This post was updated on May 20th, 2019
If you have reason to suspect that the reproductive functions of the man of the house may be contributing to recent difficulties in your baby-making partnership, then a course of antioxidant male fertility supplements may be on the horizon for your team. You certainly wouldn’t be alone in this situation with 30% of infertility issues amongst couples attributable solely to male factors, while another 20% are a result of both male and female factors. With statistics like this, it seems there are a lot of couples wanting to know how to increase fertility in men.
When a man has no underlying health issues concerning his fertility, oxidative stress can often be the cause of poor sperm performance. But what the heck is “oxidative stress” and more importantly what can be done about it? Here’s a summary of the most important stuff worth knowing about if you’re looking for how to increase male fertility.
Sperm and oxidative stress
Sperm cells are fragile wee-things and have a long gauntlet to run from the time of manufacture in the testes, until they arrive at their intended destination. Whether conceiving naturally, or through any number of assisted reproduction techniques, sperm are constantly exposed to a subset of free-radical compounds, known as reactive oxidative species (ROS).
While low levels of ROS play a critical role in the normal functioning of sperm, an increased concentration can damage the fatty tissue that forms the membrane of sperm cells resulting in reduced motility and negatively impacting its ability to fuse with a female egg. ROS can also alter sperm DNA, resulting in the passage of defective paternal DNA on to the fetus and thus making a successful pregnancy unlikely.
The body produces antioxidant compounds as a natural defense against these ROS, but when the dynamic equilibrium between antioxidants vs. oxidants swings in favor of the later, oxidative stress occurs, triggering a reduction in reproductive performance from the affected batch of swimmers.
Antioxidants as male fertility supplements
Given the simplicity of the mechanism by which oxidative stress reduces male fertility, if an imbalance is suspected, then treatment via antioxidant supplements seems a sensible course of action. Antioxidants, are essentially vitamins and indeed, there is a massive industry of nutraceuticals being supplied to men who are looking to improve their fertility through supplementation products.
Which male fertility supplements are good to take?
One of the biggest challenges for couples looking to buy antioxidants is finding good quality, independent information on the efficacy of various compounds. This is because, like all fertility drugs for men, most of the people that will tell you about the benefits of various antioxidants have something to gain from you making a supplement purchase either directly, or through affiliations.
This is not the case here, as I can pinky-swear that I receive no benefits (of any kind) from suppliers of male fertility supplements.
While most vendors of various antioxidants can point to scientific studies that support their product claims, having just one or two studies that demonstrate an improvement in fertility, does not mean it’s a cure. While this is a downside of being at the leading edge of science, as some surely manufacturers are, it’s also something we need to be wary of when making our purchasing decision.
What science really says about antioxidant supplements
Having spent days trawling the scientific literature for the best information on the efficacy of antioxidant supplements, I can safely report that while the quality of evidence is poor, there is a scientific consensus that antioxidants do actually improve male fertility outcomes.
After a review of 48 randomized controlled trials assessing the efficacy of antioxidants in a total of 4179 sub fertile men, Showell et al. (2014) reported that the probability of a couple having a live birth where the male is sub fertile increases from 5% where no antioxidant supplements are taken, to between 10-31% after treatment with oral antioxidants.
The table below shows a summary of the results report by Showell et al. (2014) after 3 months of treatment where a check (✔) indicates that the antioxidant was demonstrated as effective, while crosses (✗) indicate either no or negative effects were observed i.e. you’d do just as well taking a placebo. While several fertility vitamins for men have been tested, other compounds have been shown to have antioxidant efficacy also and thus help to improve male fertility.
Table 1. Summary of 48 randomized controlled trials assessing the efficacy of antioxidants after 3 months of treatment (Showell et al. 2014).
In a similar review of 32 primary studies on men with poor sperm quality, Kumalic and Pinter (2014) made the following conclusions regarding the efficacy of various antioxidants:
- Sperm Motility: Vitamin E, Coenzyme Q10, and Selenium treatments have been most often found effective for men with low sperm motility.
- Sperm Concentration: Vitamin E and Coenzyme Q10 were most often proved to be effective for men with low sperm concentration.
- Sperm Morphology: Selenium and Coenzyme Q10 were most often proven to be effective for helping men with a high number of abnormal shaped sperm.
- DNA Damage: Vitamin C, Vitamin E, Zinc and Selenium showed the most favorable effects on DNA fragmentation.
