What supplements can help increase fertility in men?

Supplements for Increasing Male Fertility

Antioxidant therapy may improve sperm parameters in men with infertility, but evidence for improving live birth rates remains conflicting and of low quality. 1

Recommended Supplements with Some Evidence

• Antioxidants: European Association of Urology (EAU) guidelines acknowledge that oxidative stress is an important contributing factor to idiopathic male infertility, but evidence for antioxidant therapy remains conflicting 1
• Prebiotic/probiotic supplements: A randomized controlled trial (RCT) of 56 men with idiopathic infertility showed significant increases in sperm concentration, motility, normal morphology, and DNA integrity with prebiotic/probiotic supplementation compared to placebo 1
• Omega-3 fatty acids: Found in fish and nuts, these have shown some of the strongest evidence for improving male fertility parameters 2
• Coenzyme Q10: Has demonstrated positive effects on male fertility in small RCTs 3
• L-carnitine: Shows beneficial effects on sperm parameters in small controlled trials 3
• Selenium: Supplementation has shown positive effects in small RCTs 3
• Zinc and folate combination: Has demonstrated benefits for male fertility in controlled studies 3
• Korean red ginseng: Shows positive effects on male fertility parameters in limited studies 3

Lifestyle Modifications to Improve Fertility

• Weight loss: EAU guidelines strongly recommend weight loss for overweight or obese men as it can enhance sperm parameters 1, 4
• Regular physical exercise: Recommended as it can improve sperm parameters and overall health 1, 4
• Smoking cessation: Should be encouraged as it can improve sperm quality 1, 4
• Alcohol moderation: High alcohol intake has been negatively associated with fecundability rates 5, 3

Dietary Recommendations

• Increase consumption of:

  • Fish, shellfish and seafood 5, 2
  • Poultry 5
  • Nuts and whole grains 5, 2
  • Fruits and vegetables 5, 6
  • Low-fat dairy products 5

• Decrease consumption of:

  • Processed meats 5, 6
  • Full-fat dairy products 5
  • Sugar-sweetened beverages and sweets 5
  • Red meat 5, 7
  • Trans fatty acids and saturated fats 5, 7

Important Considerations and Caveats

• The quality of evidence for most supplements is low, with many studies having methodological limitations 8
• Spermatogenesis takes approximately 74 days (about 2.5 months), so any intervention requires at least this timeframe to show full effects 4
• For men with severe oligoasthenoteratozoospermia (OAT) syndrome, assisted reproductive technology may be more effective than supplements alone 4
• Underlying conditions such as varicocele, accessory gland infections, and hormonal imbalances should be treated as they may impact fertility outcomes 4
• Testosterone therapy is contraindicated in men seeking fertility as it suppresses spermatogenesis 1, 9

Hormonal Considerations

• For men with secondary hypogonadism seeking fertility, gonadotropin therapy (hCG with or without FSH) is recommended rather than testosterone replacement 1
• Selective estrogen receptor modulators (SERMs) may increase pregnancy rates and improve sperm and hormonal parameters, but evidence quality is low 1

Remember that while supplements may improve sperm parameters, they may not necessarily translate to improved pregnancy or live birth rates. A comprehensive approach including lifestyle modifications and treating any underlying conditions is recommended.