consumption (improves sperm motility)
- Having a BMI between 20 and 25 (improves sperm count)
- Folate consumption (improves sperm count, motility and morphology)
- Higher omega 3 to omega 6 fatty acid ratio (improves sperm count, motility and morphology)
Supplements shown beneficial to sperm quality
- Improving sperm count
- 2000 mg/day vitamin C (increases sperm count 129% in 2 months)
- 5 mg folic acid + 66 mg zinc (improves sperm count by 74%, but induces 4% increase in abnormal sperm)
- 4 mg/day lycopene (improves sperm count by 22 million/ml)
- 3 g/day L-Carnitine (increases sperm count 15%)
- Vitamin D (men low in vitamin D have lower sperm counts)
- Improving sperm motility
- 2 g/day L-Carnitine + Vitamin E (increases sperm motility 59%)
- 3 g/day L-Carnitine (increases sperm motility by 40%)
- 2000 mg/day Vitamin C (increases sperm motility 39% in 2 months)
- 4 mg/day lycopene (increases sperm motility by 25% in 3 months)
- 200 mg selenium + 400 IU Vitamin E
- Vitamin D (men low in vitamin D have lower sperm motility)
- Improving sperm morphology
- 2000 mg/day Vitamin C (improves sperm morphology 114% in 2 months)
- 200 mg/day pycnogenol (improves sperm morphology by 38% in 90 days)
- 200 mg selenium + 400 IU Vitamin E
- Vitamin D (men low in vitamin D have lower sperm morphology)
- Other beneficial supplements
- Myo-inositol (improves fertilization potential of sperm)
- NOTE: Combining high doses of Vitamin C and Vitamin E does not improve sperm quality and induces sperm DNA damage; protective effect is found when only one or the other is taken
High BMI, alcohol, red meat and weight loss reduce sperm quality; cereal and fruits beneficial
The sperm concentration was negatively influenced by body mass index (BMI) and alcohol consumption and was positively influenced by cereal consumption and the number of meals per day. The sperm motility was also negatively influenced by BMI, alcohol consumption, and smoking habit, whereas it was positively influenced by the consumption of fruits and cereals. The consumption of alcohol had a negative influence on the fertilization rate. The consumption of red meat as well as being on a weight loss diet had a negative impact on the implantation rate. In addition, the consumption of red meat and being on a weight loss diet had an effect on the pregnancy chance.
Men with high self-rated health have higher sperm count and better morphology
A total of 3,457 Danish young men delivered a semen sample, had a physical examination performed, and responded to a questionnaire including a question about self-rated health. RESULT(S): After control for confounders, men with good and poor self-rated health had, respectively, 0.5 mL and 0.8 mL smaller testes size compared to men with very good self-rated health, the trend was statistically significant. Men with good and poor self-rated health had, respectively, 12.2% and 26.9% lower total sperm count compared to men with very good self-rated health and had +0.4% and 1.4% fewer morphologically normal sperms (trend statistically significant). Percentages of motile spermatozoa and semen volume were not significantly associated with self-rated health. CONCLUSION(S): We found significant associations between self-rated health and semen quality and testicular size. Given the cross-sectional study design, we cannot establish a causal relationship but argue that self-rated health may be associated with semen quality.
Men with a body mass index between 20 and 25 have the highest sperm count
Serum testosterone, sex hormone-binding globulin (SHBG), and inhibin B all decreased with increasing BMI, whereas free androgen index and estradiol increased with increasing BMI. Serum FSH was higher among slim men. After control for confounders, men with a BMI <20 kg/m(2) had a reduction in sperm concentration and total sperm count of 28.1% and 36.4%, respectively, and men with a BMI >25 kg/m(2) had a reduction in sperm concentration and total sperm count of 21.6% and 23.9%, respectively, compared to men with BMI between 20-25 kg/m(2). Percentages of normal spermatozoa were reduced, although not significantly, among men with high or low BMI. Semen volume and percentage of motile spermatozoa were not affected by BMI. CONCLUSION(S): High or low BMI was associated with reduced semen quality. It remains to be seen whether the increasing occurrence of obesity in the Western world may contribute to an epidemic of poor semen quality registered in some of the same countries. If so, some cases of subfertility may be preventable.
