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LE Magazine July 2003

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Increasing Male Fertility and Longevity
By Dr. Ed Rosick

A healthy lifestyle and nutritional supplements
can help keep your sperm healthy and happy

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There should be no doubt that male fertility in the western world is under assault by the very industries that have given us a high standard of living. However, through lifestyle changes and nutritional supplements, you can protect and nourish your overall health and fertility.

With all the environmental toxins that your body has to fight off each and every day, it makes no sense to put more toxins into your body via cigarettes or excessive alcohol. Numerous studies have shown that excessive alcohol consumption can impair fertility through decreased testosterone production and direct impairment of sperm production and function.17,18,19 Cigarette use can also significantly decrease a man's ability to reproduce. Multiple tests have confirmed that chronic smoking can cause testicular atrophy, decreased semen volume and impaired sperm production.20,21,22 In addition, byproducts of cigarette smoke can significantly increase a person's free radical load, which can damage sperm.

Zinc-an essential mineral for healthy sperm and optimal testosterone levels

One supplement that should be considered absolutely essential for a healthy sperm is zinc. This busy mineral is involved in almost every aspect of male reproduction, including sperm formation, sperm motility and testosterone metabolism. There have been multiple studies on the effectiveness of zinc in treating male infertilty.23,24 A prime example of the usefulness of zinc was illustrated in a study of 37 infertile men with documented low sperm counts and decreased testosterone levels.25 The men were given 60 mg of zinc daily for 45 to 50 days. In 22 patients that had low testosterone levels, mean sperm count increased significantly from 8 to 20 million and testosterone levels also increased.

Selenium and arginine may help
improve sperm motility

Selenium, like zinc, is a mineral that is crucial for maintaining optimal fertility. It is thought that this mineral (that's deficient in many areas of the country) is important for sperm motility. In one study done in Scotland, 69 infertile men were given either placebo, selenium or selenium in combination with vitamins A, C and E for three months.35 At the end of the study, the men who took either selenium alone or in combination with the other vitamins showed significant improvements in sperm motility.

Another supplement that can help increase sperm motility is arginine. This amino acid is a biochemical precursor for the molecules putrescine, spermidine and spermine, all of which are thought to be important for maintaining sperm motility. A study done in Italy on 40 men whose infertility was thought to be due to immotile sperm were given supplemental arginine for six months.36 The men were then rechecked, and a significant improvement in their sperm motility was noted.

Folic Acid-A B vitamin that is needed for
healthy reproduction in women and men

It took many years for mainstream medicine to realize the vital importance of a particular B vitamin, folic acid, in pregnancy. It's now standard protocol for doctors to have their pregnant female patients take folic acid supplements to lessen the risk of having a child born with neural tube defects. What's not so widely known, or told to patients, is that folic acid is also important in maintaining male fertility. A recent study done at the University of California at Berkley highlighted the role of folic acid in maintaining healthy sperm. The study examined folic acid levels in both the blood and semen of 48 men, 24 who were smokers and 24 nonsmokers. They found that low levels of folic acid were associated with a decreased sperm count and decreased sperm motility. The authors also postulated the low levels of folic acid might contribute to sperm DNA damage that can then lead to possible health problems in their offspring.26

Vitamins C and E are essential
antioxidants for maintaining fertility

Multiple studies have shown that optimal vitamin C levels are very important for maintaining healthy sperm; the concentration of vitamin C in semen directly reflects vitamin C intake. It is postulated that vitamin C maintains the health of sperm by protecting the sperm's DNA from free radical damage. A study examined the effects of decreasing vitamin C intake from 250 mg/day to 5 mg/day in otherwise healthy men; the results showed a 50% decline in the men's semen vitamin C levels and a 91% increase in sperm with significant DNA damage.27 Another important study looked at the effects of giving vitamin C supplements to 30 infertile but otherwise healthy men. During a one-week period, the men were either given a placebo, 200 mg/day of vitamin C or 1000 mg/day of vitamin C. The results were important and impressive: the men who received 200 mg/day of vitamin C showed a 112% increase in their sperm count; the men receiving 1000 mg/day had a 140% increase in their sperm count; the men receiving the placebo showed no increase in their sperm count.28

