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Male Infertility
Related Terms
• Sperm Motility
Principal Proposed Natural Treatments
• None
Other Proposed Natural Treatments
• Carnitine, Antioxidants, Coenzyme Q10 (CoQ10), Lycopene, Maca, Panax Ginseng, Selenium, Vitamin B, Vitamin C, Vitamin E, Zinc plus Folate, Many Others
Herbs and Supplements to Use Only with Caution
• Andrographis, Licorice, Melatonin, Soy
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Proposed Natural Treatments
References
Male infertility, the inability of a man to produce a pregnancy in a woman, is often caused by measurable deficits in sperm function or sperm count. In about half of all cases, however, the source of the problem is never discovered.
The good news is that without any treatment at all, about 25% of supposedly infertile men bring about a pregnancy within a year of the time they first visit a physician for treatment. In other words, infertility is often only low fertility in disguise.
Proposed Treatments for Male Infertility
Zinc Plus Folate
A 26-week, double-blind, placebo-controlled trial compared the effects of treatment with zinc (66 mg of zinc sulfate, supplying 15 mg of zinc), folate (5 mg), and zinc plus folate against placebo.22 A total of 108 fertile men and 103 men with impaired fertility (“subfertile men”) participated in the study. The two supplements combined significantly improved the sperm count and the percentage of healthy sperm in the subfertile men; neither supplement alone produced this effect, and there was little effect of the combined therapy on fertile men.
For more information on dosage and safety issues, see the full articles on folate and zinc.
Vitamin B12
Mild B12 deficiencies are relatively common in people over 60.1,2 Such deficiencies lead to reduced sperm counts and lowered sperm mobility. Thus vitamin B12 supplementation has been tried for improving fertility in men with abnormal sperm production.
In one double-blind study of 375 infertile men, supplementation with vitamin B12 produced no benefits on average in the group as a whole.3 However, in a particular subgroup of men with sufficiently low sperm count and sperm motility, B12 appeared to be helpful. Such "dredging" of the data is suspect from a scientific point of view, however, and this study cannot be taken as proof of effectiveness.
For more information, including dosage and safety issues, see the full vitamin B article.
Antioxidants
Free radicals, dangerous chemicals found naturally in the body, may damage sperm. For this reason, a number of studies have evaluated the benefits of antioxidants for male infertility.
In a double-blind, placebo-controlled study of 110 men whose sperm showed subnormal activity, daily treatment with 100 IU of vitamin E resulted in improved sperm activity and increased rate of pregnancy in their partners.6 For more information, including dosage and safety issues, see the full vitamin E article.
Preliminary studies suggest that vitamin C may improve sperm count and function.7 However, a recent double-blind study of 31 individuals that tested both vitamin C and vitamin E found no benefit.8 The dosages studied ranged from 200 to 1,000 mg daily. For more information, including dosage and safety issues, see the full vitamin C article.
Other Herbs and Supplements
Growing evidence, including one double-blind trial, suggests that that the supplement L-carnitine or (sometimes taken for this purpose as acetyl-L-carnitine) may improve sperm function.12–20,27
Highly preliminary evidence suggests improvements in sperm function or pregnancy rates with with Panax ginseng,11lycopene,21coenzyme Q,24 and selenium.25
In a double-blind trial of 28 men with impaired sperm activity, use of docosahexaenoic acid (DHA), a component of fish oil, failed to improve sperm health.9 Another double-blind study failed to find L-arginine effective for improving pregnancy rates.26 The herb Lepidium meyenii (Maca) is claimed to enhance fertility, but the one double-blind, placebo-controlled study on the subject merely found that it did not affect male hormone levels (the study did not directly evaluate effects on fertility).28
Many other substances have been suggested as treatments for poor sperm function and infertility, including the herbs ashwagandha, eleutherococcus, pygeum, saw palmetto, and suma, as well as the supplements SAMe, and calcium, but there is no meaningful supporting evidence for these treatments.
In addition, all of the treatments listed in the article on impotence have also been proposed as treatments for male infertility.
Herbs and Supplements to Use Only with Caution
Soy or soy isoflavones,29 as well as the herb licorice10 may reduce testosterone levels in men. For this reason, men with impotence, infertility, or decreased libido may want to avoid these natural products.
Similarly, according to a preliminary double-blind study, the supplement melatonin affects testosterone and estrogen metabolism in men, and may impair sperm function.23
There is contradictory evidence from animal studies on whether the herb andrographis may impair fertility.30,31
References
1. Werbach MR. Nutritional Influences on Illness: A Sourcebook of Clinical Research. 2nd ed. Tarzana, Calif: Third Line Press; 1993:628–629.
2. Saltzman JR, Kemp JA, Golner BB, et al. Effect of hypochlorhydria due to omeprazole treatment or atrophic gastritis on protein-bound vitamin B12 absorption. J Am Coll Nutr. 1994;13:584–591.
3. Kumamoto Y, Maruta H, Ishigami J, et al. Clinical efficacy of mecobalamin in treatment of oligozoospermia: results of double-blind comparative clinical study [in Japanese; English abstract]. Hinyokika Kiyo. 1988;34:1109–1132.