Drinking before becoming pregnant lowers live birth rate by up to 21% in IVF patients
In this prospective cohort study, men and women completed a self-administered questionnaire before their first IVF cycle. We conducted multicycle analyses with final models adjusted for potential confounders that included cycle number, cigarette use, body mass index, and age. RESULTS: Women drinking at least four drinks per week had 16% less odds of a live birth rate compared with those who drank fewer than four drinks per week (odds ratio 0.84). For couples in which both partners drank at least four drinks per week, the odds of live birth were 21% lower compared with couples in which both drank fewer than four drinks per week (odds ratio 0.79). CONCLUSION: Consumption of as few as four alcoholic drinks per week is associated with a decrease in IVF live birth rate.
Alcohol lowers sperm morphology and production; smoking lowers motility and fluid quality
Only 12% alcoholics and six per cent smokers showed normozoospermia compared to 37 % nonalcoholic nonsmoker males. Teratozoospermia, followed by oligozoospermia dominated alcoholics. Overall impact of asthenozoospermia and teratozoospermia, but not of oligozoospermia, was observed in smokers. Light smokers predominantly showed asthenozoospermia. Heavy alcoholics and smokers showed asthenozoospermia, teratozoospermia as well as oligozoospermia. CONCLUSIONS: Alcohol abuse apparently targets sperm morphology and sperm production. Smoke-induced toxins primarily hamper sperm motility and seminal fluid quality. Progressive deterioration in semen quality is related to increasing quantity of alcohol intake and cigarettes smoked.
Higher omega 3 to omega 6 fatty acid ratio improves sperm count, motility and morphology
Proven fertile men had higher blood and spermatozoa levels of omega-3 fatty acids compared with the infertile patients. The ratio of serum omega-6/omega-3 fatty acids was significantly higher in infertile (14.8) patients compared to fertile controls (6.3). Additionally, levels of arachidonic acid (polyunsaturated omega-6 fatty acid) were higher and the omega-3 index (EPA+DHA) was lower in infertile subjects than in fertile controls. Infertile men had higher mean arachidonic acid:DHA ratio and arachidonic acid:EPA (6.4 and 12.0, respectively) than fertile men (3.3 and 6.7, respectively). A strong negative correlation was found between the arachidonic acid:DHA and arachidonic acid:EPA ratios and total sperm count, sperm motility, and sperm morphology. CONCLUSIONS: Infertile men had lower concentrations of omega-3 fatty acids in spermatozoa than fertile men. These results suggest that research should be performed to assess the potential benefits of omega-3 FA supplementation as a therapeutic approach in infertile men.
L-carnitine, vitamin C, vitamin E, selenium and coQ10 shown to improve semen quality
Oxidative stress contributes to defective spermatogenesis leading to male factor infertility. The aim of this study was to review the current literature on the effects of various antioxidants to improve fertilisation and pregnancy rates. Reviewing the current literature revealed that Carnitines and vitamin C and E have been clearly shown to be effective by many well-conducted studies and may be considered as a first line treatment. The efficacy of antioxidants, such as glutathione, selenium and coenzyme Q10 has been demonstrated by few, but well-performed studies, and may be considered second line treatment. There is, however, a need for further investigation with randomised controlled studies to confirm the efficacy and safety of antioxidant supplementation in the medical treatment of idiopathic male infertility as well as the need to determine the ideal dose of each compound to improve semen parameters, fertilization rates and pregnancy outcomes.