Besides vitamin C, vitamin E helps protect sperm through its ability to inhibit free radical-induced damage to the sperm's outer membrane. In one study, supplementation with vitamin E decreased the peroxidation damage to sperm caused by free radicals and also increased sperm motility.29 In another randomized controlled trial, it was shown that 600 mg/day of vitamin E improved the sperm's ability to fertilize an egg in test tubes.30

L-carnitine and coenzyme Q 10 helps
keep sperm strong and alive

In order to make their long journey through a man's reproductive system, sperm need a significant amount of energy. Carnitine is a supplement that is thought to be involved in both sperm energy production and motility. There have been multiple studies looking at the effectiveness of giving L-carnitine or acetyl-L-carnitine supplements to men who have low sperm counts and sperm with abnormal motility. In one study, 100 men with abnormal sperm were given 1 gram of L-carnitine three times daily for four months. At the end of the study, the men's sperm showed significant increases in motility, as well as an increase in the total number of sperm.31 Another study examined 47 men with abnormal sperm who were given 1 gram of L-carnitine three times a day for three months. The results again showed an increase in sperm concentration, as well as increased sperm motility.32

Another well-known supplement that appears to hold promise for helping men maintain their fertility is coenzyme Q 10. While this important and extremely safe supplement has been in the news of late concerning its beneficial effects for people who have Parkinson's disease, CoQ10 is also important for a sperm's energy production, along with providing protection against free radicals. Initial studies of CoQ10 supplements in men with defective sperm have shown that anywhere from 10 mg/day to 60 mg/day of supplementation can increase sperm counts and motility.33,34

Don't give up your rights to
your health or fertility

I can still vividly recall the joy that overcame me when my wife walked into my office five years ago and showed me her positive pregnancy test and I realized I'm going to be a father! However, for many couples, that wonderment is something that they have a hard time obtaining through no fault of their own. While some things in life can't be controlled, you certainly have a right to live in a healthy environment that does not rob you of your ability to have children. By demanding that the government examine more closely the chemicals that are put into our land, water and air, by buying organic, hormone-free foodstuffs, and by taking the correct nutritional supplements, you can do your part in keeping both yourself and your fertility happy and healthy.

A protocol to maintain healthy sperm

Lifestyle issues:

  • Avoid cigarettes and all tobacco products
  • Avoid alcohol, or at least no more than two drinks/day
  • Increase consumption of organically grown fruits and vegetables, especially cruciferous vegetables like broccoli, cauliflower and brussel sprouts
  • Increase consumption of food containing essential fatty acids, such as wild (not farm-raised) salmon, mackerel, sardines, nuts, avocados and olives)
  • Dairy products in moderation, and only from organic sources that do not use hormones, pesticides or herbicides

Supplements:

  • Daily antioxidant complex that includes 250 to 500 mg of vitamin C and 400 to 800 I.U. of vitamin E (in the form of mixed tocopherols and toco-trienols)
  • Zinc-30 mg/day to no more than 60mg/day
  • Selenium-200 mcg/day
  • Arginine-2 to 4 gms/day
  • Daily Vitamin B complex that contains at least 400 mcg of folic acid
  • Carnitine (either L-carnitine or acetyl-l-carnitine) 500 to 1000 mg three times a day
  • CoQ-10 30 to 100 mg/day

Hormonal replacement:

  • Men who have decreased sperm counts secondary to low testosterone levels may be able to boost their sperm production by increasing their testosterone level via testosterone injections, patches or gel.

Note: A physician trained in male hormonal replacement therapy should monitor any exogenous hormone administration.


References

1. Pizzorno JE. Textbook of Natural Medicine, 2nd edition, 1999: 1377-1387.

2. Shin, D, Honig, SC. Economics of treatments for male infertility. Urologic Clinics of North America 2002 Nov; 29(4): 841-53.

3. Schlegel PN. Is assisted reproduction the optimal treatment for varicocele-associated male infertility? Urology 1997; 49: 435-40.

4. McLachlan et al. Effects of testosterone plus medroxyprogesterone acetate on semen quality, reproductive hormones, and germ cell populations in normal young men. Jour Endo & Metab 2002 Feb;87(2): 546-56.

5. Carlsen E. et al. Evidence for decreasing quality of semen during the past 50 years. British Medical Journal 1992 Sept; 305(6854): 609-13.

6. Becker S, Birhane K. A meta-analysis of 61 sperm counts studies revisited. Fertility and Sterility 1997; 67: 1103-8.

7. Kunstmann AJ et al. Decline in semen quality among fertile men in Paris during the past 20 years. New England Jour Med 1995 Feb; 332(5): 281-5.

