To Your Health

I have a 10-year-old son by a previous marriage, but after trying for six years, it looks like my husband may not be able to father a child. We simply cannot afford the cost of the entire batch of medical tests and treatment that insurance will not cover. What could nutritional supplements do to help?

Q. I have a 10-year-old son by a previous marriage, but after trying for six years, it looks like my husband may not be able to father a child. We simply cannot afford the cost of the entire batch of medical tests and treatment that insurance will not cover. What could nutritional supplements do to help?

A. This topic is complex, and infertility has two sides. Even though you have a 10-year-old child, you or your husband (either or both) might now be unable to produce offspring, so we need to keep an open mind and mount a team effort. However, if we assume you are still fertile, the subject to discuss becomes male infertility. This is much less studied though it probably accounts for a lot of childless marriages.

Males and females have different strategies for reproduction. Women invest a lot of resources in producing a single large egg, while men produce millions of much less complicated sperm. For your husband, the ability to generate sperm is the first project, and there is no doubt that nutritional supplements make a difference. It really is difficult to prioritize the nutrients men need for sperm production, so the nutrients below are not listed in order of importance.

Zinc has been associated with male reproduction for decades, so it is well recognized as a critical nutrient for men. Experimental zinc deficiency reduces sperm production, and a zinc supplement normalizes the sperm count. Zinc supplements also increase the production of testosterone, and zinc deficiency appears to be one of the primary reasons for reduced testicular function in males. Cadmium, a toxic mineral that directly competes with zinc, is found in significantly higher levels in the blood and semen of male smokers who have sluggish sperm. There is also evidence to suggest that lead, another zinc antagonist, may be toxic to sperm at levels that were previously thought to have no effect. Zinc is safe to use in amounts up to 120 mg/day, as long as there is no stomach distress.

In about half the men given 60 IU vitamin E per day, the total number of sperm increased, and the percentage of abnormal sperm decreased, and in addition, it produced a modest increase in semen volume.

Once sperm cells are produced, they must make their own way to the awaiting egg. Most of the same nutrients needed to produce sperm also improve sperm motility, the ability of sperm to move. The same zinc supplement mentioned above that increased sperm production also improved sperm motility. A very high supplement of L-Carnitine, 3,000 mg/day, can also improve sperm motility in most men. L-Carnitine transports the fuel molecules needed for energy production, so it is reasonable that it would help sperm motility.

Folinic acid, a form of folic acid, supplemented at 15 mg/day, improved the number and motility of sperm during a three-month period and also reduced the number of obviously immobile, tailless sperm. The changes were most remarkable in those men whose partners subsequently became pregnant. Again, that is a lot of folinic acid, almost 40 times the amount ordinarily found in a multivitamin, but folic acid is important for all rapidly dividing cells.

A vitamin C supplement of 200 mg/day produced measurable improvement in sperm motility after one week and each week thereafter, but 1,000 mg/day produced an even more rapid improvement. There was also a significant reduction in the percent of abnormal sperm along with other evidence of improvement in sperm quality. Clearly, a daily dose of 1,000 mg of vitamin C is a very inexpensive way to help any infertile male, since it seems to help almost every aspect of sperm function.

Sperm contains high concentrations of the omega-3 essential fatty acids, especially docosahexaenoic acid (DHA), the fatty acid in fish oil. DHA is very susceptible to oxidative damage, and this damage can spread throughout the cell, ultimately killing the sperm cell. For this reason fat-soluble antioxidants such as vitamin E and Coenzyme Q-10 (in addition to water-soluble vitamin C) are critical. The activity of sperm is directly correlated with their vitamin E content, and supplements of vitamin E have improved fertilization rates within one month of supplementation. Coenzyme Q-10, another fat-soluble antioxidant, also improves low fertilization.

Summing up: To improve your husband's odds of producing healthy sperm, choose for him a multivitamin/mineral with generous amounts of all the vitamins and minerals, and then add about 60 mg of extra zinc. Find a good antioxidant blend with generous amounts of vitamin C and vitamin E. Coenzyme Q-10 is a prudent addition to these more familiar antioxidants. If more fish on the menu is not attractive, use the capsules with both DHA and EPA (eicosopentaenoic acid) at about 2,000 mg per day as a source of DHA. EPA can be made into DHA, and the two together are much less expensive than pure DHA. Legal restrictions prevent folic acid supplements higher than 0.8 mg per pill, but liquid folic acid makes it easy to get the 15 mg/day used in the research. If your husband works in a contaminated environment, it may be worthwhile to change jobs and avoid exposure to toxic minerals. If he is a smoker, he should certainly quit.

May you have a beautiful baby!

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