2,000 mg Vitamin C increases sperm count 129%, motility 39%, and morphology 114% in 2 months
This study was carried out to monitor the effect of oral supplementation of vitamin C on various semen parameters in oligospermic, infertile, otherwise healthy individuals. These patients received in an open trial of 1,000 mg of vitamin C twice daily for a maximum of 2 months. Results showed that the mean sperm count was increased to 32.8 x 10(6) sperms/mL after 2 months of vitamin C intake (from 14.3 x 10(6)). The mean sperm motility was increased significantly to 60.1% (from 43%), and mean sperms with normal morphology increased significantly to 66.7% (from 31.2%). This study showed that vitamin C supplementation in infertile men might improve sperm count, sperm motility, and sperm morphology and might have a place as an additional supplement to improve the semen quality towards conception.
1000 mg/day vitamin C is superior to 200 mg in improving sperm quality in smokers
Heavy smokers were randomly divided into one of three supplementation groups: placebo, 200 mg and 1,000 mg of vitamin C. RESULTS: The placebo group showed no improvement in sperm quality. The groups receiving vitamin C showed improvement in sperm quality with most improvement in the 1,000-mg group. CONCLUSIONS: Vitamin C supplementation of heavy smokers in excess of 200 mg/d results in improved sperm quality.
High or low vitamin D associated with lower sperm count, motility and morphology
Sperm concentration, sperm progressive motility, sperm morphology, and total progressively motile sperm count were lower in men with vitamin D ≥50 ng ml when compared to men with 20 ng ml ≤ vitamin D <50 ng ml. Total sperm count and total progressive motile sperm count were lower in men with vitamin D <20 ng ml when compared to men with 20 ng ml ≤ vitamin D <50 ng ml. The adjusted means of various hormonal parameters did not show statistical difference in the different categories of vitamin D. In conclusion, serum vitamin D levels at high and low levels can be negatively associated with semen parameters.
High vitamin D levels associated with higher sperm motility and morphology
Vitamin D serum levels correlated positively with sperm motility and progressive motility, and men with vitamin D deficiency (<25 nM) had a lower proportion of motile, progressive motile and morphologically normal spermatozoa compared with men with high vitamin D levels (>75 nM). Vitamin D increased intracellular calcium concentration in human spermatozoa, increased sperm motility and induced the acrosome reaction (necessary for fertilization) in vitro. CONCLUSIONS: Vitamin D increased intracellular calcium concentration, sperm motility and induced the acrosome reaction in mature spermatozoa, and vitamin D serum levels were positively associated with sperm motility, suggesting a role for vitamin D in human sperm function.
2 grams L-carnitine + vitamin E increases sperm motility by 59%; no effect on density or morphology
Patients with asthenozoospermia were randomly divided into Groups A and B. Group A was treated with L-carnitine (2 g/d) and vitamin E, while Group B was treated with vitamin E only, both for 3 months. RESULTS: Group A showed a significantly increased percentage of forward motile sperm after the treatment (45.4%) as compared with pretreatment (28.6%), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology. The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment. No adverse events were found during the treatment. CONCLUSION: L-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.
L-carnitine only effective in men with normal phospholipid hydroperoxide glutathione peroxidase levels
Thirty asthenozoospermic patients divided in two groups according to phospholipid hydroperoxide glutathione peroxidase (PHGPx) levels. INTERVENTION(S): Placebo for 3 months, then oral L-carnitine (2 g/day) for 3 months; semen samples were collected at baseline, after placebo, after carnitine administration, and again after 3 months with no drugs. RESULT(S): When asthenozoospermic subjects were divided in two groups on the basis of PHGPx levels, we observed an improvement of mean sperm motility only in the group of patients with normal PHGPx levels. CONCLUSION(S): Phospholipid hydroperoxide glutathione peroxidase has an important role in male infertility, and carnitine treatment might improve sperm motility in the presence of normal mitochondrial function.
