A study published in Oct of this year (in the journal Advances in Nutrition) aimed to evaluate the benefits of antioxidants on sperm count and quality1. There have been numerous studies in this field but, as often in science, it can be hard to pin down a definitive answer. This is a well-designed meta-analysis which tries to take into account data from lots of different studies and apply rigid statistical analysis to make sure that the effects seen are true (or to be as sure as we can be). This meta-analysis amalgamated data from 18 separate studies including almost 1800 men.
CoQ10 improves sperm count
The best supplement for improving sperm count was Coenzyme Q10 (CoQ10)1. CoQ10 is an antioxidant produced naturally in your body and is used for cell growth and energy production. Levels decrease as we age. It is also found in meat, fish and nuts but dietary sources are not usually sufficient for raising your overall levels2. CoQ10 is a common supplement for male fertility and found at dosages between 10mg and 100mg in some fertility multivitamins. Ubiquinol is the activated form and should be more effective than taking the ubiquinone form. It is more readily used by the body.
Carnitine and CoQ10 may improve sperm motility
Carnitine was shown to be the most effective at improving sperm motility, though CoQ10 also significantly improved this parameter. Similar to CoQ10, carnitine is produced in the body and plays an essential role in energy production3. It is also found in meat, fish and dairy products. Intake can be very low in vegan diets. A common dosage found in a male fertility multivitamin is 100mg. The acetyl-L-Carnitine form may be better absorbed in the intestine and across the blood brain barrier. The latter is clearly not relevant to male fertility.
Vitamin C may improve sperm morphology
Vitamin C was the most effective antioxidant in improving sperm morphology (the shape and size of sperm). The difference between treatment and placebo however was not as clear when the studies were all pooled together in this meta-analysis. A typical Vitamin C dose is 500mg – 1000mg and is found in much lower levels in a multivitamin. Dietary sources of vitamin C include kiwi fruit, citrus, red peppers, broccoli. It is worth noting that each of these fruits or vegetables contain about 50-70mg of vitamin C so you would need to take in more than your ten-a-day to meet this level. This level of dietary intake may cause other issues with digestion.
Personalised nutrition for male fertility
Scientific studies are essential to progress our knowledge and understanding of nutrition. We take an active role in research ourselves and have published in this field and contributed to an expert book for physicians and health care providers in male fertility. See our research page here. But how does this relate to the individual? There are a couple of reasons why it can be hard to get a straight answer from a large scale study and why we need to apply a personalised approach:
- Studies use single nutrients or mixed nutrients and not always the same nutrients or dosages so it can be hard to compare like with like
- Most studies do not measure baseline nutrient status. If you already have plenty of selenium then that is unlikely to be the cause of a male fertility issue. Giving yet more selenium is not going to be the solution, and in fact could be harmful
- Individuals have different nutrient status and different nutrient demands also. High stress, intense exercise or an underlying inflammatory condition will impact your levels of antioxidants. Also consider how much you need to get from your diet or supplements
- We need to consider digestion. It is one thing to take in nutrients in the form of food, but your actual blood levels of antioxidants will depend on digestion and absorption.
- Su et al (2021)Effect of Antioxidants on Sperm Quality Parameters in Subfertile Men: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Advances in Nutrition, nmab127, https://doi.org/10.1093/advances/nmab127
- ‘CoEnzyme Q10’ – Mayo Clinic 2020
- ‘Carnitine Factsheet’ National Institutes for Health 2021
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