Male fertility rates are rapidly declining. In 1940 the average male at a sperm count of 113 million/ ml of semen. Today a count of 20 million/ ml is considered normal!! Although counts above 40 million/ ml have better pregnancy rates. Sperm morphology (which is essentially how many normal shaped sperm there are per sample), have dropped from a normal level of 40% to just 4% considered normal! Once again, a very scary statistic.
Because of this almost 50% of infertility cases are attributed to male factors. Along with this, numerous genetic conditions in a baby such as cystic fibrosis can be attributed to male factors. And yet this is not being discussed enough. So many women are being put through invasive procedures and testing to investigate a couple’s infertility and no one has looked at her male partner. Not even a semen analysis that only involves them masturbating. Which isn’t too far out of the normal everyday box of duties is it boys…
As discussed in my previous blog, importance of preconception care, alcohol, smoking, poor dietary choices (ie junk food, high sugar, low vegetable intake), environmental toxins, stress, obesity can all contribute to male infertility.
So, while it is best to start your preconception journey with removing the above factors, thankfully we also have some wonderful nutrients to support men’s fertility.
CoQ10 would be up there in my number one nutrient for male infertility. This is because it benefits multiple areas of male infertility including poor motility (how the sperm are moving forward), morphology (the shape), and poor sperm numbers. One of the ways it does this is by fuelling the mitochondria. The mitochondria is the powerhouse in every single one of our billions of cells, and gives the cell energy. This is particularly important for a sperm cell that has to travel a long way through treacherous terrain of vaginal acidity, up a cervix, and through a fallopian tube to make it to its destination- an egg. Exhausting just thinking about it. CoQ10 also helps to fight oxidative stress, which is essentially when free radical (bad guys) come in and damage our cells. You may have heard of this in anti-ageing campaigns, but all our cells are sensitive to oxidative stress, and very much a sensitive little sperm cell. Oxidative stress can damage sperm cells, causing them to be immotile and also damage their shape, which prevents them reaching and then joining with an egg cell.
A study of 220 men with low sperm motility, morphology and volume, had significant increases over all parameters after using a 200mg ubiquinol-form CoQ10 for 26 weeks.
Food sources: Small amounts of coq10 are found in spinach, cauliflower, cabbage, oysters, broccoli, beef, pork, chicken. However, you would need to consume up to 77 cups of broccoli to get 100mg of coq10, and the research for improving sperm parameters is using 200-300gm of coq10. Therefore, I always recommend a supplement source.
Recommended dose: 200-300mg of a ubiquinol-form of CoQ10.
Acetyl-L-carnitine is another nutrient with double roles in men’s fertility of improving the energy of a sperm cell and also fighting free radical damage. In particular, acetyl-L-carnitine is my go to in low sperm motility. Acetyl-L-carnitine is involved in fuelling the mitochondria and has been shown to improve immotile sperm cells, to a more rapid forward movement and also a straight movement (important that they aren’t swimming in circles!). Acetyl-L-carnitine has also been shown to improve sperm’s cervical mucous penetration. Many sperm cells can get stuck in a woman’s cervix as it is coated in mucous, so any help getting through there is good. Acetyl-L-carnitine has been shown to improve DNA integrity in a sperm head, which is another important marker of sperm health. If a sperm has DNA fragmentation, essentially the tightly wound chromosomes have separated. DNA from a male is what joins with the DNA of a woman to create an embryo, without this, no fertilisation can take place.
Food sources: we produce the amino acid carnitine from other amino acids, lysine and methionine. Methionine is found in eggs, nuts, beef, dairy products, and lysine in eggs, soya beans, black beans, pumpkin seeds, dairy products, meat.
Recommended dose: all research is on 3g/ daily of acetyl-L carnitine.
Is the most powerful antioxidant in the body. It plays a major role in fighting oxidative stress as well as the production and regeneration of other antioxidant groups. It is also involved in normal immune activity and support liver detoxification pathways.
Decreased glutathione levels have been detected in men with poor sperm motility and morphology compared to men with healthy sperm parameters. Factors such as smoking, alcohol, toxin and heavy metal exposure all reduce glutathione levels in the body.
We can produce glutathione certain foods and exercise is also one of the best ways to increase glutathione in the body, particularly vigorous exercise such as interval training.
Food sources: we can make glutathione from foods such as broccoli, kale, cabbage, cauliflower.
Recommended dose: at this stage, I am a bit dubious about glutathione supplements and how well they work.. I use a combination of n-acetyl cysteine (NAC) and selenium to help the body to make glutathione (see below).
