It has been stated that fifteen percent of couples have difficulty conceiving and half of them involve a male factor. Male factor infertility is generally brought to light when abnormalities are found on semen analysis, typically an abnormality in sperm density (count), motility (how well the sperm move) or morphology (shape). Sometimes two or all three parameters are abnormal. Unfortunately, sometimes the evaluation uncovers no specific cause for these abnormalities.
Antioxidants have been looked at as a possible solution for a variety of physical ills. They have been looked at as a mean to maintain health and possibly prevent cancer. Therefore it is no surprise that the question has been raised: Can antioxidants help fix an abnormal semen analysis?
Free radicals are reactive molecules with unpaired electrons that can attack and change other substances in their surrounding and cause damage to cells. Although it may be normal to have a low level of free radicals, excess free radicals known as Reactive Oxygen species (or ROS) must be inactivated by antioxidants in the semen if sperm are to function normally. Damage from ROS can affect the fluidity of cell membranes, affecting sperm motility as well as morphology. If the damage is severe enough, theoretically, it can even cause cell death, reducing the sperm count.
Therefore the idea behind antioxidant supplements is to enhance the levels of antioxidants to the point where sperm are maximally protected and fertility potential is amplified. Several products are available that have the goal of supplementing our natural antioxidants. The following is a list of a few antioxidants, relevant to this consideration:
Carnitine: is a diet derived antioxidant that may affect sperm motility. There are two forms of Carnitine: L-carnitine and Acetyl carnitine which may help to stabilize certain cell membranes. They also help to protect sperm DNA. Several uncontrolled studies have documented improvement in sperm motility and concentration after L carnitine supplementation. Doses of 2 grams, three grams or four grams daily have been reported. Effects take two to six months to manifest. However, at least one controlled study of L-carnitine with acetyl carnitine found no significant effects on fertility.
Vitamin E: Vitamin E helps stabilize cell membranes and enhances the activity of other antioxidants. It has been used to improve sperm motility. A typical dose ranges from 400 units daily to three times a day. Unfortunately, prolonged intake of high levels of vitamin E has also been associated with worse outcomes for certain disorders.
Vitamin C: Vitamin C levels are ten times higher in semen than in the blood. Its use has been found to reduce sperm agglutination (sticking together) as well as to improve sperm morphology. A typical dose is 1000mg daily.
Selenium: Deficiency of selenium casuses impaired sperm motility and morphology specifically abnormalities of the midpiece of the sperm. Selenium may work synergistically with vitamin E as antioxidant. Selenium is typically dosed at 200mgcs per day.
Glutathione: Glutathaione combines with vitamin E and selienium to form Glutathione peroxadiase. It is typically dosed at 50 mg daily.
Trace metals: Adequate zinc and copper are needed to maintain the optimal functioning level of certain antioxidant enzymes. Several reports ofn folic acid, 5mg daily and zinc sulfate 66mg daily have been published. Co enzyme Q10 recycles vitamin E and is involved in sperm production. Several reports of coenzyme Q 10 improving motility are in the literature. Dosage varies from 60 to 300 mg per day.
There is abundant evidence for the role of antioxidants in maintaining fertility. Unfortunately, the evidence that increasing intake of antioxidants actually enhances fertility is relatively scant. There are questions for each antioxidant as to the ideal dose and duration of therapy and there are some studies that show that prolonged exposure to certain antioxidants may do more harm than good. Future study will hopefully allow for the optimization of safety and efficacy of antioxidant supplements.