2 g/day L-carnitine improves sperm concentration and motility in 2 months
Infertile male patients underwent L-carnitine therapy 2 g/day or placebo; the study design was 2 months of washout, 2 months of therapy/placebo, 2 months of washout, and 2 months placebo/therapy. MAIN OUTCOME MEASURE(S): Excluding outliers, a statistically significant improvement in semen quality was seen after the L-carnitine therapy for sperm concentration and total and forward sperm motility. The increase in forward sperm motility was more significant in those patients with lower initial values, i.e., <5 x 10(6) or <2 x 10(6) of forward motile sperm/ejaculate or sperm/mL. CONCLUSION(S): Based on a controlled study of efficacy, L-carnitine therapy was effective in increasing semen quality, especially in groups with lower baseline levels.
3 g/day L-carnitine improves sperm count and motility in 79% of patients
On the basis of reported experimental and clinical studies we investigated the effectiveness of L-carnitine administration in a group of patients with idiopathic asthenospermia. A favorable effect of the compound on sperm motility and rapid linear progression has been shown in 37 out of 47 patients treated. In addition, the total number of sperms increased. L-carnitine was supplemented orally by a daily dosage of 3 g for three months.
3 g/day L-carnitine improves sperm count by 15% and motility by 40%
Patients with unexplained asthenozoospermia received 3 g/day of oral L-carnitine for 4 months. The results of the study indicate that L-carnitine is able to increase spermatozoal motility (percent motile spermatozoa increased from 26.9% to 37.7%; per cent spermatozoa with rapid linear progression increased from 10.8% to 18.0%; mean velocity increased from 28.4 microns/second to 32.5 microns/second; linearity index increased from 3.7 to 4.1, especially in the subgroup of patients with poor rapid linear progression of spermatozoa (percent of motile spermatozoa increased from 19.3% to 40.9%, and per cent of spermatozoa with rapid linear progression increased from 3.1% to 20.3%) An increase in spermatozoal output was also observed (total number of ejaculated spermatozoa increased from 142.4 x 10(6) to 163.3 x 10(6)). The authors conclude that oral administration of L-carnitine may improve sperm quality at least in patients with idiopathic asthenozoospermia.
200 mcg selenium + 400 IU vitamin E completely improves motility, morphology or both in 53% of patients
The study included infertile men with idiopathic asthenoteratospermia who received supplemental daily Selenium (200 μg) in combination with vitamin E (400 units) for at least 100 days. RESULTS: We observed 52.6% cases total improvement in sperm motility, morphology, or both, and 10.8% cases spontaneous pregnancy in comparison with no treatment. No response to treatment occurred in 36.6% cases after 14 weeks of combination therapy. Mean difference between semen analyses of cases before and after treatment was 4.3%. On the basis of paired t-test results, combination therapy with oral selenium and vitamin E was effective for treatment of asthenospermia or asthenoteratospermia or induction of spontaneous pregnancy. CONCLUSIONS: Supplemental Se and vitamin E may improve semen quality and have beneficial and protective effects, especially on sperm motility. We advocate their use for the treatment of idiopathic male infertility diagnosed with asthenoteratospermia or asthenospermia in semen analysis.
225 mcg selenium + 400 mg vitamin E improves sperm motility in 3 months
Twenty-eight infertilemen were supplemented daily by vitamin E (400 mg) and selenium (225 microg), during 3 months. The remaining 26 patients received vitamin B (4.5 g/day) for the same duration. Only 20 patients achieved their treatment and returned for control analysis. MDA concentrations in sperm were much less than in seminal plasma and motility and viability were inversely correlated with semen MDA levels. In contrast to vitamin B supplementation, vitamin E and selenium supplementation produced a significant decrease in MDA concentrations and an improvement of 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.
Selenium and Vitamin E improve sperm motility and morphology
In order to verify the hypothesis that selenium and vitamin E could improve male fertility, nine oligoasthenoteratozoospermic men were supplemented for a period of 6 mo with selenium and vitamin E. Compared to the baseline period (presupplementation) of 4 mo, statistically significant increases were observed for selenium and vitamin E levels, sperm motility, percent live, and percent normal spermatozoa. These improvements are likely to be "supplementation-dependent," since all of the parameters returned to baseline values during the posttreatment period. None of the couples reported a pregnancy during the study. The mechanism(s) involved in these improvements of semen parameters is presently under investigation.
