-IBIS-1.7.0-
tx
reproductive system
infertility: male
Nutrition
dietary guidelines
eating principles:
Decrease cholesterol and improve cardiovascular system.
Decrease animal products that may contain DES residues. or xenoestrogens
Eat foods containing zinc: nuts, walnuts, pumpkin seeds, safflower seeds, oysters.
therapeutic foods:
Oatmeal, raw egg yolk, Iron foods, Phosphorus foods, crab, lobster, dates, ocean fish, kelp, dulse, other seaweeds, scallions, lamb, shrimp, black beans, kidney beans, yams, lycium fruit, foods that tonify the Kidney (Ni, 140.)
Mussels, eggs, shrimp, chicken, beef, pigeon, lamb, oysters, peanuts, walnuts (Butt and Bloomfield, 71.)
Wheat germ, folic acid-rich foods, kelp, brewer's yeast, B-complex rich foods (Airola, 126.)
fresh juices:
Celery juice with one tsp. wheat germ and l tsp. dulse (Jensen.)
Oatstraw juice or tea (Jensen.)
Carrot (Walker, 142.)
Carrot and spinach (Walker, 142.)
Spinach (Walker, 142.)
specific remedies:
Lamb stew with daikon radish and black jujube (Ni, 140.)
Cake from black sweet rice, black sesame seeds, black fungus, lotus seeds walnuts and black beans. Eat with 1/2 glass red wine (Ni, 140.)
Tea from walnuts, lotus seeds, pearl barley, Chinese black dates, lycium fruit and drink four times per day (Ni, 140.)
Cook together scallions, shrimp, and egg, and eat with a shot of white liquor (Ni, 140.)
Eat 3 oz fresh walnuts once a day for 30-40 days (Butt and Bloomfield, 140.)
Steam l0 oz fresh shrimps and eat with brandy once a day for l0-20 days (Butt and Bloomfield, 140.)
4 oz. mussels, 4 oz. pork, 2 oz. garlic, 4 oz. potatoes: boil in 2 qt. water until reduced to l pt. and eat and drink once per day for 6-12 days (Butt and Bloomfield, 140.)
1 1/2 glasses whole, raw milk, 2 tbsp. skim milk powder, 2 egg yolks, 1 tbsp. wheat germ oil, 2 tbsp. wheat germ, 1 tbsp. sesame seeds, 2 tbsp. pumpkin seeds, 2 tsp. lecithin granules, 1 tbsp. natural raw honey, 1 tbsp. crushed ice: Grind sesame seeds and pumpkin seeds in grinder, then blend all ingredients in blender. Eat slowly with a spoon (Airola, 125-126.)
avoid:
Calming or Cooling foods, especially grapefruit and lemon juice, beer, cabbage, celery, broccoli, radish. (Butt and Bloomfield, 71.)
Cottonseed oil and other hydrogenated oils: High dietary intake of hydrogenated oils has been associated with impaired sperm cell function. Cottonseed oil commonly contains significant levels of toxic pesticide residues; it also contains especially high levels of the chemical gossypol, which is known to directly interfere with the formation of sperm cells.
(Weller DP, et al. Econ Med Plant Res 1985;1:87-112.)
supplements
Vitamin B12: 1,5000 mcg per day of methylcobalamin. Vitamin B12 is essential to the process of cellular replication, especially through the central role it plays in DNA and RNA synthesis. B12 deficiency has been associated with decreased sperm count and motility. In one study Isoyama et al reported a 60% increase in standard sperm measurements after administering 1,500 mcg B12 per day (as methylcobalamin) to a group of infertile men over a period of 8-60 weeks. In an earlier study of 26 infertile men using the same daily dose, a different team led by Isoyama had reported increased sperm concentration in 38.4% of the men supplemented, along with increased total sperm counts in 53.8% after eight weeks; half of those studied demonstrated increased sperm motility. Sandler and Faragher found an increase in sperm count from less than 20 million/ml to over 100 million/ml in 27% of participants using 1000 mcg per day of vitamin B12. In a double-blind comparative clinical study Kumamoto, et al, found that significantly higher doses (6,000 mcg per day) contributed to 57% improvement in men with sperm counts under 20 million/ml.
