Micronutrient Supplementation Increases Sperm Quality in the Sub-fertile Male

Martin Imhof, Jakob Lackner, Markus Lipovac, Peter Chedraui, Claus Riedl
European Urological Review, 2011;6(2):120-123
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Abstract

Background and Aims: Nearly 50 % of male infertility is idiopathic and to date there is still no proven therapy. We evaluated the effect of a non-prescription nutraceutical containing eight micronutrients on sperm quality in males with idiopathic sub-fertility. Methods: This open comparative pilot study was carried out at the Fertility Centre IMI, Vienna, Austria. A total of 132 sub-fertile males (active treatment group) were invited to participate and take two daily capsules of the active compound for a three-month period between the first and the follow-up semen analysis. Each capsule contained L-carnitine, L-arginine, zinc, vitamin E, glutathione, selenium, co-enzyme Q10 and folic acid. Sub-fertile men receiving no active treatment served as controls (n=73). The main outcome measure was the standardised semen analysis. Results: All parameters evaluated by semen analysis significantly increased after three months of treatment with the active compound. Median ejaculatory volume, sperm cell density, sperm motility (progressive and total) and normal morphology rate increased by 33.3, 215.5, 83.1, 36.4 and 23.0 %, respectively. These increments were significantly higher than those observed among controls. In the active treatment group no side effects were encountered and a total of 34 pregnancies were reported after six months’ follow-up, whereas 11 were reported in the control group. Conclusion: Semen analysis results significantly improved in sub-fertile men after treatment with an active micronutrient compound, leading to pregnancies without any adverse effects.

Acknowledgements: We kindly thank Lenus Pharma GmbH, Vienna, Austria for supporting this initiative and providing the active compound. All authors have made substantial contributions in relation to the research design, statistical analysis and interpretation and drafting and approval of the final version of this manuscript.
Support: The publication of this article was funded by LENUS Pharma GesmbH. The views and opinions expressed are those of the author and not necessarily those of LENUS Pharma GesmbH.
Keywords
Sperm quality, oligoasthenoteratozoospermia, idiopathic male infertility, sub-fertility
Disclosure The authors have no conflicts of interest to declare.
Received: October 25, 2011 Accepted November 04, 2011
Correspondence: Martin Imhof, General Public Teaching Hospital Korneuburg, Vienna, Wiener Ring 3-5, A-2100 Korneuburg, Austria. E: martin.imhof@meduniwien.ac.at

Birth rates in Western countries are decreasing. Ten per cent to 17 % of all couples experience primary or secondary sub-fertility,1–4 defined as the failure to conceive after one year of regular, unprotected intercourse with the same partner. Sub-fertility resulting in permanent childlessness may be a very difficult situation for couples.5,6 In addition, sub-fertile couples try to conceive by all possible means, including assisted reproduction, which obviously does not actually treat the sub-fertility cause.

Male factor accounts for nearly 25–30 % of all infertility causes.2,7 Several treatable conditions have been identified: hypogonadism, varicocele, gonadotrophin deficiency, genital tract infections and obstructions and sperm autoimmunity. In others cases, sub-fertility can be attributed to known irreversible conditions. However, no specific cause is found in about 50 % of all infertile men with seminal abnormalities seeking treatment. These sperm disorders are the single most common cause of male sub-fertility. Strong associations between sperm quality parameters and pregnancy have been established.8,9 Thus, low sperm quality has increasingly raised therapeutic interest.2,10

The pathogenic mechanisms involved in this form of defective sperm production are unknown;11 thus, focusing on the development of effective treatments is not easy. Various agents have been used in the attempt to increase the fertility potential of men with decreased semen quality. Nevertheless, studies have rendered heterogeneous results, and the effect of gonadotrophins or anti-oestrogens on pregnancy rates remains controversial.2 A recent review aimed at searching the rationale for the treatment of idiopathic male factor infertility over the past 20 years concluded that there is no evidence supporting androgen and gonadotrophin use for enhancing male fertility. Evidence regarding anti-oestrogen, aromatase inhibitor and antioxidant use was found to be insufficient. No therapeutic drug option was found to clearly benefit idiopathic impaired male fertility in terms of natural conception.12 To date, there is still no proven therapy for the improvement of semen quality in this large group of men.

Although the aetiology of oligoasthenoteratozoospermia is generally poorly understood and most of the precise mechanisms are far from being known, idiopathic sub-fertility may be considered a multifactorial disorder in which many genetic, environmental and lifestyle-related factors act together. Unfavourable conditions of any origin can interfere with spermatogenesis and reduce sperm quality and production.

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