Which Supplements Actually Improve Sperm Quality?

Full Transcript: Episode 650

Lisa Hendrickson-Jack: This is the Fertility Friday podcast, episode number 650.

In today’s episode, we’re going to be looking at which supplements actually improve sperm quality. With so much conflicting information out there, it’s important to determine what the research is actually saying and how that can impact the actions that we end up taking.

And what better place to look other than a recent meta-analysis that pulled together 18 placebo-controlled and head-to-head trials of nearly 2,000 men with abnormal semen analysis. And they ranked eight antioxidants against each other. And we’ll be talking about which nutrients actually made the biggest difference for sperm parameters and the implications of that.

If this is your first time tuning into the podcast, I’m Lisa Hendrickson-Jack, certified fertility awareness educator. I’ve been teaching women to chart their menstrual cycles and to use their menstrual cycle as a vital sign for over 20 years. I’m the author of The Fifth Vital Sign, co-author of Real Food for Fertility, and also the founder of the Fertility Awareness Institute, where we teach women’s health professionals to use the menstrual cycle as a true vital sign in practice.

My message has been the same for over 20 years. We really should be using the menstrual cycle as a vital sign because there’s so much that we can learn when we track it accurately, when we pay attention to what our body is saying. So with that said, let’s go ahead and jump into today’s topic.

Given that my focus is so much on the menstrual cycle, why am I always talking about sperm? Well, when you learn how the menstrual cycle works, you quickly realize that women are not fertile every single day of the cycle, like many of us were taught in junior high. There’s only a short window of time where pregnancy can actually happen. And that short window of time is a total of about six days per cycle, the five days leading up to ovulation plus ovulation day itself.

Now, when you’re working with couples who are trying to conceive and they’re actually getting the timing right, meaning that they’re timing sex at the right time, cycle after cycle, and nothing’s happening. They’re not conceiving. There’s not even a hint of any activity. At some point, we really have to start looking at sperm quality to determine if that could be playing a role.

And when you actually look at sperm quality, male factor infertility, poor sperm quality, is the sole factor of…% of infertility cases, and is a contributing factor 50% of the time.

This is why I’m always talking about sperm, because it plays a really crucial role in this whole process. Although as women, we carry the babies, we show all the physical evidence of the pregnancy. At the end of the day, our male counterparts are responsible for 50% of that genetic material. And poor sperm parameters can play a significant role in our risk of miscarriage and even in early childhood diseases. So I think we tend to underestimate the role of sperm, but I will just keep talking about it.

As we dive into the study, there are a few key points that we always want to consider when talking about supporting sperm quality. One is that sperm quality certainly doesn’t just magically improve overnight. The process of sperm development takes an estimated 74 days. So we’re looking at a time frame of at least three months of any type of supplementation or dietary changes or anything of that nature before we’re actually going to see any of those results. And often those results take time to compound. So looking at a time frame of three to six months or more is typically a good idea.

If we go back to the meta-analysis, the researchers were looking specifically at folic acid, zinc, vitamin E, carnitine, selenium, CoQ10, NAC, and vitamin C. So they were looking at these trials that had assessed these particular antioxidants to determine which had the most significant impact on sperm parameters. The most common sperm parameters that are assessed in sperm analysis would be sperm count or concentration, sperm motility, as well as morphology.

The first point that I want to share today from that research paper was that the researchers found that CoQ10 was the only antioxidant that increased sperm count and concentration compared to the placebo. In these studies that they compared, the men were taking anywhere from 60 to 300 milligrams a day for anywhere from three to six months. And when they looked at the numbers, CoQ10 raised sperm concentration by an average of about 6 million per milliliter compared to the placebo. And so that placed it ahead of the other supplements measured. CoQ10 also significantly improved motility and to a lesser extent morphology also.

One of the reasons why CoQ10 tends to have such a strong impact on sperm parameters is because of the impact that it has on mitochondrial function. Similar to egg quality, the health of the mitochondria plays a crucial role in overall sperm quality.

If I take a direct quote from the study, the researchers said, quote, “In humans, CoQ10 is highly expressed in the mitochondria of the sperm midpiece. A lower concentration of CoQ10 was observed in the seminal plasma and spermatozoa of infertile men with low sperm motility.”

Now, although CoQ10 had the strongest effect on sperm concentration and also had a significant effect on sperm motility, carnitine actually produced the largest improvement in sperm motility of any antioxidant that they studied. So carnitine gave the biggest boost to motility. When they looked at all of the studies and they compared all of the results, carnitine improved sperm motility the most, by just under 13 percentage points compared to the placebo.

And of course, the results of this study really do mirror what we shared in the sperm chapter of Real Food for Fertility, where we noted that two to three grams a day of L-carnitine over a period of three to six months has been shown to significantly improve sperm motility.

There is another important takeaway from this study. One of the things that is most interesting about this study is that even though coenzyme Q10 and carnitine both had significant positive effects on concentration and motility, the other antioxidants studied didn’t really have a greater effect than the placebo on any of the main factors. So none of the supplements had a significant positive impact on morphology, motility, or concentration outside of CoQ10 and carnitine beyond what they actually saw in the placebo itself.

I think that that does tell us something interesting. I think that it really highlights the importance of not relying solely on supplementation to fix the whole problem. When it comes to male fertility, there is really good evidence for several key supplements and key nutrients in the role that they play in sperm development, in determining sperm quality, in reducing DNA damage, which is a significant impact with sperm.

And so there’s a number of key nutrients from omega-3 to zinc to folate, vitamin D, to vitamin A. I talk about vitamin A quite a bit. There’s many different factors that play an important role in supporting sperm quality.