8. Irvine S et al. Evidence of deteriorating semen quality in the United Kingdom: birth cohort study in 577 men in Scotland over 11 years. Brit Med Jour 1996 Feb; 312: 467-71.

9. Swan et al. Have sperm densities declined? A reanalysis of global trend data. Envir Health Prospect 1997;105: 1228-1232.

10. Swan et al. The question of declining sperm density revisited: An analysis of 101 studies published 1934-1996. Envir Health Prospect 2000 Oct; 108: 961-966.

11. Burrows PJ. Comprehensive office evaluation in the new millennium. Urologic Clin North Am 2002 Nov; 29(4): 27-41.

12. Aitken RJ. The role of free oxygen radicals and sperm production. Int Jour Androl 1989; 12: 95-97.

13. Zini A et al. Reactive oxygen species in semen of infertile patients. Int Jour Androl 1993; 16: 183-88.

14. Colborn et al. Our Stolen Future. 1996: 1st edition. Chapters 4-5.

15. Akingbemi BT et al. A metabolite of methoxychlor, 2,2-bis(p-hydroxyphenyl)-1,1,1-trichloroethane, reduces testosterone biosynthesis in rat Leydig cells through suppresion of steady-state mRNA levels of the cholesterol side-chain cleavage enzyme. Population Briefs, Population Council 1999; 5(4): 31-2.

16. Fraser LR et al. Effects of estradiol 17B and enviromental estrogens on mammalian sperm function. European Society of Human Reproduction and Embryology 2002 July.

17. Buffum J. Pharmacosexology: the effects of drugs on sexual function. J Psycho Drugs 1982; 14: 5-44.

18. Donnelly et al. Direct effects of alcohol on the motility and morphology of human spermatozoa. Andrologia 1999; 31: 43-7.

19. Villalta J et al. Testicular function in asymptomatic chronic alcoholics: relation to ethanol intake. Alcohol Clin Exp Res 1997; 21: 128-33.

20. El Mulla KF et al. The effect of smoking and varicocele on human sperm acrosin activity and acrosome reaction. Human Repro 1995; 10: 3190-4.

21. Mak V et al. Smoking is associated with the retention of cytoplasm in human spermatozoa. Urology 2000; 56: 463-6.

22. Saaranen M et al. Cigarette smoking and semen quality in men of reproductive age. Andrologia 1987; 19: 670-6.

23. Tikkiwal M et al. Effect of zinc administration on seminal zinc and fertility of oligospermic males. Ind J Phys Pharm 1987; 31:30-34.

24. Takihara H et al. Zinc sulfate therapy for infertile males with or without varicocelectomy. Urology 1987; 29: 63-64.

25. Netter A et al. Effect of zinc administration on plasma testosterone, dihydrotestosterone and sperm count. Arch Androl 1981; 7: 69-73.

26. Wallock, LM, Ames, BN. Adequate folic acid in diet may be important for both men and women of reproductive age. Ascribe Newswire, University of California, Berkley, 2001 Feb.

27. Fraga CG et al. Ascorbic acid protects against endogenous oxidative DNA damage in human sperm. Proc Natl Acad Sci 1991; 88: 11003-06.

28. Dawson EB et al. Effects of ascorbic acid on male fertility. Ann N Y Acad Sci 1987; 498: 312-23.

29. Suleimen SA et al. Lipid peroxidation and human sperm motility: protective role of vitamin E. Jour Androl 1996; 17: 530-37.

30. Kessopoulou E et al. A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated with male infertility. Fertil Steril 1995; 64: 825-31.

31. Costa M et al. L-carnitine in idiopathic asthenozoospermia: a multicenter study. Andrologia 1994; 26: 155.

32. Vitali G. et al. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res 1995; 21: 157.

33. Lewin A, Lavon H. The effect of coenzyme Q10 on sperm motility and function. Mol Aspects Med 1997; 18: S213-19.

34. Tanimura J. The influence of several drugs on male infertility. Bul Osaka Med Sch 1967; 13: 90-100.

35. MacPherson SR et al. The effect of oral selenium supplementation on human sperm motility. Br. Jour Urology 1998; 82: 76-80.

36. Scibona M et al. L-arginine and male infertility. Minerva Urol Nefrol 1994; 46: 251-53.

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