High intake of vitamin C, vitamin E and beta-carotene associated with high sperm quality
Healthy, non-smoking men provided semen and were interviewed. Average daily nutrient intake from food and supplements was derived from a self-administered food frequency questionnaire. Semen volume, sperm concentration, total sperm count, motility, progressive motility and total progressively motile sperm count (TPMS) were measured. RESULTS: After controlling for covariates, a high intake of antioxidants was associated with better semen quality but, in almost all cases, there was no clear dose relationship in that moderate intake groups had the poorest semen quality. For example, positive associations were observed between vitamin C intake and sperm number as reflected in the higher mean count, concentration and TPMS; between vitamin E intake and progressive motility and TPMS; and between beta-carotene intake and sperm concentration and progressive motility. Folate and zinc intake were not associated with improved semen quality. CONCLUSIONS: In a convenience sample of healthy non-smoking men from a non-clinical setting, higher antioxidant intake was associated with higher sperm numbers and motility.
1000 mg vitamin C + 800 mg vitamin E does not improve semen quality
In a randomized, placebo-controlled, double-blind study we investigated whether high-dose oral treatment with vitamins C and E for 56 days was able to improve semen parameters of infertile men. Patients without genital infection but with asthenozoospermia (<50% motile spermatozoa) and normal or only moderately reduced sperm concentration (>7×106 spermatozoa/ml) were examined. After randomization, the patients received either 1000 mg vitamin C and 800 mg vitamin E or identical placebo capsules. To investigate the influence of the epididymal storage period on semen parameters, the patients were asked to deliver two semen samples with abstinence times of 2 and 7 days both before and at the end of vitamin treatment. No changes in semen parameters were observed during treatment, and no pregnancies were initiated during the treatment period. Combined high-dose antioxidative treatment with vitamins C and E did not improve conventional semen parameters or the 24-h sperm survival rate. Prolonged abstinence time increased ejaculate volume, sperm count, sperm concentration and the total number of motile spermatozoa.
Vitamin C and Vitamin E induce DNA damage in sperm when taken together; protective separately
Both in-vitro experiments and an in-vivo pilot study have proven that vitamin C and vitamin E could protect the DNA of spermatozoa from oxidative damage when given separately, but induced DNA damage when given in combination.
600 mg/day vitamin E only improves zona binding in men with high ROS infertility
Thirty infertile men with high levels of reactive oxygen species generation in semen and a normal female partner were allocated to two groups according to the blinded randomization. Each patient received either 600 mg/d of vitamin E (order A) or identical placebo tablets (order B) for 3 months. Then after a 1-month wash-out period the patients were crossed-over to the other treatment. RESULTS: improvement in (only) one of the sperm function tests: the zona binding assay. The zona binding ratio for order A improved from 0.2 (range 0 to 0.5) before treatment to 0.5 (range 0.1 to 1.0) after treatment, the corresponding values for order B were 0.2 (range 0 to 1.0) before treatment and 0.3 (range 0.1 to 0.7) after treatment. CONCLUSION: Oral administration of vitamin E significantly improves the in vitro function of human spermatozoa as assessed by the zona binding test.
4 g/day arginine improves sperm count and motility in 3 months
In 1973, Schachter et al published a study in which arginine was given to 178 men with low sperm count. Seventy-four percent of the subjects had significant improvement in sperm count and motility after taking 4 g/day for three months.
L-arginine HCL improves sperm motility
The clinical efficacy and acceptance of L-arginine HCL was tested in 40 infertile men. All of these men had a normal number of spermatozoa (> 20 million/ml), but a decreased motility; this decreased motility was not due to infection or to immunological disorders. The treatment consisted of 80 ml of 10% L-arginine HCL administered daily per os for 6 months. L-arginine HCL showed to be able to improve the motility of spermatozoa without any side-effects.