SELENIUM and NAC
Selenium is a trace mineral that is extremely low in our Australian soils and a common deficiency I find in my patients. It is involved in the production of antioxidants such as glutathione and thyroid function. For sperm health it is also directly involved in the production of sperm cells, making it extremely important for men’s fertility. A selenium deficiency has been associated with damage to sperm cells. I will often combine selenium with NAC, an amino acid, for men with poor sperm parameters, as the combination (mentioned above) helps to build glutathione levels in the body. A study looking at combined selenium and NAC supplementation, showed an improvement in sperm concentration, motility and morphology. Both are fairly inexpensive supplements as well, making it a great combo for men’s infertility.
Food sources: selenium is found in butter, brazil nuts, garlic, broccoli, onions and grains grow in selenium rich soil** (unfortunately Au soils are selenium deficient). Meat, chicken, fish, and eggs
Recommended dose: selenium can be supplemented at 100-150mcg ( I will occasionally go higher but please work with your naturopath as there is a risk of selenium toxicity), and NAC at 1-2g/ day.
Zinc is also a trace mineral involved in sperm production as well as helping increase testosterone levels in men. It has powerful antioxidant properties, making it useful for fighting free radicals to improve sperm morphology. Lower zinc levels in seminal fluid have been found in smokers compared with non-smokers. Low seminal fluid zinc levels have been correlated with a significantly lower sperm count and normal morphology of sperm, compared to zinc replete men. Low zinc is also associated with decreased semen volume and decreased serum testosterone.
A study combining zinc (66mg) and folic acid (5mg), found a 74% increase in total normal sperm count in men that has been previously considered subfertile.
Food sources: red meat, beans, chicken, nuts, seeds, ginger
Recommend dose: 20-60mg of a zinc picolinate form
DOCOSAHEXAENOIC ACID (DHA)
DHA is an essential omega-3 fatty acid found in seafood and fish. It can also be found in vegetarian algae sources; however, absorption of algae forms can be problematic with reduced availability so generally seafood is a better form. Unfortunately, with increased contamination in our oceans, seafood and fish are no longer safe food to eat in large amounts. due to possible exposure to heavy metals such as mercury. In combination with this, our diets are extremely high in trans omega 6 fats and saturated fats, increasing our need for omega 3, (DHA and EPA) to overcome the large inflammatory burden these foods place on our bodies.
In human sperm cells, elevated saturated or trans fatty acid concentration and a low DHA level is a concern. Sperm and testosterone production all require a good level of DHA. DHA is also concentrated in a sperm’s head and tail. A low DHA level has been shown to affect acrosome formation. The acrosome is a cap-like structure that covers the sperms head. It helps get the sperm through an eggs protective coat and allows the sperm and egg to fuse. DHA also prevents oxidative stress of a sperm cells, and a low DHA level has been directly linked with poor quality sperm health.
Food sources: oily, cold-water fish such as sardines and anchovies. These are also small fish so minimal risk of heavy metal contamination.
Recommended dose: 400-500mg DHA per day, taken in conjunction in a fish oil capsule with EPA.
My final nutrient for sperm health is not a nutrient at all but a very useful medicinal herb. Withania, also known as Ashwaganda, is one of my favourite herbs, also useful in women’s health and stress conditions, as well as being fabulous for men’s fertility.
A study of 12 men taking 650mg Withania root extract daily for 90 days had the following improvements:
- 167% increase in sperm count (from 9.6 to 25 million)
- 53% increase in semen volume (from 1.7 to 2.76 ml)
- 57% increase in motility (from 18.6 to 29%)
- Serum testosterone increased by 17%/
Withania has also ben shown to improve semen quality by combating oxidative stress and sperm cell death by fighting oxidative damage. It also helps regenerate antioxidants in the body,
Withania also has the added benefit of being an adaptogenic herb, which helps out body to cope with stress, Making it a great herb for burnout and stressed men.
Recommended dose: 3-6g per day of a standardized Withania extract in tablet or tincture form (please see your natural health practitioner for a prescription as many internet sources are not true Withania extract)
The above are just some of the most important nutrients that can improve men’s fertility and there are many more. A high quality antioxidant supplement along with a good quality fish oil can offer the majority of these, and then additional supplements where needed. While I do recommend supplements to improve men’s fertility, no supplement can out do a poor diet and lifestyle. It is essential a man quit smoking and reduce alcohol to a bare minimum before trying to conceive, along with consuming a whole foods based diet (aka no junk food and refined sugars) with a good amount of protein, vegetables, fats, and whole grains. This will greatly increases your chances of not just conceiving, but creating a beautiful, healthy baby.
If you would like specific support with your health and preconception care, please contact firstname.lastname@example.org with any queries you have or to make an appointment. Appointments can also be booked online here
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