by Dallas Clouatre, Ph.D.
Approximately one in six couples in the
United States desiring children encounters
major difficulties in conception. Experts
estimate that in a third of all such cases,
it is the man’s fertility that is at the root of
the problem and in another third the
man’s fertility contributes to the difficulties.
Approximately six percent of males
are infertile.
Male infertility is an increasingly
pressing problem in the industrialized
world. Sperm counts have dropped more
than half over the last 50 years (from
about 160 million per milliliter of semen
to 66 million according to a 2002 report
in the London paper, The Independent)—most likely due to pollution. In the United
Kingdom, the Medical Research Council
reports that the fertility of Scottish men
born since 1970 is 25 percent less than
those born in the 1950s, with sperm
counts continuing to drop by two per cent
a year. Similar results are found in the
U.S. At fault is a whole class of hormonedisrupting
chemicals that we have added
to the environment, including solvents,
pesticides and household chemicals.
These chemicals, which are almost universally
estrogenic in their actions,
increase cancer in both women and men
and damage the immune system as well
as impairing male fertility. Also at fault is
the increasing load of heavy metals, such
as mercury, that burdens the food supply.
In the vast majority of cases of male infertility,
the issue is insufficient sperm production.
In about 10 percent of cases, it is
sperm motility that is chiefly implicated.
Some of the factors that influence fertility
are relatively easy to control. For
instance, it is well established that tight
fitting clothing and underwear that raise
the temperature of the testes reduce
sperm production. Similarly, stress,
many prescription drugs, alcohol and
tobacco, exposure to radiation and similar
elements from the environment and
habits all reduce sperm count. Many of
the most powerful influences involve the
food supply and it is in this area that natural
remedies shine.
Several aspects of health governed by
nutrition influence fertility. Low or marginal
testosterone levels often reflect
nutritional status, such as an inadequate
intake of the mineral zinc. Elevated
estrogen levels in men may indicate not
just environmental factors, but also
excess weight inasmuch as fat cells produce
estrogen. And then there is the
issue of free radical damage: a large and
growing scientific literature supports the
thesis that free radical or oxidative
damage reduces sperm count, quality
and motility.
Deficiencies in simple vitamins and
minerals can have a dramatic impact on
fertility. In cases of extremely low sperm
count, vitamin B12 (e.g., methylcobalamin)
has proven to be useful in one half
of patients treated. Folic acid also may be
helpful. Similarly, a marginal intake of
vitamin C is linked to oxidative damage
to sperm DNA, reduced sperm production,
and poor sperm motility. Adding
200 mg or more vitamin C to the daily
diet in one study of infertile men
improved sperm count, viability and
motility while simultaneously reducing
abnormalities, immaturity and agglutination
(clumping). Indeed, vitamin C treatment
over a period of 60 days appears to
be as effective as is pharmaceutical treatment
with mesterolone or clomiphene
citrate. As for the minerals, zinc can be a
crucial link to fertility in men with low
testosterone levels.
Free radical scavengers and nutrients
that support the body’s own production
of antioxidants have been shown to powerfully
influence sperm quantity and
quality. For example, the mineral selenium
is very important to male fertility both
because of its support for the production
of glutathione and because selenium
containing proteins are found in the
sperm, where they are important structural
components. Supplementation in
conjunction with vitamin E may be
important for the realization of selenium’s
benefits. In one trial, supplementation
with the combination proved
effective in normalizing the number of
live sperm, their motility and regularity.
Of course, vitamin E itself is important in
normalizing sperm number and motility,
as has been shown in clinical trials.
Natural gamma-tocopherol, which is the
much preferred form of vitamin E, is the
item of choice here. Another important
antioxidant and free radical scavenger
that has been shown to enhance sperm
quality is Pycnogenol® (pine bark
extract).
Coenzyme Q10 is yet another free radical
scavenger with special benefits for
enhancing sperm quality. Research has
demonstrated that CoQ10 is necessary
for the proper mobility of the sperm and
the protection of sperm membranes. Of
significance also is the fact that seminal
fluid CoQ10 levels often are low in men
with reduced sperm count and poor
motility. In infertile men, the amount of
CoQ10 in the seminal plasma correlates
directly with sperm count. Clinical trials
have shown improvement in sperm
count and mobility when CoQ10 was
supplemented.
When most people think of nutritional
support for fertility, they think of the
amino acid L-arginine. Certainly, a deficiency of this nutrient is associated with
poor sperm production and health. The
amino acid is required for the production
of nitric oxide and other components
of sperm replication and motility.
An L-arginine deficient diet can reduce
sperm count within less than two weeks.
Supplementation with L-arginine in one
study of men with low numbers of active
sperm improved the counts in three
quarters of the subjects after three
months. However, men with extremely
low sperm counts are less likely to benefit from supplementing with L-arginine
alone.
Finally, acetyl-L-carnitine appears to
be primarily responsible for supplying
energy to the sperm and free L-carnitine
found in seminal fluid correlates directly
with sperm count and motility. Trials
with L-carnitine have demonstrated efficacy in increasing both sperm count and
motility. In one such trial with 47 infertile
men, 79 percent responded with greatly
improved sperm counts after three
months of treatment. L-carnitine leads
to the greatest improvement in men
whose sperm motility is most impaired.
Some new forms of L-carnitine are likely
to strongly enhance the known benefits
of the compound. Only recently available,
for instance, is acetyl-L-carnitine
arginate, a compound that supplies both
one of the most bioavailable forms of Lcarnitine
and L-arginine, hence performs
double duty when it comes to supporting
male fertility.
Auxiliary nutrients may improve the
impact of primary compounds in nutrition
and in supplementing for infertility
this can be important. Taurine and
lecithin themselves are linked in medical
research to membrane stability as well
as sperm quantity and quality, but they
play a further role in improving the
uptake of other nutrients. In the case of
taurine, there is evidence that this amino
acid plays a role as a universal carrier of
fat-soluble vitamins and other nutrients.
It is clear that there are good natural
approaches available to men seeking to
improve fertility. Vitamins and minerals,
such as vitamin C and E plus zinc, premiere
antioxidants, such as CoQ10, and
specialty compounds such as acetyl-Lcarnitine
arginate, can be combined to
support all the known nutritional bases
of support. One such formula, FertilOX™
from Jarrow Formulas®, has already
made it to the cutting edge of nutritional
support and provides all of the nutrients
discussed above in tablet form. This
surely is good news to the 15 percent of
couples in the United States who desire
children and currently are having difficulties
in achieving conception.
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