Evidence is limited on the medical benefit of herbs or supplements in increasing male fertility. None of these supplements treats a specific underlying cause of infertility, such as a sperm duct defect or chromosomal disorder. However, there are supplements with studies showing possible benefits for improving sperm count or quality, such as: Coenzyme Q10, Folic acid and zinc combination, L-carnitine, Selenium, Vitamin C and Vitamin E, aescin (horse chestnut seed extract), glutathione, Korean red ginseng, nigella sativa, omega-3, and the Menevit antioxidant.
Coenzyme Q10 is a powerful antioxidant that has been shown to be beneficial for a variety of health conditions including male fertility. In men with abnormal sperm parameters, it has been shown to improve both sperm integrity and sperm motility. It may also benefit men with pyospermia, an elevated number of white blood cells in the semen.
Most so-called fertility supplements contain zinc and folic acid. Zinc is an essential mineral for sperm formation, and folate, the natural form of folic acid, depends on zinc to help form DNA in the sperm. Studies of these nutrients as a treatment for male infertility have produced conflicting results. The first randomized, placebo-controlled trials to assess whether folic acid and zinc supplements help to improve male fertility, results suggest that these dietary supplements have little to no effect on fertility and may even cause mild gastrointestinal symptoms.
L-carnitines are essential nutrients in the body with extensive physiological functions and are highly concentrated in the epididymis and sperm. Carnitines play an important role not only in initiating sperm motility, promoting sperm maturation and enhancing sperm fertilizing, but also in protecting sperm against oxidative damage, reducing apoptosis of spermatogenic cells and inhibiting sperm aggregation. Clinical studies in men diagnosed with infertility issues showed that the amount of motile sperm rose significantly and so did the sperm count per ejaculate after treatment, while the percent of sperm with abnormal morphology decreased significantly.
Selenium (Se) is an essential trace element, taking part in many physiological processes as an antioxidant and a component of metabolic changes, e.g., the metabolism of thyroid hormones. The potential benefits are mainly due to the fact that Se is a cofactor of the antioxidant enzyme (GPx) and a component of two selenoproteins (phospholipid hydroperoxide glutathione peroxidase (PHGPx/GPx4) and selenoprotein P), which are involved in spermatogenesis. Se was shown to cause a significant increase in sperm count, mobility, viability, normal sperm morphology, and ejaculate volume. Se, in combination with vitamin E, has been shown to be effective in improving sperm parameters and pregnancy rates in infertile men with idiopathic asthenoteratospermia. On the other hand, Se is known to exert toxic effects on various tissues and organs, especially the testes.
Importantly, even with supplements, there may still be side effects from taking them at increased doses.