Higher folate levels associated with higher sperm count, motility and normal morphology
There was a significant difference in genotype frequency distribution of MTHFR C677T polymorphism between infertile patients and controls. The 677T allele carriers (TC or TT) had a significantly increased risk of infertility compared with the CC homozygotes (odds ratio 1.60, and odds ratio = 2.68), after adjustment for confounding factors. Men with the 677T, 1298C, and 1793G alleles showed significantly higher serum tHcy and lower folate levels. We found a positive correlation between serum folate concentrations and sperm density, percentage of sperm with progressive motility, as well as percentage of sperm with normal morphology. CONCLUSION: MTHFR C677T polymorphism is associated with an increased risk of idiopathic male infertility. Further study on the biologic role that this polymorphism plays in the development of infertility may lead to better understanding of the etiology of impaired spermatogenesis.
5 mg folic acid + 66 mg zinc increases sperm count by 74%; induces 4% increase in abnormal sperm
Fertile and subfertile men were randomly assigned to receive one of four treatments for 26 weeks: folic acid and placebo, zinc sulfate and placebo, zinc sulfate and folic acid, and two placebos. Folic acid was given at a daily dose of 5 mg, and zinc sulfate was given at a daily dose of 66 mg. RESULT(S): Subfertile men demonstrated a significant 74% increase in total normal sperm count and a minor increase of 4% abnormal spermatozoa. A similar trend was observed in fertile men. Pre-intervention concentrations of folate and zinc in blood and seminal plasma did not significantly differ between fertile and subfertile men. CONCLUSION(S): Total normal sperm count increases after combined zinc sulfate and folic acid treatment in both subfertile and fertile men. Although the beneficial effect on fertility remains to be established, this finding opens avenues of future fertility research and treatment and may affect public health.
Myo-inositol improves fertility potential of sperm in subfertile men
Myo-inositol did not affect the mitochondrial function of spermatozoa isolated from normozoospermic men, whereas it increased significantly the number of spermatozoa with high mitochondrial membrane potential (measurement of fertility potential) and decreased significantly the number of those with low mitochondrial membrane potential in oligo-astheno-teratozoospermia patients. No effect of myo-inositol was observed on phosphatidylserine externalization and chromatin compactness in both normozoospermic men and oligo-astheno-teratozoospermia patients. CONCLUSION: The data suggest that myo-inositol is able to ameliorate mitochondrial function in oligo-astheno-teratozoospermia patients. We conclude that this compound may be useful for the treatment of male infertility.
4 mg/day lycopene improves sperm concentration and motility in three months
We evaluated the effect of oral lycopene therapy in men with idiopathic infertility. All patients were administered 2000 mcg of Lycopene, twice a day for three months. Twenty patients (66%) showed an improvement in sperm concentration, sixteen (53%) had improved motility and fourteen (46%) showed improvement in sperm morphology. In cases showing an improvement, the median change in concentration was 22 million/ml, motility 25% and morphology 10%. The improvement in concentration and motility were statistically significant. Baseline sperm concentration less than 5 million/ml was associated with no significant improvement. Higher baseline concentrations were associated with significant improvement and resulted in six pregnancies in 26 patients (23%). Oral Lycopene therapy seems to have a role in the management of idiopathic male infertility. Maximum improvement seems to occur in the sperm concentration (66% cases).
200 mg/day pycnogenol improves sperm morphology by 38% in 90 days
Subfertile men were given 200 mg Pycnogenol daily orally for 90 days. Semen samples were analyzed before and after treatment for sperm count, motility score and strict morphology before and after capacitation, and mannose receptor binding. RESULTS: The mean sperm morphology increased by 38% following Pycnogenol treatment, and the mannose receptor binding assay scores (predicts fertilization rates) improved by 19%. CONCLUSION: Pycnogenol therapy resulted in improved capacitated sperm morphology and mannose receptor binding.