(Isoyama R, et al. Hinyokika Kiyo 1984;30:581-586; Sandler B, Faragher B. Infertility 1984;7:133-138; Isoyama R, et al. Hinyokika Kiyo 1986;32:1177-1183; Kumamoto Y, et al. Hinyokika Kiyo 1988;34:1109-1132.)
Vitamin C: 1 g, two to three times daily. Researchers have demonstrated a direct correlation between dietary intake of acsorbic acid and the concentration of ascorbic acid in seminal plasma. Lower consumption of Vitamin C may contribute to increased susceptibilty of the sperm to genetic damage and higher incidence of infertility. In a study of thirty infertile but otherwise healthy men Dawson et al compared the sperm counts of men given placebo, 200 mg, or 1000 mg Vitamin C daily. After one week those receiving 200 mg per day experienced a 112% increase in sperm count and the group receiving 1000 mg per day showed a 140% increase in sperm count, while no change was observed in the placebo group. Both groups supplemented with Vitamin C demonstrated significant reductions in the number of agglutinated sperm. Ultimately, the most important outcome revealed itself in the number of pregnancies among the subjects. At the conclusion of the 60-day study every participant supplemented with Vitamin C had achieved successful impregnation, but none of those in the placebo group reported a pregnancy. Supplementation with ascorbic acid seems to show especially significant benefit in improving sperm quality among smokers.
(Abel, 1982; Dawson EB, et al. Ann NY Acad Sci 1987;498:312-323; Fraga CG, et al. Proc Natl Acad Sci USA 1991;88:11003-11006; Dawson EB, et al. Fertil Steril 1992;58:1034-1039; Dabrowski K, Ciereszko A. Experientia 1996;52:97-100.)
Vitamin E: 400 IU, twice daily. Vitamin E provides important antioxidant protection against free-radical induced damage to the delicate cell membranes of spermatozoa. Oral supplementation of Vitamin E has been shown to significantly decrease measures of lipid peroxidation in the seminal plasma and sperm cells and improve sperm motility. In a study by Suleiman et al looking at these factors, Vitamin E supplementation was associated with a 21% pregnancy occurrence. In a randomized, cross-over, controlled trial, conducted by Kessopoulou, et al, 600 mg of Vitamin E per day contributed to improved sperm function and enhanced ability of the sperm to successfully penetrate the egg. In a small study involving nine men with low sperm count and diminished sperm motility Vezina, et al, reported that supplementation with a combination of vitamin E and selenium for six months significantly increased sperm motility and the overall percentage of healthy spermatozoa as compared to the baseline pre-supplementation levels.
(Aitken RJ, et al. J Androl 1989;10:214-220; Suleiman SA, et al. J Androl 1996:17:530-537; Kessopoulou E, et al. Fertil Steril 1995;64:825-831; Vezina D, et al. Biol Trace Elem Res 1996;53:65-83.)
Magnesium: 400 mg, twice daily; check ionic magnesium levels. (Marz, 445, 1997.)
Selenium: Selenium provides important antioxidant protection to the cell membranes of sperm cells and contributes to sperm motility directly and through its effect upon glutathione levels. Selenium is specifically important to the formation of phospholipid hydroperoxide glutathione peroxidase. This enzyme, present in spermatids, becomes a key structural protein comprising over 50% of the mitochondrial capsule in the mid-piece of mature spermatozoa. Iwanier and Zachara found that even though selenium supplementation, with a selenium-rich yeast for a period of twelve weeks, increased selenium concentration and glutathione peroxidase activity in the seminal fluid, it did not result in any corresponding improvement in sperm count, motility, or morphology. However, in a more recent study of sixty-nine infertile men, Scott, et al, reported a significant increase in sperm motility among those supplemented with selenium or a combination of selenium and Vitamins A, C, and E for three months, as compard with a placebo group. Even though sperm density did not appear to be significantly improved overall, eleven percent of the participants taking the selenium successfully impregnated their partners during the study.
