Male infertility, the inability of a man to produce a pregnancy in a woman, can be caused by a great variety of problems, from anatomical defects to hormonal imbalances. 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.
Treatment
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. A total of 108 fertile men and 103
men with impaired fertility (“subfertile”) 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. 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
B12 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. 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.
However, a recent double-blind study of 31 individuals that tested both vitamin
C and vitamin E found no benefit. 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
Incomplete evidence suggests possible benefit with Panax ginseng,L-carnitine or
acetyl-L-carnitine , a tomato extract containing lycopene, coenzyme Q10, and
selenium.
Docosahexaenoic acid (DHA), a component of fish oil, has also been evaluated as
a possible treatment for infertility, but a double-blind trial of 28 men with
impaired sperm activity found no benefit. Another double-blind study failed to
find L-arginine effective.
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.
All the treatments listed in the article on impotence have also been proposed as
treatments for male infertility.
Not Recommended Treatments
The herb licorice may reduce testosterone levels in men. For this reason, men
with impotence, infertility, or decreased libido may want to avoid this herb.
Similarly, according to a preliminary double-blind study, melatonin affects
testosterone and estrogen metabolism in men, and may impair sperm function.