4. Bedwal RS, Bahuguna A. Zinc, copper and selenium in reproduction. Experientia. 1994;50:626–640.
5. Netter A, Hartoma R, Nahoul K. Effect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm count. Arch Androl. 1981;7:69–73.
6. Suleiman SA, Elamin Ali M, Zaki ZMS, et al. Lipid peroxidation and human sperm motility: protective role of vitamin E. J Androl. 1996;17:530–537.
7. Dawson EB, Harris WA, Rankin WE, et al. Effect of ascorbic acid on male fertility. Ann N Y Acad Sci. 1987;498:312–323.
8. Rolf C, Cooper TG, Yeung CH, et al. 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;14:1028–1033.
9. Conquer JA, Martin JB, Tummon I, et al. Effect of DHA supplementation on DHA status and sperm motility in asthenozoospermic males. Lipids. 2000;35:149–154.
10. Armanini D, Palermo M. Reduction of serum testosterone in men by licorice. N Engl J Med. 1999;341:1158.
11. Salvati G, Genovesi G, Marcellini L, et al. Effects of Panax Ginseng C.A. Meyer saponins on male fertility. Panminerva Med. 1996;38:249–254.
12. Loumbakis P, Anezinis P, Evangeliou A, et al. Effect of L-carnitine in patients with asthenospermia [abstract]. Eur Urol. 1996;30(suppl 2):255.
13. Muller-Tyl E, Lohninger A, Fischl F, et al. The effect of carnitine on sperm count and sperm motility [translated from German]. Fertilitat. 1988;4:1–4.
14. Micic S, Lalic N, Nale DJ, et al. Effects of L-carnitine on sperm motility and number in infertile men [abstract]. Fertil Steril. 1998;70(3 suppl 1):S12.
15. Vicari E. Effectiveness of a short-term anti-oxidative high-dose therapy on IVF program outcome in infertile male patients with previous excessive sperm Radical Oxygen Species production persistent even following antimicrobials administered for epididymitis: preliminary results. In: International Meeting on Infertility and Assisted Reproductive Technology, Porto Cervo, Italy, June 11–14, 1997. Bologna, Italy: Monduzzi Editore SpA; 1997.
16. Vicari E, Cerri L, Cataldo T, et al. Effectiveness of single and combined antioxidant therapy in patients with astheno-necrozoospermia from non-bacterial epididymitis: effects after acetyl-carnitine or carnitine-acetyl-carnitine. Presented at: 12th National Conference, Italian Andrology Association; June 9–12, 1999; Copanello (CZ), Italy.
17. Campaniello E, Petrarolo N, Meriggiola MC, et al. Carnitine administration in asthenospermia. Presented at: 4th International Congress of Andrology; May 14–18, 1989; Florence, Italy.
18. Costa M, Canale D, Filicori M, et al. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Andrologia. 1994;26:155–159.
19. Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res. 1995;21:157–159.
20. Moncada ML, Vicari E, Cimino C, et al. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil. 1992;23:221–224.
21. Kumar R, Gupta NP. Lycopene therapy in idiopathic male infertility: results of a clinical trial. Presented at: 34th Annual Conference of the Urological Society of India. January 18-21, 2001; Nagpur, India. Abstract #102.
22. Wong WY, Merkus HM, Thomas CM, et al. Effects of folic acid and zinc sulfate on male factor subfertility: a double-blind, randomized, placebo-controlled trial. Fertil Steril. 2002;77:491-498.
23. Luboshitzky R, Shen-Orr Z, Nave R, et al. Melatonin administration alters semen quality in healthy men. J Androl. 2002;23:572-578.
24. Lewin A, Lavon H. The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Med.1997;18 Suppl:S213–9.
25. Scott R , MacPherson A, Yates RWS, et al. The effect of oral selenium supplementation on human sperm motility. Br J Urol. 1998;82:76–80.
26. Pryor JP, Blandy JP, Evans P, et al. Controlled clinical trial of arginine for infertile men with oligozoospermia. Br J Urol. 1978;50:47-50.
27. Lenzi A, Lombardo F, Sgro P, et al. Use of carnitine therapy in selected cases of male factor infertility: a double-blind crossover trial. Fertil Steril. 2003;79:292–300.
28. Gonzales GF, Cordova A, Vega K. Effect of Lepidium meyenii (Maca), a root with aphrodisiac and fertility-enhancing properties, on serum reproductive hormone levels in adult healthy men. J Endocrinol. 2003;176:163–168.
29. Gardner-Thorpe D, O’Hagen C, Young I, et al. Dietary supplements of soya flour lower serum testosterone concentrations and improve markers of oxidative stress in men. Eur J Clin Nutr. 2003;57:100–106.
30. Akbarsha MA, Manivannan B, Shahul Hamid K, et al. Antifertility effect of Andrographis paniculata (Nees) in male albino rat. Indian J Exp Biol. 1990;28:421–426.
31. Burgos RA, Caballero EE, Sanchez NS, et al. Testicular toxicity assessment of Andrographis paniculata dried extract in rats. J Ethnopharmacol. 1997;58:219–224.
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