But again, with this study showing that many of these supplements didn’t really show a greater impact than the placebo, I think that it doesn’t tell us that these nutrients aren’t important. I think we have plenty of research to show us that there are many key nutrients that we know of that play a really crucial role in sperm development. But I do think that it shows us that supplementation alone may not be the only answer.

I think there’s also an argument to be made that in some cases, the supplement form that we may take is not always the same form that we get in food. There’s a lot of great examples of that. One of the examples would be folate. The folate that we get from food sources is quite different to the folic acid that is often contained in supplements. And other nutrients like iron or zinc, often the form that we are getting from food may be better absorbed. And this applies to a variety of different nutrients. And there are also other cofactors and other nutrients in food that perhaps we haven’t even studied yet that help our bodies to better utilize.

So while supplementation is important, from what I’ve seen working with women who are trying to conceive, working with couples to support and improve sperm parameters over time, you would tend to see better results when you combine a strong nutritional foundation, rich in the key nutrients that we know support sperm quality, versus supplementation just by itself.

And of course, I’ll mention that in the study, they were looking specifically at antioxidants. They did not look at vitamin A. They did not look at omega-3 fatty acids. So there’s a lot of different nutrients that play an important role in supporting overall sperm quality that we really should consider beyond simply trying to supplement for every single piece of it.

One of the ways to cover both bases would be to consider incorporating organ meats, particularly liver. Organ meats are rich in CoQ10. They’re the richest natural food source of CoQ10. And while you may not be able to get sufficient CoQ10 only from diet, and supplementation is certainly warranted when supporting sperm quality, having it as part of the diet certainly does help. Similarly with vitamin A, similarly with folate, B vitamins, liver is rich in many of these key nutrients that naturally support sperm quality and of course, egg quality as well.

Red meat is something to consider as well, given that carnitine had the most significant positive impact on sperm motility. And again, where are we getting our carnitine from in our diet? Red meat is one of the richest sources.

Looking at seafood, fish with the skin on to provide omega-3 fatty acids and to provide other key nutrients that again are known to support sperm quality. And of course, plenty of fruits and vegetables. There are a lot of studies that show the importance of antioxidants in supporting sperm quality. And so looking at green leafy vegetables, looking at dark colored fruits, things like blueberries and other fruits and vegetables that are known to be very high in not only micronutrient density, but high in antioxidants.

Citrus fruits, vitamin C has been shown to support morphology. And this study found that vitamin C did have the strongest positive impact on morphology, though it didn’t significantly surpass the placebo in this case. But there are several studies that link antioxidants, citrus fruits, foods that have a high concentration of vitamin C to supporting sperm parameters.

I think the takeaway from the study is that there are certain key nutrients that do have a more pronounced effect. There are key nutrients that not only support sperm parameters overall, but specific factors. Knowing that CoQ10 had the strongest positive impact on improving sperm concentration, knowing that carnitine had the strongest effect on motility, but CoQ10 also had a positive effect on motility, even knowing that vitamin C had the strongest effect on morphology, although it wasn’t as statistically significant in this case.

But I do think it shows us the potential limitations of relying solely on supplements. I think learning more about which key nutrients support sperm parameters and ensuring that our diet is the foundation by which we are starting to get these nutrients, and the supplements are then supplementing the foundation, I think is the best approach.

And of course, this is important for a number of reasons. As someone who has worked with women in the context of fertility awareness cycle charting, supporting women to conceive by understanding what’s happening in their cycle, when you really start to understand that pregnancy can only happen in a short six-day window each cycle, when you have clients, when you’re working with women who are timing sex correctly, cycle after cycle, and nothing is happening, no pregnancies are occurring, just no activity whatsoever, at some point we should be considering if there is something we should be investigating further with sperm.

So while typically the main focus is on women, the main focus is looking at them, their cycles, their hormones, everything really under the sun with women, which we should be investigating. Absolutely. What can often happen is men fly under the radar, particularly when their semen parameters are higher or around the WHO sperm guidelines.

If there’s one takeaway to have, the standard sperm guidelines were never designed to be optimal. They were never designed to provide optimal numbers for conception. And so if your partner’s sperm parameters are just in line with the World Health Organization, then certainly that does not mean that the parameters are optimal. And one of the things I always say is that there’s no man alive that is so healthy and amazing that he couldn’t even benefit from a multivitamin, for example.

I do think it’s important to consider. We need to move away from this idea that fertility is solely a woman’s issue. And if it’s not happening, she’s the one that has to go make all the changes. We really have to start looking at him as an equal contributor. After all, he’s responsible for 50% of the genetic material. And so it is important to look at all of the factors.

It’s important to learn how to chart your cycles, to be able to identify your fertile window, to time sex correctly. That is an important piece of it. And without correct timing, you don’t really have anything, because if you’re not timing sex at the only point in the cycle where conception can happen, then conception is not going to happen. That’s why we can use fertility awareness as a birth control method. But with that said, we really shouldn’t be looking at timing as the only factor, because while timing is essential, it is certainly not sufficient, especially if we are looking at really particularly poor sperm parameters.

If you’re wanting a much deeper dive into this topic, we have an entire in-depth sperm chapter in Real Food for Fertility. In fact, in that chapter alone, we have more than 250 citations. So it is certainly… together the evidence and the research, not only about the prevalence of infertility, the specific prevalence of male factor infertility, but we also go in depth into the WHO sperm parameters and into the nutrition and supplementation. So into the research, what the research is actually saying, which nutrients have been studied to support sperm parameters and where we can get those from food, and what is that combination of supplementation and nutrition that would really lend itself to the optimal outcome.

Head over to realfoodforfertility.com, grab the first chapter for free. And of course, you can find the book wherever books are sold.

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