In case you were confused with the contrasting conclusions regarding the efficacy of Coenzyme Q10 between the two scientific reviews, this appears to be a result of the treatment duration. Coenzyme Q10 has been reported to be relatively ineffective after 3 months, as shown in Table 1 above, but positive results have been found when this fertility pill for men is taken for 6 months or more.
How to use this knowledge to buy the best male fertility supplements
At the risk of boring you to death with the details of these scientific studies, I have done so to give you the power to discern a “good” antioxidant supplement from a not-so good one, and when you start looking for the “best male fertility supplements”, you’ll soon see that there are many products out there with relatively light support for their claims of efficacy.
Whether recommended by your physician, or selected by your own good judgment, my advice for choosing an antioxidant that will work best is to find one, or a combination of a couple of products, that have high doses of the key compounds shown above that we now know improve male fertility.
If you want to get really technical in your analysis, you can even look at the cost/mg of each of the important antioxidants, and then buy the supplement that offers you the lowest cost for the most active ingredients.
Are you a suitable candidate for antioxidant male infertility treatment?
While this might be backwards thinking on my part; given that antioxidants are a male infertility treatment, what sort of symptoms or diagnosis would a man need to make him a potentially suitable candidate for this kind of solution?
Lifestyle factors that put you at risk for oxidative stress
The first indicator that oxidative stress may be affecting your baby-making potential may be how many of the following lifestyle factors you may be able to relate to. The following factors are well known to strain your body’s natural antioxidant defenses:
- Aging (sorry fellas, I know there’s not a lot you can do about this one)
- Exposure to pollutants and chemicals
- Psychological stress
- Alcohol and tobacco use
- Pharmaceutical medications
- Poor diet and physical inactivity
A sperm oxidative stress test
A sure way to find out if you’re a good candidate for antioxidant therapy, is to get a sperm oxidative stress test.
Given what we know about the impact of ROS on male fertility, it is surprising to read that most clinics do not test their infertile patients for the presence of oxidative stress because the available tests are expensive or difficult to perform (Tunc et al 2010).
But that’s not to say there aren’t tests available: In fact there are over 30 different assays to quantify sperm oxidative stress (Tremellen 2008). The most commonly used method for testing sperm oxidative stress is known as the chemiluminescence method (Kashou et al. 2013), however a standardized protocol known as the NBT assay was more recently developed to provide an inexpensive alternative for the measurement of seminal ROS production (Tunc et al 2010).
In any case, if you’re wondering if your hard-working, under-appreciated little-guys might be letting the stress get to them, talk to your physician or fertility specialist about getting them tested.
The product test
In the world of common sense, given that there is little evidence of adverse effects from antioxidant supplements, the best way to find out if these fertility pills for men are a good treatment for you is to try ‘em. Get your sperm analyzed both prior and after 3 months of treatment. If you see an improvement, then you have your answer, if not, then you can either give it another 3 months or move on to your other male infertility treatment options.
If you’re a couple who is struggling to conceive either naturally or through assisted reproduction, there is a good chance that the male in your partnership may be reducing your odds of success.
Sperm oxidative stress is a common ailment for many men, which can be treated with modest results using antioxidant male fertility supplements. For a small number of people, antioxidants are likely to make a real difference in getting you to your goal of a newborn.
The emotional stress of failing to conceive, or repeated miscarriage can make you both a good candidate for antioxidant male fertility supplements, as well as an easy target for manufacturers and sellers of nutraceutical solutions so be wary when venturing into the marketplace that the products you buy contain high doses of the compounds presented in this article. Despite any claims you may see, the “best male fertility supplements” is still just a term used by marketing teams and until we start making fertility drugs for men specifically for their personal diagnosis, it’s likely to stay that way.
Kym Campbell is a Health Coach and PCOS expert with a strong passion for using evidence-based lifestyle interventions to manage this disorder. Kym combines rigorous scientific analysis with the advice from leading clinicians to disseminate the most helpful PCOS patient-centric information you can find online. You can read more about Kym and her team here.
Tremellen K, Miari G, Froiland D, Thompson J. A randomised control trial examining the effect of an antioxidant (Menevit) on pregnancy outcome during IVF-ICSI treatment. The Australian and New Zealand Journal of Obstetrics & Gynaecology, 2007.