(Iwanier K, Zachara BA. J Androl 1995;16:441-447; Hansen JC, Deguchi Y. Acta Vet Scand 1996;37:19-30; Vezina D, et al. Biol Trace Elem Res 1996;53:65-83; Scott R, et al. Br J Urol 1998;82:76-80; Ursini F, et al. Science 1999;285:1393-1396.)
Zinc picolinate: 60 mg per day, especially with low sperm count or decreased testosterone levels. Zinc is arguably the mineral most crucial to healthy functioning of the male reproductive system. Zinc deficiency has been linked to decreased testosterone levels and sperm count. Researchers have found that zinc levels are generally lower in infertile men with diminished sperm count. Zinc plays a central role in proper sperm motility and production. Numerous studies have found that zinc supplementation can be beneficial in the treatment of male infertility through its effect on testosterone, dihydrotestosterone, and sperm count. In their important study of thirty-seven men with long-term idiopathic infertility and lowered sperm counts, Netter, et al, showed that zinc sulfate, providing a daily dose of 24 mg elemental zinc, produced dramatic results over a period of 45-50 days. Specifically, they noted significant increases in both testosterone levels and sperm count; nine pregnancies were also reported. In their study of fourteen infertile males with low sperm counts, Tikkiwal et al found that daily supplementation of 89 mg zinc, in the form of oral zinc sulfate, for four months significantly increased seminal zinc levels, improved sperm count, and enhanced the number of progressively healthy and motile sperm.
(Netter A, et al. Arch Androl 1981;7:69-73; Madding CI, et al. Ann Nutr Metab 1986;30:213-218; Tikkiwal M, et al. Indian J Physiol Pharmacol 1987;31:30-34; Favier A. Rev Prat 1993;43:146-151.)
L-Arginine: 2 g, twice daily. Arginine is an amino acid precursor in the synthesis of putrescine, spermidine, and spermine, all of which are considered essential to sperm motility. In a study involving 178 men with low sperm count, Schachter et al found that seventy-four percent of the subjects experienced significant improvement in sperm count and motility after taking 4 g of arginine per day for three months. Recent research in Italy involving 40 infertile men, who had initially shown normal sperm counts but decreased motility, demonstrated significantly improved sperm motility after daily administration of 80 ml of a 10% arginine HCl solution over a six month period. Arginine supplementation is generally considered to have no adverse side effects.
(Schachter A, et al. J Urol 1973;110:311-313; Scibona M, et al. Minerva Urol Nefrol 1994;46:251-253.)
L-carnitine: 1 g, three times daily. Sperm concentrate carnitine while in the epididymis where fatty acid oxidation is their main source of energy metabolism. L-carnitine is necessary for transport of fatty acids into the mitochondria and provides an energetic substrate for spermatozoa in the epididymis. It plays a direct role in sperm motility and contributes to successful maturation of sperm cells. Several studies have demonstrated a positive correlation between L-carnitine levels and both sperm count and sperm motility.
(Menchini-Fabris GF, et al. Fertil Steril 1984;42:263-267; Goa KL, Brodgen RN. Drugs 1987;34:1-24; Lenzi A, et al. Arch Ital Urol Nefrol Androl 1992;64:187-196; Moncada ML, et al. Acta Eur Fertil 1992;23:221-224; Costa M, et al. Andrologia 1994;26:155-159; Vitali G, et al. Drugs Exp Clin Res 1995;21:157-159.)
Antioxidants: Sperm require a variety of reactive oxygen species to achieve fertilization. However, high concentrations of these free radicals can directly damage sperm cells, especially their fragile cell membranes which depend upon polyunsaturated fatty acids and phospholipids and are highly susceptible to oxidative damage. Antioxidants may play a beneficial role in maintaining this delicate balance.
(de Lamirande E, et al. Rev Reprod 1997;2:48-54.)
EPA or flax oil. Essential fatty acids are especially important to healthy sperm cells where they play a critical role in energy production and membrane fluidity.
