NOW-fertility consultant Riadh Ben Temime explains some of the factors affecting male fertility and how nutritional supplements might help.
The World Health Organisation (WHO) estimates that infertility affects nearly 190 million people worldwide, with male infertility accounting for up to 50% of the nearly one-in-five couples who seek help when trying to conceive. At the same time research has shown that sperm counts have declined over the past 40 or so years in men from North America, Europe, Australia, and New Zealand in particular.
These statistics make it even more important for fertility doctors to ensure they look at both men and women when assessing why they may be having problems conceiving naturally. Initial screening to evaluate male fertility should include a thorough history, a physical examination and two semen analyses.
In fact, semen analysis is the cornerstone of male fertility evaluation and WHO guidelines provide the basis for reference values worldwide via its laboratory manual for the examination and processing of human semen; it has been regularly revised since first published in 1980 and last year WHO published its 6th edition.
The causes of male infertility are various; They include infections, varicocele, hormonal disorders, genetic disorders, and environmental factors. However, male infertility remains idiopathic in almost 40% to 60% of the cases. This makes it extremely important to live a healthy lifestyle. Not smoking, maintaining a normal body weight, limited alcohol consumption and exercise are recommended to improve semen quality.
There are also recent studies that indicate the important role of nutrients, vitamins, and minerals in sperm health. The majority of the clinical trials that study the effects of various types of antioxidant supplements on sperm health and pregnancy rates confirm a beneficial effect of antioxidants on at least one of the key semen parameters; the biggest effect was determined on sperm motility – the sperm’s ability to move efficiently.
The trials saw different combinations of antioxidants assessed, including vitamin E, vitamin C, selenium, Coenzyme Q10, N-acetylcysteine, L-carnitine, and zinc. Micronutrients improved seminal fluid conditions, provided energy to male germ cells, protected these cells from oxidative stress and reduced sperm DNA fragmentation.
Since spermatogenesis is an energy intensive process, it requires a highly balanced supply of minerals, antioxidants, and nutrients. Vitamin and antioxidant supplementation is used to help oxidative stress-induced sperm abnormalities and it works by reducing protein and DNA damage and apoptosis.
Most of the studies that looked at the effect of supplementation reported improvements in at least one semen parameter: The most noteworthy effect was increased sperm motility and concentration when multiple antioxidants were used.
However, there is still a lack of agreement amongst experts on what dose of supplements would benefit sperm the most, how long the treatment should last and whether supplements work best when taken singularly or when combined with other oral antioxidants.
So once again, my advice to patients – alongside consulting a fertility specialist – comes back to some of the points I raise above; eat healthily, avoid drinking excessive amounts of alcohol, don’t take recreational drugs and maintain a healthy body weight via regular exercise.
Speak to your GP or fertility doctor about the supplements they think may be beneficial to you, based on your lifestyle and fertility issues.
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