Vitamins that may be helpful
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 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 twice daily 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 two times per day. Long-term zinc supplementation requires
1–2 mg of copper per day to prevent
copper deficiency.
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.
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 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 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 (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 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.
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 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.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
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