Coenzyme Q10: 50 mg, one to two times per day. Coenzyme Q10 is concentrated in the mitochondria of cells where energy production occurs; hence it is highly concentrated in the mid-piece of sperm cells where it is crucial to motility. CoQ10 also prevents lipid peroxidation of sperm membranes through its antioxidant action. Significant increases in sperm motility were reported in test tube experiments where sperm samples from 22 asthenospermic men were incubated in vitro with 50 microM of coenzymeQ10. In their study of 17 infertile patients Lewin and Lavon observed a significant improvement in fertilization rate when supplemented with 60 mg CoQ10 per day for a mean period of 103 days even though they observed no significant changes in other standard sperm parameters. Research by Tanimura using coenzyme Q7, a related substance, indicated that 10 mg per day of coenzyme Q7 could produce increases in sperm count and motility when given to infertile men.
(Tanimura J. Bull Osaka Med Sch 1967;13:90-100; Lewin A, Lavon H. Mol Aspects Med 1997;18 S213-S219.)
Glutathione: Glutathione provides antiodiant protection that is critical to sperm survival and function, especially motility. Glutathione, along with selenium, is necessary for the formation of phospholipid hydroperoxide glutathione peroxidase. This enzyme, present in spermatids, becomes a key structural protein comprising over 50% of the mitochondrial capsule in the mid-piece of mature spermatozoa. In a two-month, placebo-controlled, double-blind, cross-over trial involving twenty infertile men Lenzi et al found that subjects who were adminstered a daily 600 mg intramuscular injection of glutathione demonstrated a statistically significant positive effect on sperm motility, especially forward motility.
(Lenzi A, et al. Arch Androl 1992;29:65-68; Lenzi A, et al. Hum Reprod 1993; 8:1657-1662; Lenzi A, et al. Hum Reprod 1994;9:2044-2050; Hansen JC, Deguchi Y. Acta Vet Scand 1996;37:19-30; Irvine DS. Rev Reprod 1996;1:6-12; Ursini F, et al. Science 1999;285:1393-1396.)
footnotes
Aitken RJ, Clarkson JS, Hargreave TB, et al. Analysis of the relationship between defective sperm function and the generation of reactive oxygen species in cases of oligozoospermia. J Androl 1989;10:214-220.
Costa M, Canale D, Filicori M, et al. L-carnitine in idiopathic astheno-zoospermia: a multicenter study. Italian Study Group on Carnitine and Male Infertility. Andrologia 1994;26:155-159.
Dabrowski K, Ciereszko A. Ascorbic acid protects against male infertility in a teleost fish. Experientia 1996;52:97-100.
Dawson EB, Harris WA, Rankin WE, et al. Effect of ascorbic acid on male fertility. Ann N Y Acad Sci 1987;498:312-323.
Dawson EB, Harris WA, Teter MC, Powell LC. Effect of ascorbic acid supplementation on the sperm quality of smokers. Fertil Steril 1992;58:1034-1039.
de Lamirande E, Jiang H, Zini A, et al. Reactive oxygen species and sperm physiology. Rev Reprod 1997;2:48-54.
Favier A. Current aspects about the role of zinc in nutrition. Rev Prat 1993;43:146-151. [Article in French]
Fraga CG, Motchnik PA, Shigenaga MK, et al. Ascorbic acid protects against endogenous oxidative DNA damage in human sperm. Proc Natl Acad Sci U S A 1991;88:11003-11006.
Goa KL, Brodgen RN. L-carnitine-a preliminary review of its pharmacokinetics and its therapeutic use in ischemic cardiac disease and primary and secondary carnitine deficiencies in relationship to its role in fatty acid metabolism. Drugs 1987;34:1-24.
Hansen JC, Deguchi Y. Selenium and fertility in animals and man: a review. Acta Vet Scand 1996;37:19-30.
Irvine DS. Glutathione as a treatment for male infertility. Rev Reprod 1996;1:6-12.
Isoyama R, Baba Y, Harada H, et al. Clinical experience of methyl-cobalamin (CH3-B12)/ clomiphene citrate combined treatment in male infertility. Hinyokika Kiyo 1986;32:1177-1183. [Article in Japanese]
Isoyama R, Kawai S, Shimizu Y, et al. Clinical experience with methyl-cobalamin (CH3-B12) for male infertility. Hinyokika Kiyo 1984;30:581-586. [Article in Japanese]
Iwanier K, Zachara BA. Selenium supplementation enhances the element concentration in blood and seminal fluid but does not change the spermatozoal quality characteristics in subfertile men. J Androl 1995;16:441-447.
