It is estimated that male factor problems account for roughly 40% of all fertility cases. This includes situations where there is a combination of male and female infertility. Research, especially in the area of nutrition and acupuncture, is showing that changes in diet, lifestyle, and having regular acupuncture are improving male fertility. In this post I am outlining the basic recommendations that a naturopathic doctor would consider for male fertility. However, these are general guidelines, and it is important that men ideally see a naturopathic doctor to get specific treatment for improving their health and fertility. One important note: any therapy you begin for male fertility must be used for at least four months before testing to see if there is improvement.
The most important marker for male fertility is the number of sperm that are regularly found in the ejaculate. Men are most likely to be fertile with a sperm count over 48 million per milliliter of semen and least likely with counts below 13.5 million, although healthy fertile men are expected to have counts of 100 million or more. Unfortunately, for a number of possible reasons, mostly environmental, we know that the counts of men world-wide are declining.
Men should be aware that eating animal products like beef and chicken, could lower their sperm count. Working with industrial chemicals and pesticides can render a man infertile. These are documented concerns, because in all of these examples, men are at risk of exposing themselves to xeno-estrogens, which are the by-products of an increasingly polluted world.
Xeno-estrogens introduce synthetic estrogen into a man’s body, and this can dramatically interfere with his ability to produce sperm. In Britain, environmentalists have found that fresh water male fish are becoming “feminized” and unable to reproduce. Here in Canada, David Suzuki has talked about the impact of xeno-estrogens on the ecosystem and human health. Other concerns are exposure to pesticides, heavy metals, and radiation. Obviously, a man’s reproductive system is vulnerable to these environmental “toxins” in the industrialized world.
There are other possible causes. Trauma brought about by contact sports or injury; infections that affect the reproductive tract; and lifestyle habits such as smoking and alcohol consumption. Too much heat generated around the testicles can reduce sperm count and motility. Male cyclists are at risk for this, as are men who wear briefs instead of boxers, who sit for long periods of time, and who regularly have a computer sitting on their laps. Obesity can also have a devastating effect on male fertility, with most obese men showing lower levels in all sperm parameters of count, motility, and morphology.
The best and simplest thing a man can do to improve his fertility is to increase his fruit and vegetable consumption. The simplest way to do this is to make sure that at each meal half of what is consumed is fruits and/or vegetables. I call it the 50/50 rule, and based on my clinical experience it is a simple yet very effective way to make a big difference in overall health and fertility.
Besides improving diet, there are literally hundreds of nutritional studies showing the effect of nutrient supplementation on fertility. Male fertility has been especially studied, mostly because it is much easier to measure the effect of supplementation on count, motility, and morphology. I have outlined here the most commonly prescribed nutrients and their food sources. As always, you are encouraged to consult with a naturopathic doctor or nutritionist to determine which supplements are best for you, as well as the correct dosage.
As antioxidants, vitamin C and selenium are known for their ability to “quench” free radicals. We know that sperm are sensitive to free radicals because they are so dependent on the integrity of the sperm’s cell membrane. And it is through the cell membrane that a free radical will inflict its damage. With vitamin C and selenium supplementation, the sperm is protected against this free radical damage. Also, sperm agglutination, where the sperm “stick” or clump together, is reduced with Vitamin C. Good sources of vitamin C are parsley, papaya, bell peppers, strawberries, broccoli, pineapple, Brussels sprouts, kiwi fruit, oranges, cantaloupe, lemon juice, cauliflower and kale. For selenium, the best source is brazil nuts, followed by crimini mushrooms, cod, shrimp, tuna, halibut, salmon, mustard seeds, shitake mushrooms, chicken, eggs, barley, and turkey.
Zinc is probably the most critical trace mineral for male fertility. It is involved in almost every aspect of male reproduction including the hormone metabolism, sperm formation, and sperm motility. A deficiency in zinc can result in decreased testosterone levels and sperm count. Food sources of zinc are pumpkin seeds and oysters. Pumpkin seeds are best consumed on a daily basis, while oysters could be eaten 1-2 times per week. Although oysters are low on the list of mercury content, it is always prudent to exercise caution with all fish and seafood. Other sources of zinc are meats, beans, chickpeas, legumes, cashews, oatmeal, almonds, yogurt and cheese.
Arginine is an amino acid needed in the replication of cells, and is considered important for male fertility. Studies have shown L-arginine improves sperm count and motility without side effects. It is also used for erectile dysfunction due to its positive effect on blood circulation. Dietary sources of arginine are dairy products, meats, nuts, seeds, buckwheat, oatmeal, chickpeas, and cooked soybeans.
Another amino acid that has been talked about a lot is carnitine. Carnitine is essential in the transport of fatty acids into the cell mitochondria. Mitochondria are sometimes described as "cellular power plants", because their primary function is to convert organic materials into energy. So think of carnitine as the way in which a cell is able to make its energy. This makes sense when we learn that the higher the carnitine content in the sperm, the better the motility. It also helps to increase the sperm count, and should be a primary supplement that is considered for male fertility. Food sources of carnitine are nuts and seeds, legumes, vegetables, fruits, whole grains, bee pollen, brewer’s yeast, and carob.
Co-enzyme Q10 (CoQ10) is most concentrated in the mitochondria of sperm, and is important for sperm motility. CoQ10 is also an antioxidant and therefore, like vitamin C and selenium, protects the sperm’s cell membranes against free radicals. As a supplement, CoQ10 is known to increase sperm counts and motility. Dietary sources are olive, coconut, sunflower seeds, in vegetables like parsley, broccoli, cauliflower, spinach, and Chinese cabbage, and in fruits such as avocado, black currant, strawberry, orange, grapefruit and apple.
The use of acupuncture dates back approximately 4000 years, and is part of Traditional Chinese Medicine, a system of medicine which aims to balance energy and blood in the body in order to keep it functional and healthy. Basically acupuncture will improve circulation and stimulate the body’s natural healing abilities. This results in a reduction of inflammation, and promotes physical and emotional well-being. It is also helping to improve sperm parameters.
As with the positive studies on women receiving acupuncture during IVF, men can greatly benefit from having regular acupuncture. A study published in Andrologia showed that weekly acupuncture sessions on azoospermic and severely oligozoospermic males resulted in 67% of them being able to produce sperm (in the cases of azoospermia) or had an increase in sperm count.
Research has shown that smoking and alcohol consumption can have a negative effect on sperm. Therefore, if you smoke, stop. If you have more than three alcoholic drinks per week, you must cut down. In some cases I ask the man to stop alcohol completely, especially if the couple is preparing for IVF. Don’t use recreational drugs like marijuana, and avoid saunas and hot tubs. Wear boxers, not briefs.
Modify your exercise routine: exercise less if you are doing more than an hour of intense activity on a daily basis, and exercise more if you are sedentary or only make time for short sessions of exercise once or twice per week. It’s good to sweat, but within reason. If you’re not sure what is reasonable for you, it is best to consult a personal trainer.
I encourage every man who is experiencing reduced fertility to see a naturopathic doctor. Most employee benefits plans have coverage for naturopathic care, and many naturopathic doctors have evening and weekend appointments. There should be few excuses as to why a man would hesitate to take the steps that have been shown to improve fertility. The situation is not always hopeless, and the real benefit with seeking out naturopathic care is that overall health will improve. That is a plus that is worth every bit of your time, money, and effort.