Male factor infertility accounts for approximately 40% of all cases of infertility, the inability to conceive after having unprotected intercourse for one year. The specific cause of subfertility should always be thoroughly explored before treatments are initiated. There are multiple possible causes of compromised sperm parameters including hormonal imbalances, anatomic abnormalities, infection, environmental exposures, and sometimes there is no known cause. Also, certain personal habits may contribute to an abnormal number of sperm, sperm shape, and sperm motility. Spermatogenesis, or sperm production, takes about 80-90 days; therefore, sperm parameters should be reevaluated approximately three months after starting any treatment or lifestyle change.

Lifestyle

Because the optimal sperm production occurs at temperatures lower than body temperature (which is why the testes are located outside the body), men should avoid hot tubs, saunas, or Jacuzzis while attempting pregnancy. It may be beneficial to avoid wearing tight underwear as well. Some medications may affect sperm parameters, so please check with your health care provider if that is a concern. Tobacco use, excessive alcohol use, recreational drugs, and certain environmental factors (pesticides, chemical fertilizers) may reduce sperm counts and cause abnormal sperm morphology. It is known that smoking more than 10 cigarettes a day and/or drinking more than 10 alcoholic drinks a week compromises fertility. Please STOP SMOKING to prevent complications in pregnancy and early childhood development, to prevent heart disease and cancer, and to improve sperm function.

Nutritional Supplements

In addition to lifestyle changes, it may be beneficial to take certain nutritional supplements. Although studies are few and controversial, there are some data that show sperm production, motility, and function may be improved with dietary changes and nutritional supplements. Because of the low cost of these supplements and the low risk of side effects, it may be useful for men with abnormal sperm parameters to use supplements concurrently with fertility therapy. Antioxidants such as vitamins C, E, selenium, Coenzyme Q10 and supplements such as folic acid, zinc, L-Carnitine, and vitamins B6 and B12 have been shown in some studies to enhance sperm parameters (Table 1). For instance, one study showed vitamin E might improve fertilization rates of couples pursuing in vitro fertilization in men with normal sperm values who had poor fertilization with a previous cycle. Be aware that one study demonstrated an increased risk of heart attack in older men who took more than 400 IU of vitamin E per day. One of the many benefits of vitamin C includes treatment for sperm agglutination (or clumping). Zinc supplementation for at least two months has been associated with improving sperm motility. L-carnitine supplementation has been shown to improve sperm concentration and motility. Other studies have shown that selenium and coenzyme Q10 may also play a role in sperm motility. These can be purchased separately or through products such as Proxeed or Fertile One that contain the following vitamins and other supplements thought to enhance male fertility.

Table 1. Nutritional Supplements that May Improve Sperm Parameters

References

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2. Kessopoulow E, Powers HJ, Sharma KK, Pearson MJ, Russell JM, Cooke ID, Barratt A double-blind randomized placebo cross-over controlled trial using the
antioxidant vitamin E to treat reactive oxygen species associated male infertility. Fertil Steril 1995 Oct;64(4):825-31.

3. Lavon L. The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Med 1997; 18 Suppl:S213-9.

4. Lombardo F, Gandini L, Agarwal A, Sgro P, Dondero F, Lenzi A. A prospective
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5. Scott R, MacPherson A, Yates RW, Hussain B, Dixon J. The effect of oral selenium supplementation on human sperm motility. Br J Urol 1998 Jul; 82(1):76-80.

6. Speroff L, Glass R, Kase N. Clinical Gynecologic Endocrinology and Infertility.
Lippincott, Williams & Wilkins.Balt, MD. 2005.7th ed. Ch 30.1135-1174.

7. Takihara H, Cosentino MJ, Cockett AT. Zinc Sulfate therapy for infertile male with
or without varicocelectomy. Urology 1987 Jun; 29(6): 638-41.