Kessopoulou E, Powers HJ, Sharma KK, et al. A double-blind randomized placebo cross-over controlled trial using the antioxidant vitamin E to treat reactive oxygen species associated with male infertility. Fertil Steril 1995;64:825-831.
Kumamoto Y, Maruta H, Ishigami J, et al. Clinical efficacy of mecobalamin in the treatment of oligozoospermia-results of double-blind comparative clinical study. Hinyokika Kiyo 1988;34:1109-1132.
Lenzi A, Culasso F, Gandini L, et al. Placebo-controlled, double blind, cross-over trial of glutathione therapy in male infertility. Hum Reprod 1993; 8:1657-1662.
Lenzi A, Lombardo F, Gandini L, Dondero F. Metabolism and action of L-carnitine: its possible role in sperm tail function. Arch Ital Urol Nefrol Androl 1992;64:187-196. [Article in Italian]
Lenzi A, Lombardo F, Gandini L, et al. Glutathione therapy for male infertility. Arch Androl 1992;29:65-68.
Lenzi A, Picardo M, Gandini L, et al. Glutathione treatment of dyspermia: effect on the lipoperoxidation process. Hum Reprod 1994;9:2044-2050.
Lewin A, Lavon H. The effect of coenzyme Q-10 on sperm motility and function. Mol Aspects Med 1997;18 S213-S219.
Madding CI, Jacob M, Ramsay VP, Sokol RZ. Serum and semen zinc levels in normozoospermic and oligozoospermic men. Ann Nutr Metab 1986;30:213-218.
Menchini-Fabris GF, Canale D, Izzo PL, et al. Free L-carnitine in human semen: its variability in different andrologic pathologies. Fertil Steril 1984;42:263-267.
Moncada ML, Vicari E, Cimino C, et al. Effect of acetylcarnitine treatment in oligoasthenospermic patients. Acta Eur Fertil 1992;23:221-224.
Netter A, Hartoma R, Nahoul K. Effect of zinc administration on plasma testosterone, dihydrotestosterone, and sperm count. Arch Androl 1981;7:69-73.
Sandler B, Faragher B. Treatment of oligospermia with vitamin B-12. Infertility 1984;7:133-138.
Schachter A, Goldman JA, Zukerman Z. Treatment of oligospermia with the amino acid arginine. J Urol 1973;110:311-313.
Scibona M, Meschini P, Capparelli S, et al. L-arginine and male infertility. Minerva Urol Nefrol 1994;46:251-253.
Scott R, MacPherson A, Yates RW, et al. The effect of oral selenium supplementation on human sperm motility. Br J Urol 1998;82:76-80.
Sinclair S. Male Infertility: Nutritional and Environmental Considerations. Altern Med Rev 2000;5(1):28-38. (Review)
Suleiman SA, Ali ME, Zaki ZM, et al. Lipid peroxidation and human sperm motility: protective role of vitamin E. J Androl 1996:17:530-537.
Tanimura J. Studies on arginine in human semen. 3, The influence of several drugs on male infertility. Bull Osaka Med Sch 1967;13:90-100.
Tikkiwal M, Ajmera RL, Mathur NK. Effect of zinc administration on seminal zinc and fertility of oligospermic males. Indian J Physiol Pharmacol 1987;31:30-34.
Ursini F, Heim S, Kiess M, et al. Dual function of the selenoprotein PHGPx during sperm maturation. Science 1999;285:1393-1396.
Vezina D, Mauffette F, Roberts KD, Bleau G. Selenium-vitamin E supplementation in infertile men. Effects on semen parameters and micronutrient levels and distribution. Biol Trace Elem Res 1996;53:65-83.
Vitali G, Parente R, Melotti C. Carnitine supplementation in human idiopathic asthenospermia: clinical results. Drugs Exp Clin Res 1995;21:157-159.
Weller DP, Zaneweld JD, Farnsworth NR. Gossypol: pharmacology and current status as a male contraceptive. Econ Med Plant Res 1985;1:87-112.